Evaluation of a program to remove barriers to public health care for women with HIV infection.

To facilitate access to care for HIV-infected women, a maternal-child program was started at an HIV outpatient clinic in New Orleans. The program consisted of free child care and transportation, separate waiting and examination rooms, female care providers, merged visits for mother and child, and on-site colposcopy services. This study evaluates the efficacy of the program on improving attendance at the clinic by follow-up of 143 women and 557 men (serving as controls). Multivariate models were adjusted for history of intravenous drug abuse, race, age, CD4 cell count, staging of disease, and time in the clinic. Half of the clients achieved high attendance rates. Women were as likely as men to achieve high attendance rates before the interventions, but more likely to do so at both 6 months and 1 year postintervention (after adjustment for the other variables). These results suggest that responding to special gender-related needs can improve women's attendance for clinic visits.