Type and pattern of illicit drug use and access to health care services for HIV-infected people
Type and pattern of illicit drug use and access to health care services for HIV-infected people
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DOI：
10.1089/apc.2007.9985
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发表时间：
2007-06-01
影响因子：
4.9
通讯作者：
Cunningham, Chinazo O.
中科院分区：
文献类型：
--
作者：
Sohler, Nancy L.;Wong, Mitchell D.;Cunningham, Chinazo O.
在美国，大约28%接受治疗的艾滋病毒感染者报告使用非法药物。非法吸毒者的艾滋病毒病程比非吸毒者差，这被认为是由于他们不定期地使用艾滋病毒医疗服务。我们研究了类型（可卡因与阿片类药物）和药物使用模式（基线时的药物使用，6个月随访，两个时期和不使用）与医疗保健利用之间的关系，这些样本来自一个多地点项目，该项目评估了医疗外展干预对艾滋病毒护理保留率低风险人群的影响。在所有类型和模式的药物使用中，药物使用者更有可能获得次优的门诊护理，错过预约，使用急诊室，未满足支持服务需求，并且不太可能服用抗逆转录病毒药物。此外，虽然在随访期间开始使用药物并在两个时期内持续使用药物的人与错过预约的非使用者不同（开始使用者与非使用者的比值比[ OR] = 2.20，持续使用者与非使用者的比值比[OR] = 2.92），急诊科使用（OR = 4.93的开始者与非使用者，OR = 2.24的一贯使用者与非使用者），并在随访时使用抗逆转录病毒药物（OR = 0.23开始与非使用者，OR = 0.19为一贯的用户与非用户），那些谁停止使用药物后，基线期没有不同的非用户。我们的结论是，卫生保健利用率是穷人的人谁使用非法药物比那些谁不，停止药物使用可能有助于改善卫生保健利用和艾滋病毒的结果，这一人群。
Approximately 28% of HIV- infected people in treatment in the United States report using illicit drugs. Illicit drug users have poorer course of HIV disease than non- drug users, which is thought to be due to their irregular use of HIV medical services. We examined associations between type ( cocaine versus opioids) and pattern of drug use ( drug use at baseline, 6- month follow- up, both periods, and nonuse) and health care utilization for a large sample of HIV-infected individuals drawn from a multisite project that evaluated the impact of medical outreach interventions for populations at risk of poor retention in HIV care. Across all types and patterns of drug use, drug users were more likely to have suboptimal ambulatory care, miss scheduled appointments, use the emergency department, have unmet support services needs, and were less likely to take antiretroviral medications. Additionally, while people who started using drugs during the follow- up period and consistently used drugs across both periods differed from nonusers on missed appointments ( odds ratio [ OR] = 2.20 for starters versus nonusers, OR = 2.92 for consistent users versus nonusers), emergency department use ( OR = 4.93 for starters versus nonusers, OR = 2.24 for consistent users versus nonusers), and antiretroviral medication use at follow- up ( OR = 0.23 starters versus nonusers, OR = 0.19 for consistent users versus nonusers), those who stopped using drugs after the baseline period did not differ from nonusers. We conclude that health care utilization is poorer for people who use illicit drugs than those who do not, and stopping drug use may facilitate improvements in health care utilization and HIV outcomes for this population.