HIV-infected Injection Drug Users: Health Care Utilization and Morbidity

Barash, Elizabeth; Hanson, Debra L.; Buskin, Susan E.; Teshale, Eyasu H.

doi:10.1353/hpu.2007.0053

Cited by 63 publications

(15 citation statements)

References 27 publications

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“…1–4 Among individuals diagnosed with HIV infection, these disparities are principally evident with respect to differential viral suppression (or virological failure), higher prevalence of AIDS, and increased mortality. 1,5,6 Although recent literature indicates that 72% to 77% of all HIV-positive persons in the United States are linked to HIV primary care within 4 months of initial HIV diagnosis, only 35% of persons living with HIV are virally suppressed, attributable in part to challenges with longitudinal retention in care and inconsistent adherence to antiretroviral therapy (ART).…”

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confidence: 99%

“…7 Similar disparities have been observed for patients who report IDU, with lower documented clinical service use, higher viral load burden, and increased mortality. 4,8,9 …”

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confidence: 99%

“…15–17 Finally, among persons living with HIV/AIDS in the United States, poor retention rates have been observed in Black persons and those who report IDU. 4,9,17,18 …”

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confidence: 99%

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The Contribution of Missed Clinic Visits to Disparities in HIV Viral Load Outcomes

et al. 2015

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Objectives We explored the contribution of missed primary HIV care visits (“no-show”) to observed disparities in virological failure (VF) among Black persons and persons with injection drug use (IDU) history. Methods We used patient-level data from 6 academic clinics, before the Centers for Disease Control and Prevention and Health Resources and Services Administration Retention in Care intervention. We employed staged multivariable logistic regression and multivariable models stratified by no-show visit frequency to evaluate the association of sociodemographic factors with VF. We used multiple imputations to assign missing viral load values. Results Among 10 053 patients (mean age = 46 years; 35% female; 64% Black; 15% with IDU history), 31% experienced VF. Although Black patients and patients with IDU history were significantly more likely to experience VF in initial analyses, race and IDU parameter estimates were attenuated after sequential addition of no-show frequency. In stratified models, race and IDU were not statistically significantly associated with VF at any no-show level. Conclusions Because missed clinic visits contributed to observed differences in viral load outcomes among Black and IDU patients, achieving an improved understanding of differential visit attendance is imperative to reducing dispar ities in HIV.

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“…7 Similar disparities have been observed for patients who report IDU, with lower documented clinical service use, higher viral load burden, and increased mortality. 4,8,9 …”

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confidence: 99%

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The Contribution of Missed Clinic Visits to Disparities in HIV Viral Load Outcomes

et al. 2015

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“…For example, in Baltimore, Boston, Chicago, Houston, New York, Newark, Philadelphia, and Washington, DC, IARs among female PWID declined 53% compared to 71% among male PWID. Given that females may be at higher epidemiologic and sociobehavioral risk for HIV [18] and that PWID are less likely than persons in other transmission categories to seek early HIV counseling, testing and treatment [19], to receive CD4 and viral load testing while under care [20], and have a greater risk for HIV-related morbidity and mortality [20, 21], these findings warrant public health attention.…”

Section: Discussionmentioning

confidence: 99%

Female and male differences in AIDS diagnosis rates among people who inject drugs in large U.S. metro areas from 1993 to 2007

West

Pouget

Tempalski

et al. 2015

Annals of Epidemiology

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Purpose We estimated female and male incident AIDS diagnosis rates (IARs) among people who inject drugs (PWID) in US metropolitan statistical areas (MSAs) over time to assess whether declines in IARs varied by sex after combination antiretroviral therapy (cART) dissemination. Methods We compared IARs and 95% confidence intervals (CIs) for female and male PWID in 95 of the most populous MSAs. To stabilize estimates we aggregated data across 3-year periods, selecting a period immediately preceding cART (1993–1995) and the most recent after the introduction of cART for which data were available (2005–2007). We assessed disparities by comparing IAR 95% CIs for overlap, female-to-male risk ratios, and disparity change scores. Results IARs declined an average of 58% for female PWID and 67% for male PWID between the pre-cART and cART periods. Among female PWID, IARs were significantly lower in the later period relative to the pre-cART period in 48% of MSAs. Among male PWID, IARs were significantly lower over time in 86% of MSAs. Conclusions IARs among female PWID in large US MSAs have declined more slowly than rates among male PWID. This suggests a need for increased targeting of prevention and treatment programs, and for research on MSA level conditions that may drive differences in declining AIDS rates among female and male PWID.

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“…It should be noted that hospitalizations have become a major outcome measure and constitute a considerable component of excess healthcare costs in this special population [3, 13, 14]. Thus, analyzing the clinical characteristics of admitted patients is a useful strategy to assess the effectiveness of health programs and provide areas of interest to improve healthcare to HIV-IDU.…”

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Antiretroviral Therapy (ART) Use, Human Immunodeficiency Virus (HIV)-1 RNA Suppression, and Medical Causes of Hospitalization Among HIV-Infected Intravenous Drug Users in the Late ART Era

Vallecillo¹,

Mojal

Torrens

et al. 2014

Open Forum Infectious Diseases

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HIV-infected Injection Drug Users: Health Care Utilization and Morbidity

Abstract: Health care associated with injection drug use may not be adequately addressed in the outpatient setting. The benefits of broadening the scope of primary HIV care should be examined.

Cited by 63 publications

References 27 publications

The Contribution of Missed Clinic Visits to Disparities in HIV Viral Load Outcomes

The Contribution of Missed Clinic Visits to Disparities in HIV Viral Load Outcomes

Female and male differences in AIDS diagnosis rates among people who inject drugs in large U.S. metro areas from 1993 to 2007

Antiretroviral Therapy (ART) Use, Human Immunodeficiency Virus (HIV)-1 RNA Suppression, and Medical Causes of Hospitalization Among HIV-Infected Intravenous Drug Users in the Late ART Era

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