HIV-infected injection drug users: health care utilization and morbidity.
BACKGROUND
About one-third of HIV-infected people in the U.S. have a history of injection drug use (IDU). To examine disparities in health care, we compared health care utilization and morbidity of IDUs and non-IDUs.


METHODS
A large national cohort of people receiving HIV care was used to compare IDU and non-IDU inpatient, outpatient, and emergency room (ER) visits and other standards of care. We also compared prevalence of HIV-related illnesses.


RESULTS
Injection drug users were older and more frequently female, non-White, and publicly insured than non-IDUs. Injection drug users were more than twice as likely to have one or more ER visits annually and almost twice as likely to be hospitalized. CD4 and viral load testing was half as likely to be performed for IDUs in a six-month period. Injection drug users were significantly more likely to have HIV-related morbidity.


CONCLUSIONS
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.
Department of Public Health for Seattle and King County, 400 Yesler Way, 3rd Floor, Seattle, WA 98104, USA. Elizabeth.barash@metrokc.gov
Elizabeth Tesh
ET
Barash
Debra L
DL
Hanson
Susan E
SE
Buskin
Eyasu
E
Teshale
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D015995:Prevalence; D017678:Sex Distribution; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology