Predictors and Consequences of Negative Physician Attitudes Toward HIV-Infected Injection Drug Users

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Abstract
As of December 2002, a reported 34% of all individuals with AIDS and 43% of women with AIDS were injection drug users (IDUs).1 Medical complications and behavioral problems that accompany substance abuse can complicate the medical management of human immunodeficiency virus (HIV)–positive individuals,2,3 and many IDUs do not receive optimal HIV therapy.4-7 This may be in part because of concern that IDUs who are HIV infected may not adhere to treatment plans7,8 or that medications may interact if taken concomitantly with “street drugs.”2,9 Discomfort in or negative attitudes toward treating IDUs may also be factors.10 Researchers have studied physician attitudes toward drug users, especially those with HIV infection,11,12 but few have explored the associations of physician characteristics and attitudes with health care quality.