Client Information

CLIENTS SERVED1

CARE Act providers served 1,043,730 duplicated clients in 2004, including 309,865 duplicated new clients. Of the total duplicated clients served, 84 percent (n=878,078) were HIV-positive, while the remaining 16 percent (n=165,652) were HIV-affected.2 Among new duplicated clients, 72 percent (n=224,641) were HIV-positive and 28 percent (n=85,224) were HIV-affected. 3

GENDER

In 2004, 66 percent of duplicated CARE Act clients were male, 33 percent were female, and 1 percent were transgender (Figure 2 and Table 9). Interestingly, the gender distribution varies by HIV status (positive or affected). Among duplicated HIV-positive clients, about two-thirds (68 percent) were male, and a smaller proportion (31 percent) were female. This is in contrast to HIV-affected clients: 54 percent were male, and 46 percent were female.

Figure 2. Gender of CARE Act Clients, 2004 (n = 1,005,366 )

Data on gender were unknown or unreported for 38,364 clients.

AGE

Overall, 53 percent of the clients served in 2004 were in the age group 25 to 44 years, while 34 percent were in the age group 45 to 64 years. Findings were similar for HIV-positive clients: 56 percent were 25 to 44 years old while 37 percent of the clients were 45 to 64 years old. The situation was different for HIV-affected clients: 38 percent were 25 to 44, 15 percent were 45 to 64, and nearly half (45 percent) were under the age of 25.

ETHNICITY

Twenty-three percent of all clients served in 2004 were Hispanic/ Latino(a), and 77 percent were non-Hispanic/Latino(a) (Figure 3). Similarly, 21 percent of all HIV-positive clients served were Hispanic/ Latino(a) and 79 percent were non-Hispanic/Latino(a). Among HIV-affected clients, 31 percent were Hispanic/Latino(a), and 69 percent were non-Hispanic/Latino(a). Ethnic identity was unknown for a large percentage (19 percent) of HIV-affected clients. The ethnicity of clients served in previous years was similar to the distribution in 2004. For example, 22 percent of all clients served in 2002 and 24 percent of all clients served in 2003 were Hispanic/Latino(a).

Figure 3. Ethnicity of CARE Act Clients, 2004 (n = 972,205)

Data on ethnicity were unknown or unreported for 71,525 clients.

RACE

For clients overall and for those who were HIV-positive, over 50 percent of the clients served by CARE Act providers in 2004 and previous years were members of racial minority groups.4

In 2004, Blacks comprised approximately 52 percent of clients served, both overall and among those who were HIV-positive. Whites comprised 41 percent of all clients and 42 percent of clients who were HIV-positive in 2004 (Figure 4 and Table 9).

Figure 4. Race of CARE Act Clients, 2004 (n = 900,058)

Data on race were unknown or unreported for 143,672 clients.
"Other" includes Asian, Pacific Islander, and American Indian or Alaska Native.

Table 9. Gender, Age, Ethnicity, and Race of CARE Act Clients by HIV Status, 2004

-- Unknown or unreported responses are not included in percentage calculations.
Percentages may not sum to 100 percent due to rounding error.
Source: Health Resources and Services Administration, HIV/AIDS Bureau, 2004 CARE Act Data Report.

HOUSEHOLD INCOME5

The percentage of all CARE Act clients with annual household incomes equal to or below the Federal Poverty Level (FPL) was 72 percent in 2004, an increase from 68 percent in 2002 and 69 percent in 2003 (Table 10). By HIV status, 71 percent of HIV-positive clients and 81 percent of HIV-affected clients had incomes at or below the FPL in 2004. CARE Act providers did not report the household income status for most HIV-affected clients.

HOUSING ARRANGEMENTS6

Providers reported that among all CARE Act clients in 2004, 78 percent had permanent housing arrangements, and 15 percent were non-permanently housed .7 About 4 percent of all clients lived in institutions, and 3 percent were in some other living arrangement (Table 10). The distributions of housing arrangements by HIV status in 2004 are nearly identical to the overall distribution. The distribution of housing arrangements for CARE Act clients was essentially the same from 2002 to 2004.

Table 10. Household Income and Housing Arrangements of CARE Act Clients by HIV Status, 2004

-- Unknown or unreported responses are not included in percentage calculations.
Percentages may not sum to 100 percent due to rounding error.
Source: Health Resources and Services Administration, HIV/AIDS Bureau, 2004 CARE Act Data Report.

HIV/AIDS STATUS

Most clients receiving CARE Act services in 2004 were recorded in one of three categories: 1) HIV-positive, not AIDS (38 percent); 2) AIDS as defined by CDC (33 percent), or 3) HIV-positive, AIDS unknown (20 percent). This distribution of HIV/AIDS status is similar to that of previous years. Clients who were HIV-negative comprised 9 percent of all clients (Figure 5 and Table 11).

Figure 5. Client HIV Status, 2004 (n = 964,980)

Table 11. HIV/AIDS Status, Enrollment Status, and Health Insurance Status of CARE Act Clients by HIV Status, 2004

- Data does not exist because the categories are mutually exclusive.
-- Unknown or unreported responses are not included in percentage calculations.
Percentages may not sum to 100 percent due to rounding error.
** Other public health insurance includes State-funded plans, military health care (TRICARE/CHAMPUS or care provided by the Veterans Health Administration), the State Children’s Health
Insurance Program (SCHIP), and the Indian Health Service (IHS).
Source: Health Resources and Services Administration, HIV/AIDS Bureau, 2004 CARE Act Data Report.

ENROLLMENT STATUS

In 2004, 68 percent of HIV-positive clients were continuing to receive CARE Act care and treatment from their programs (up from 63 percent in 2002), while 22 percent were new to their programs (down from 26 percent in 2002) and 9 percent were inactive in their programs (unchanged from 2002). By contrast, 43 percent of HIVaffected clients were continuing clients in 2004 (up from 33 percent in 2002), 40 percent were new clients (down from 48 percent in 2002), and 16 percent had an inactive enrollment status (down from 19 percent in 2002) (Table 11).

MEDICAL INSURANCE

In 2004, 55 percent of all CARE Act clients were covered by publicly- funded medical insurance, 31 percent had no medical insur- ance, and 11 percent had private insurance (Table 11).8 The distribution for HIV-positive clients is similar. Overall, medical insurance status among all CARE Act clients in 2004 is similar to that for 2002 and 2003. While a majority of HIV-affected clients had unreported medical insurance status, among those reported, 63 percent were covered by publicly-funded medical insurance (up from 51 percent in 2002), 25 percent had no insurance (up from 16 percent in 2002), and 10 percent had private insurance (compared to 9 percent in 2002). HIV-affected clients reported to have “Other” health insurance dropped from 24 percent in 2002 to 4 percent in 2004.

1Clients served are individuals who had at least one visit for any eligible service during the reporting period. Client counts are duplicated at the national and/or grantee level.

2 Positive clients include infants under the age of 2, whose HIV status is indeterminate. Affected clients include those who are HIV-negative as well as those with unknown HIV status.

3 “New” clients include clients whose first receipt of services from the provider agency occurred during the reporting period.

4 In 2002, the HIV/AIDS Bureau implemented an Office of Management and Budget (OMB) recommendation to collect ethnicity and race data separately. Because Ryan White CARE Act data are aggregated at the grantee and national levels, race and ethnicity data cannot be combined to determine the proportion of minority clients served.

5 The Federal Poverty Level (FPL) was $18,100 for a family of four and $8,860 for one person not in a family in 2002 for the 48 continuous States and D.C. Alaska and Hawaii FPL figures are slightly higher. (Source: http://aspe.hhs.gov/poverty/02poverty.htm).

6 The housing information reported in section 2 of the CADR describes the population served and does not imply CARE Act funding was used for housing.

7 Permanent housing includes apartments, houses, foster homes, long-term residence, and boarding houses, if they are not time-limited. Non-permanent housing includes homeless, transient, or transitional housing. Institutional housing includes residential, health care, and correctional facilities.

8 8Providers report the medical insurance that provides the most reimbursement if a client has more than one source of medical insurance.