Skip to main content
NCBI home page
American Journal of Public Health logoLink to American Journal of Public Health
. 1991 Oct;81(10):1285–1290. doi: 10.2105/ajph.81.10.1285

Utilization of health services in a cohort of intravenous drug users with known HIV-1 serostatus.

L Solomon 1, R Frank 1, D Vlahov 1, J Astemborski 1
PMCID: PMC1405342  PMID: 1928527

Abstract

BACKGROUND. Intravenous drug users (IVDUs) with human immunodeficiency virus (HIV) infection and AIDS often have no health insurance or rely on public programs to finance their health care. We examined the independent contributions of HIV serostatus, clinical symptoms, CD4 cell counts, and health insurance to utilization of health services among 1881 intravenous drug users in Baltimore, Maryland. METHODS. Participants in an ongoing natural history study of HIV were informed of HIV serostatus and seropositives were informed of CD4 cell counts; 6 months later, participants were administered a questionnaire concerning self-reported use of health services, insurance coverage, and HIV-related symptoms. RESULTS. Of 1881 participants, 67% had health insurance (including Medicaid), 48% had at least one outpatient visit, and 12% had at least one inpatient visit within the prior 6 months. The proportion of the study population that was HIV-1 seropositive was 32%. In multivariate analysis, the single most important predictor of health care utilization was the presence of two or more HIV-related clinical symptoms. HIV positive serostatus alone or known low CD4 counts were not significantly associated with use of health care services. CONCLUSIONS. These data suggest that HIV seropositive IVDUs are not receiving recommended preventive care. Additional efforts will be needed to ensure that HIV-seropositive drug users participate in currently recommended protocols for early treatment of asymptomatic HIV-1 infection.

Full text

PDF
1285

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andrulis D. P., Beers V. S., Bentley J. D., Gage L. S. The provision and financing of medical care for AIDS patients in US public and private teaching hospitals. JAMA. 1987 Sep 11;258(10):1343–1346. [PubMed] [Google Scholar]
  2. Bakeman R., Lumb J. R., Smith D. W. AIDS statistics and the risk for minorities. AIDS Res. 1986 Summer;2(3):249–252. doi: 10.1089/aid.1.1986.2.249. [DOI] [PubMed] [Google Scholar]
  3. Curran J. W., Jaffe H. W., Hardy A. M., Morgan W. M., Selik R. M., Dondero T. J. Epidemiology of HIV infection and AIDS in the United States. Science. 1988 Feb 5;239(4840):610–616. doi: 10.1126/science.3340847. [DOI] [PubMed] [Google Scholar]
  4. Dans P. E., Matricciani R. M., Otter S. E., Reuland D. S. Intravenous drug abuse and one academic health center. JAMA. 1990 Jun 20;263(23):3173–3176. [PubMed] [Google Scholar]
  5. Des Jarlais D. C., Friedman S. R., Hopkins W. Risk reduction for the acquired immunodeficiency syndrome among intravenous drug users. Ann Intern Med. 1985 Nov;103(5):755–759. doi: 10.7326/0003-4819-103-5-755. [DOI] [PubMed] [Google Scholar]
  6. Green J., Arno P. S. The 'Medicaidization' of AIDS. Trends in the financing of HIV-related medical care. JAMA. 1990 Sep 12;264(10):1261–1266. doi: 10.1001/jama.264.10.1261. [DOI] [PubMed] [Google Scholar]
  7. Hahn R. A., Onorato I. M., Jones T. S., Dougherty J. Prevalence of HIV infection among intravenous drug users in the United States. JAMA. 1989 May 12;261(18):2677–2684. [PubMed] [Google Scholar]
  8. Hoffman R. A., Kung P. C., Hansen W. P., Goldstein G. Simple and rapid measurement of human T lymphocytes and their subclasses in peripheral blood. Proc Natl Acad Sci U S A. 1980 Aug;77(8):4914–4917. doi: 10.1073/pnas.77.8.4914. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hulka B. S., Wheat J. R. Patterns of utilization. The patient perspective. Med Care. 1985 May;23(5):438–460. doi: 10.1097/00005650-198505000-00009. [DOI] [PubMed] [Google Scholar]
  10. Iglehart J. K. Financing the struggle against AIDS. N Engl J Med. 1987 Jul 16;317(3):180–184. doi: 10.1056/NEJM198707163170333. [DOI] [PubMed] [Google Scholar]
  11. Newhouse J. P., Manning W. G., Morris C. N., Orr L. L., Duan N., Keeler E. B., Leibowitz A., Marquis K. H., Marquis M. S., Phelps C. E. Some interim results from a controlled trial of cost sharing in health insurance. N Engl J Med. 1981 Dec 17;305(25):1501–1507. doi: 10.1056/NEJM198112173052504. [DOI] [PubMed] [Google Scholar]
  12. Rhame F. S., Maki D. G. The case for wider use of testing for HIV infection. N Engl J Med. 1989 May 11;320(19):1248–1254. doi: 10.1056/NEJM198905113201905. [DOI] [PubMed] [Google Scholar]
  13. Scitovsky A. A. The economic impact of AIDS in the United States. Health Aff (Millwood) 1988 Fall;7(4):32–45. doi: 10.1377/hlthaff.7.4.32. [DOI] [PubMed] [Google Scholar]
  14. Volberding P. A., Lagakos S. W., Koch M. A., Pettinelli C., Myers M. W., Booth D. K., Balfour H. H., Jr, Reichman R. C., Bartlett J. A., Hirsch M. S. Zidovudine in asymptomatic human immunodeficiency virus infection. A controlled trial in persons with fewer than 500 CD4-positive cells per cubic millimeter. The AIDS Clinical Trials Group of the National Institute of Allergy and Infectious Diseases. N Engl J Med. 1990 Apr 5;322(14):941–949. doi: 10.1056/NEJM199004053221401. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES