TY - JOUR
T1 - Type of substance use and access to HIV-related health care
AU - Cunningham, Chinazo O.
AU - Sohler, Nancy L.
AU - Berg, Karina M.
AU - Shapiro, Scott
AU - Heller, Daliah
PY - 2006/6
Y1 - 2006/6
N2 - HIV-infected substance users have poorer health outcomes than other HIV risk groups. Few studies have examined the impact of specific types of substance use on health care. This study investigated the associations between specific types of substances of abuse and access to health care. HIV-infected individuals living in eight different single room occupancy hotels in the Bronx, New York, were interviewed between August 1999 and February 2001 regarding demographics, health care access and utilization, and drug and alcohol use. Of the 238 participants, the majority were male (59%), black or Hispanic (93%), and active drug users (61%). Individuals reporting any drug or crack/cocaine use were less likely to have a regular provider than those reporting no drug or no crack/cocaine use (adjusted odds ratio [AOR] = 0.50, p = 0.05; AOR = 0.35, p = 0.004, respectively), while those with binge alcohol use were more likely to have a regular doctor than those without binge alcohol use (AOR = 2.61, p = 0.05). Individuals reporting any drug or crack/cocaine use were also less likely to perceive quality of health care positively (AOR = 0.50, p = 0.02; AOR = 0.37, p = 0.002, respectively). Heroin use, and injection drug use were not associated with these outcomes. When the sample was limited to recent drug users, similar patterns were found. Although drug use in general is associated with negative health outcomes, in this study, poorer measures of access to health care among substance users was associated predominantly with crack/cocaine use. It is important that clinicians and researchers working with substance-using populations understand how specific types of substance use differentially impact on health care.
AB - HIV-infected substance users have poorer health outcomes than other HIV risk groups. Few studies have examined the impact of specific types of substance use on health care. This study investigated the associations between specific types of substances of abuse and access to health care. HIV-infected individuals living in eight different single room occupancy hotels in the Bronx, New York, were interviewed between August 1999 and February 2001 regarding demographics, health care access and utilization, and drug and alcohol use. Of the 238 participants, the majority were male (59%), black or Hispanic (93%), and active drug users (61%). Individuals reporting any drug or crack/cocaine use were less likely to have a regular provider than those reporting no drug or no crack/cocaine use (adjusted odds ratio [AOR] = 0.50, p = 0.05; AOR = 0.35, p = 0.004, respectively), while those with binge alcohol use were more likely to have a regular doctor than those without binge alcohol use (AOR = 2.61, p = 0.05). Individuals reporting any drug or crack/cocaine use were also less likely to perceive quality of health care positively (AOR = 0.50, p = 0.02; AOR = 0.37, p = 0.002, respectively). Heroin use, and injection drug use were not associated with these outcomes. When the sample was limited to recent drug users, similar patterns were found. Although drug use in general is associated with negative health outcomes, in this study, poorer measures of access to health care among substance users was associated predominantly with crack/cocaine use. It is important that clinicians and researchers working with substance-using populations understand how specific types of substance use differentially impact on health care.
UR - http://www.scopus.com/inward/record.url?scp=33745611573&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33745611573&partnerID=8YFLogxK
U2 - 10.1089/apc.2006.20.399
DO - 10.1089/apc.2006.20.399
M3 - Article
C2 - 16789853
AN - SCOPUS:33745611573
SN - 1087-2914
VL - 20
SP - 399
EP - 407
JO - AIDS Patient Care and STDs
JF - AIDS Patient Care and STDs
IS - 6
ER -