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Hazel D Dean

Publications and source records attributed to Hazel D Dean.

6 recordsLinked to original sources
PubMed2006

The economic burden of HIV in the United States in the era of highly active antiretroviral therapy: evidence of continuing racial and ethnic differences.

BACKGROUND: Assessing the economic burden of HIV/AIDS can help to quantify the effect of the epidemic on a population and assist policy makers in allocating public health resources. OBJECTIVE: To estimate the economic burden of HIV/AIDS in the United States and provide race/ethnicity-specific estimates. METHODS: We conducted an incidence-based cost-of-illness analysis to estimate the lifetime cost of HIV/AIDS resulting from new infections diagnosed in 2002. Data from the HIV/AIDS Reporting System of the Centers for Disease Control and Prevention were used to determine stage of disease at diagnosis and proportion of cases by race/ethnicity. Lifetime direct medical costs and mortality-related productivity losses were estimated using data on cost, life expectancy, and antiretroviral therapy (ART) use from the literature. RESULTS: The cost of new HIV infections in the United States in 2002 is estimated at $36.4 billion, including $6.7 billion in direct medical costs and $29.7 billion in productivity losses. Direct medical costs per case were highest for whites ($180,900) and lowest for blacks ($160,400). Productivity losses per case were lowest for whites ($661,100) and highest for Hispanics ($838,000). In a sensitivity analysis, universal use of ART and more effective ART regimens decreased the overall cost of illness. CONCLUSION: Direct medical costs and productivity losses of HIV/AIDS resulting from infections diagnosed in 2002 are substantial. Productivity losses far surpass direct medical costs and are disproportionately borne by minority races/ethnicities. Our analysis underscores economic benefits of more effective ART regimens and universal access to ART.

Antiretroviral Therapy, Highly Active↗
PubMed2005

The integrated epidemiologic profile: using multiple data sources in developing profiles to inform HIV prevention and care planning.

HIV/AIDS epidemiologic profiles describe the HIV/AIDS epidemic among state and local populations. The Centers for Disease Control and Prevention and the Health Resources Services Administration collaborated to develop one set of guidelines for developing epidemiologic profiles that would serve as the basis for both prevention and care planning. The Integrated Guidelines for Developing Epidemiologic Profiles was published in 2003. Profiles based on these guidelines describe the epidemic in terms of sociodemographic, geographic, behavioral, and clinical characteristics and should include enough data sources (e.g., sexually transmitted disease, tuberculosis, behavioral, and care-related data) to allow users to make informed, evidenced-based decisions. Development and use of these epidemiologic profiles should lead to more effective prevention and care planning and contribute to objective measures of the impact and outcomes of programs, supported by both federal agencies.

Data Collection↗
PubMed2005

Characteristics of adults and adolescents who have migrated from place of AIDS diagnosis to place of death, United States, 1993-2001.

This study compared demographic characteristics of adults and adolescents who received an AIDS diagnosis in one state and died in a different state. We analyzed reports of deaths among persons (> or = 13 years old) with AIDS whose state of residence at diagnosis and state of occurrence of death were different (migrants). Between January 1993 and December 2001, 251,441 deaths of adults and adolescents with AIDS occurred. Of these, 13,860 (5.4%) migrated. Migrants were more likely to be male than female, white than black, and men who have sex with men than persons with heterosexual contact. A small proportion of persons with AIDS migrated between residence at AIDS diagnosis and place of death, suggesting that the effect of migration on destination health care services is likely to be small.

Adolescent↗
PubMed2005

HIV/AIDS among minority races and ethnicities in the United States, 1999-2003.

BACKGROUND: During June 1981 to June 1982, 37% of more than 400 cases of AIDS reported to the CDC were in minority races and ethnicities. In 2003, 72% of the estimated 43,171 cases of AIDS diagnosed in the 50 states; District of Columbia; and U.S. dependencies, possessions and free nations were in minority races and ethnicities. METHODS: We analyzed HIV/AIDS data for 2000-2003 reported by the 32 states that have had confidential name-based reporting of HIV infection since 1999. For analysis of AIDS data, we used data for 1999-2003 reported by the 50 states and the District of Columbia. HIV/AIDS and AIDS data were statistically adjusted for reporting delays and redistribution of cases initially reported without risk factors. RESULTS: For all years, the numbers of HIV/AIDS and AIDS diagnoses were consistently higher among non-Hispanic blacks than among other races and ethnicities. In the 32 states with HIV reporting, the HIV/AIDS diagnosis rate in 2003 was 74 per 100,000 for blacks, 25 per 100,000 for Hispanics, 11 per 100,000 for American Indians/Alaska Natives, nine per 100,000 for whites, and seven per 100,000 for Asians/Pacific Islanders. The rates for persons living with HIV/AIDS at the end of 2003 were highest for blacks (765 per 100,000) and Hispanics (220 per 100,000). In the 50 states and the District of Columbia, AIDS diagnosis rates in 2003 were 58 per 100,000 for blacks, 20 per 100,000 for Hispanics, eight per 100,000 for American Indians/Alaska Natives, and four per 100,000 for Asians/Pacific Islanders. CONCLUSION: HIV/AIDS disproportionately affects minority races and ethnicities in the United States. To reduce rates of HIV/AIDS in these populations, effective and culturally appropriate prevention interventions must be developed and implemented.

Acquired Immunodeficiency Syndrome↗
PubMed2002

HIV surveillance methods for the incarcerated population.

In the United States, monitoring the HIV/AIDS epidemic among the incarcerated population is done by (a) conducting a census of persons in prisons and jails reported to be infected with HIV or diagnosed with AIDS, (b) seroprevalence surveys in selected correctional facilities, and (c) population-based HIV/AIDS case surveillance by state health departments. We describe methods for HIV/AIDS case surveillance in correctional settings and present data from the HIV/AIDS Reporting System (HARS) and the Supplement to HIV and AIDS Surveillance (SHAS) to describe the demographic, behavioral, and clinical characteristics of HIV-infected persons who were incarcerated at the time of diagnosis. HARS data showed a higher proportion of females and a lower proportion of injection drug users for incarcerated persons diagnosed with HIV (not AIDS) compared to those initially diagnosed with AIDS. The SHAS data showed a high prevalence of injection drug use, crack use, alcohol abuse, and exchanging sex for money or drugs. Together, HARS and SHAS collect fairly comprehensive information of risk behaviors from persons with HIV infection and AIDS. Advances in HIV prevention and care for the incarcerated community will require an accurate and timely description of the magnitude of the HIV epidemic in correctional settings. These data are needed to guide programmatic efforts to reduce HIV transmission in prisons and jails and in the general community upon release and ensure needed risk reduction and health care services for incarcerated persons.

Adolescent↗