State-level spending on health care and social services for people living with HIV/AIDS in the USA: a systematic review

Abstract

Every year for the past decade, approximately 50,000 people have been diagnosed with HIV or AIDS in the USA, and the incidence of HIV/AIDS varies considerably from state to state. Studies have shown that health care services, most notably treatment with combination antiretroviral therapy, can help people living with HIV/AIDS (PLWHA) live healthier, longer lives, and prevent the spread of HIV from person to person. In addition, social services, such as housing support and provision of meals, have also shown to be important for helping PLWHA adhere to antiretroviral treatment and maintain contact with health care providers for improved health outcomes. Although spending on health care and social services for PLWHA varies across the USA, the relationship between state-level spending on these services and HIV/AIDS-related outcomes is not clear. We therefore conducted a systematic review of peer-reviewed literature to identify studies that explore state-level spending on health care services and/or social services for PLWHA and HIV/AIDS-related health outcomes in the USA.

State variation in HIV/AIDS health outcomes

“…Studies have also demonstrated that increased spending on healthcare services, such as testing, antiretroviral treatment, and primary patient care also leads to reductions in HIV/AIDS diagnoses and mortality [ 9 ]. Yet less is known about the association between spending on nonmedical services, such as public health and social services, and HIV/AIDS diagnoses and AIDS deaths, or about how variation in social service and public health spending may explain state-level variation in these HIV/AIDS outcomes across the United States [ 10 ].…”