AIDS PATIENT CARE and STDs Volume 15, Number 3, 2001 Mary Ann Liebert, Inc. Association Between Ancillary Services and Clinical and Behavioral Outcomes among HIV-Infected Women MANYA MAGNUS M.P.H., L.P.N., 1 NORINE SCHMIDT, M.P.H., 1 KATHRYN KIRKHART, Ph.D., 2 CATHY SCHIEFFELIN, M.P.H., 2 NOMI FUCHS, M.P.H., 2 BARBARA BROWN, B.A., 2 and PATRICIA J. KISSINGER, Ph.D. 1 ABSTRACT The purpose of this study was to evaluate the association between ancillary services, includ- ing case management, and clinical and behavioral outcomes for human immunodeficiency virus (HIV)-infected women. Data were obtained from databases systematically maintained by Family Advocacy, Care and Education Services (FACES) and the HIV Outpatient Program (HOP) in New Orleans. HIV-infected women receiving primary care from HOP and ancillary services from FACES between January 1, 1997 and December 31, 1998 were eligible. Data were analyzed using generalized estimating equations (GEE) with STATA software. The majority of women included in the study were African American (86.7%), infected heterosexually (78.8%), and had absolute CD4 counts greater than 200 (58.6%). After adjusting for age, time, entry time into HOP, pregnancy, CD4 count, substance abuse status, and social and clinical stressors, receipt of more than four combined case manager contacts or ancillary services per month was significantly associated with being prescribed a protease inhibitor, improved ad- herence and retention in primary care, and enrolling on a research protocol. Receiving more than one transportation service per month was significantly associated with improved adher- ence, improved retention, one or more emergency room visits per month, and one or more hos- pitalizations per month. Receiving more than one contact with case managers per month was associated with improved retention in primary care. Findings suggest that receipt of case man- agement and ancillary services is associated with improvements in multiple outcomes for HIV- infected women. A client-centered approach to providing ancillary services appears to be ef- fective in improving behavioral and utilization characteristics in this population of low- income, high-risk women. 137 INTRODUCTION D UE TO THE COMPLEXITY OF THE DISEASE ,a comprehensive system of care for human immunodeficiency virus (HIV)-infected indi- viduals is required. 1–6 Comprehensive care be- comes even more important as the classifica- tion of HIV shifts from a terminal illness to that of a chronic infectious disease. Due to its goal of assisting clients in negotiating, gaining, and maintaining access to health care and social ser- vice systems as their disease progresses, 7–10 case management is often perceived as benefi- cial in supporting integrated care. Published 1 Tulane University, School of Public Health and Tropical Medicine, Department of Epidemiology, New Orleans, Louisiana. 2 Family Advocacy, Care and Education Services (FACES), Children’s Hospital, New Orleans, Louisiana.