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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2005.061929v1 96/6/1044    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Burke-Miller, J. K. Articles by Gange, S. J. Search for Related Content PubMed PubMed Citation Articles by Burke-Miller, J. K. Articles by Gange, S. J. Related Collections Quality of Care HIV/AIDS Women's Health

Jane K. Burke-Miller, MS, Judith A. Cook, PhD, Mardge H. Cohen, MD, Nancy A. Hessol, MSPH, Tracey E. Wilson, PhD, Jean L. Richardson, DrPH, Pete Williams, MD and Stephen J. Gange, PhD

Jane K. Burke-Miller and Judith A. Cook are with the Center on Mental Health Services Research and Policy, Department of Psychiatry, University of Illinois at Chicago. Mardge H. Cohen is with the CORE Center, Cook County Hospital, Cook County Bureau of Health Services, Chicago. Nancy A. Hessol is with the Department of Medicine, University of California, San Francisco. Tracey E. Wilson is with the Department of Preventive Medicine and Community Health, State University of New York Downstate Medical Center, Brooklyn. Jean L. Richardson is with the Department of Preventive Medicine, University of Southern California, Los Angeles. Pete Williams is with the Division of Infectious Diseases, Montefiore Medical Center, Bronx, NY. Stephen J. Gange is with the Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, Md.

Correspondence: Requests for reprints should be sent to Jane K. Burke-Miller, MS, Center on Mental Health Services Research and Policy, University of Illinois at Chicago, 104 S Michigan Ave, Suite 900, Chicago, IL 60603 (e-mail: jburke{at}psych.uic.edu).

Objectives. We used longitudinal data to examine the roles of 4 dimensions of patient satisfaction as both predictors and outcomes of use of highly active antiretroviral therapy (HAART) among women in the United States with HIV/AIDS.

Methods. Generalized estimating equations were used to analyze time-lagged satisfaction–HAART relationships over 8 years in the Women’s Interagency HIV Study.

Results. Multivariate models showed that, over time, HAART use was associated with higher patient satisfaction with care in general, with providers, and with access/convenience of care; however, patient satisfaction was not associated with subsequent HAART use. Symptoms of depression and poor health-related quality of life were associated with less satisfaction with care on all 4 dimensions assessed, whereas African American race/ethnicity, illegal drug use, and fewer primary care visits were associated with less HAART use.

Conclusions. Our findings suggest that dissatisfaction with care is not a reason for underuse of HAART among women with HIV and that providers should not be discouraged from recommending HAART to dissatisfied patients. Rather, increasing women’s access to primary care could result in both increased HAART use and greater patient satisfaction.

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