An assessment of Ryan White Title IIIb HIV early intervention programs in Region VI of the United States Public Health Service.

A survey was conducted of 15 early intervention programs in Region VI of the United States Public Health Service (USPHS) to determine when human immunodeficiency virus (HIV)-infected clients assessed care. Data were collected from 672 HIV-infected patients who received medical care between March 1991 and July 1993. Eighty-four percent were male, 42% were white, 35% were African-American, 22% were Hispanic, and less than 1% defined themselves as "other." Information also was obtained on HIV risk factors and CD4 counts on entry to the facility. Thirty percent of patients had entry CD4 counts > 500/mm3, 55% had counts between 499 and 200/mm3, and 25% < 200/mm3. The distribution of entry CD4 counts were similar to those reported from two large, urban, public-hospital HIV clinics. The most common risk factor for all ethnicities was male-to-male sex (53%), followed by heterosexual exposure (17%), and injection drug use (16%). The results indicate that the majority of clients who initially present to Title IIIb "early intervention" programs in Region VI are of ethnic minority groups. Based on entry CD4 counts, patients in Title IIIb programs present late with one fourth at acquired immunodeficiency syndrome (AIDS)-defining levels. Regardless of ethnicity, male-to-male sex was the highest risk factor in this region. These findings have significant implications for the targeting of specific populations for outreach and for possibly reallocating funds for future planning of Ryan White Comprehensive AIDS Emergency Care Act programs.