Type of substance use and access to HIV-related health care
Type of substance use and access to HIV-related health care
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DOI：
10.1089/apc.2006.20.399
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发表时间：
2006-06-01
影响因子：
4.9
通讯作者：
Heller, Daliah
中科院分区：
文献类型：
--
作者：
Cunningham, Chinazo O.;Sohler, Nancy L.;Heller, Daliah
与其他艾滋病毒风险群体相比，艾滋病毒感染物质使用者的健康结果更差。很少有研究研究特定类型的物质使用对医疗保健的影响。这项研究调查了特定类型的滥用物质与获得医疗保健的机会之间的关系。1999年8月至2001年2月期间，对居住在纽约布朗克斯区八家不同单间旅馆的艾滋病毒感染者进行了关于人口统计资料、保健服务的获取和利用以及药物和酒精使用情况的访谈。在238名参与者中，大多数是男性(59%)，黑人或西班牙裔(93%)，以及活跃的吸毒者(61%)。报告使用任何毒品或可卡因/可卡因的人比报告没有使用毒品或可卡因/可卡因的人更不可能有固定的提供者(调整后的优势比[AOR]=0.5，p=0.05；AOR=0.35，p=0.004)，而那些有酗酒史的人比没有酗酒的人更有可能有正规的医生(AOR=2.61，p=0.05)。报告使用任何药物或可卡因/可卡因的个人也不太可能对医疗保健质量持积极态度(分别为AOR=0.5，P=0.02；AOR=0.37，P=0.002)。海洛因和注射毒品的使用与这些结果无关。当样本仅限于最近吸毒者时，发现了类似的模式。尽管药物使用总体上与负面健康后果有关，但在这项研究中，吸毒者获得医疗保健的较差措施主要与吸毒/可卡因的使用有关。重要的是，从事药物使用人群工作的临床医生和研究人员了解特定类型的物质使用如何对卫生保健产生不同的影响。
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.