title: Utilization of HIV/AIDS treatment services: comparing injecting drug users and other clients.
abstract: This study compared healthcare utilization by injection drug users (IDUs) and non-IDUs. Data were abstracted from patients' medical records, admitted on HIV/AIDS treatment centers, between 1986 and 2002, forming a non-concurrent cohort study. Variables included: sociodemographics, HIV/AIDS exposure group, healthcare utilization (consultations, procedures, and prescriptions). Descriptive analyses included age-period and cohort effects. Out of 170 patients, with an average age of 30 years, 39.4% were IDUs, 71.8% were males and had low levels of education. At the first consultation, 86.5% neither received an ARV prescription nor had a request for CD4 or viral load. Injection drug users, as compared to non-IDUs, were less likely to receive ARV prescriptions and requests for CD4 lymphocyte and viral load counts, even though the number of consultations did not differ between the two groups. Healthcare utilization increased in calendar-year in the non-IDUs group, parallel to the implementation of the Brazilian health policy of universal care. However, this favorable trend was not observed among IDUs. Differential outcomes for HIV/AIDS among IDUs, towards worse prognosis, suggest difficulties in terms of adherence and follow-up of ARV therapy in this population.
authors.affiliation: Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Angelita Cristine de
authors.initials: AC
authors.lastname: Melo
authors.forename: Waleska Teixeira
authors.initials: WT
authors.lastname: Caiaffa
authors.forename: Cibele Comini
authors.initials: CC
authors.lastname: César
authors.forename: Ricardo Vieira
authors.initials: RV
authors.lastname: Dantas
authors.forename: Bernard François
authors.initials: BF
authors.lastname: Couttolenc
mesh_terms: D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data; D001938:Brazil; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011787:Quality of Health Care; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D019562:Viral Load