title: Associations between medical service use and HIV risk among HIV-positive drug users in Baltimore, MD.
abstract: The objectives of this study were first, to identify psychosocial and medical service utilization factors associated with unprotected sex with HIV-negative or unknown serostatus partners among persons living with HIV/AIDS, and second, to identify risk behaviours associated with HIV medical service use. We assessed 244 HIV-positive participants in an HIV intervention targeting drug users (1997-99). Fifty-seven per cent of HIV-positive participants reported unprotected sex within the past 90 days, 16.4% with serodiscordant partners. Odds of risky sex were lower among those currently receiving HIV medical care (odds ratio (OR)=0.36), and were greater among females (OR=2.6), those having friends with lower norms of condom use (OR=3.3), and those having a main sexual partner (OR=6.2). Lower odds of receiving HIV medical care were associated with current drug use (OR=0.33), sharing drugs with a sex partner (OR=0.27), and exchanging sex for drugs or money (OR=0.24). Findings suggest the importance of community-based HIV prevention intervention targeting HIV-positive drug users not recovery HIV medical care.
authors.affiliation: Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD 21205, USA. clatkin@jhsph.edu
authors.forename: C A
authors.initials: CA
authors.lastname: Latkin
authors.forename: V L
authors.initials: VL
authors.lastname: Forman-Hoffman
authors.forename: G
authors.initials: G
authors.lastname: D'Souza
authors.forename: A R
authors.initials: AR
authors.lastname: Knowlton
mesh_terms: D000328:Adult; D015142:Baltimore / Q000453:epidemiology; D003625:Data Collection; D005260:Female; D006679:HIV Seropositivity / Q000150:complications*; D006293:Health Promotion; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000523:psychology; D015819:Substance Abuse, Intravenous / Q000523:psychology; D047568:Unsafe Sex