Utilization of health services in a cohort of intravenous drug users with known HIV-1 serostatus.
- 1 October 1991
- journal article
- Published by American Public Health Association in American Journal of Public Health
- Vol. 81 (10) , 1285-1290
- https://doi.org/10.2105/ajph.81.10.1285
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.Keywords
This publication has 23 references indexed in Scilit:
- The 'Medicaidization' of AIDS. Trends in the financing of HIV-related medical careJAMA, 1990
- Zidovudine in Asymptomatic Human Immunodeficiency Virus InfectionNew England Journal of Medicine, 1990
- The Case for Wider Use of Testing for HIV InfectionNew England Journal of Medicine, 1989
- Epidemiology of HIV Infection and AIDS in the United StatesScience, 1988
- The Economic Impact of AIDS in the United StatesHealth Affairs, 1988
- Financing the Struggle against AIDSNew England Journal of Medicine, 1987
- AIDS STATISTICS AND THE RISK FOR MINORITIESAIDS Research, 1986
- Patterns of UtilizationMedical Care, 1985
- Some Interim Results from a Controlled Trial of Cost Sharing in Health InsuranceNew England Journal of Medicine, 1981
- The Estimation of a Simultaneous-Equation Tobit ModelInternational Economic Review, 1979