6008.0: Thursday, October 25, 2001 - 8:45 AM

Abstract #27973

Access to health care services among drug users (DUs) at a syringe exchange program (SEP) in New York City

David C. Perlman, MD1, Leslie Horn, MPH1, Ann Nugent, MA1, Stacey Pearson-Brass, MD1, Nadim Salomon, MD1, Patricia Friedmann, MS1, Carmen L. Masson, PhD2, and Don C. Des Jarlais, PhD3. (1) Department of Medicine, Chemical Dependency Institute, Beth Israel Medical Center, Milton and Carroll Petrie Division, First Avenue at 16th Street, New York, NY 10003, 212-420-4470, dperlman@bethisraelny.org, (2) San Francisco General Hospital, 1001 Potrero Ave., San Francisco, CA 94110, (3) Chemical Dependency Institute, Beth Israel Medical Center, New York, New York

Introduction: Many active (DUs) are not engaged in longitudinal medical care or episodically use emergency departments. Methods: DUs at a SEP were interviewed about their access to health care services. Results: 70 (60%) male, 47 (40%) female. 38% White, 30% Black, 26% Hispanic, 6% other. 56% had health insurance (predominantly Medicaid), 42% had no active insurance. 59 (50%) reported a `regular health care source' other than emergency rooms: 42 (71%) used doctors/ clinics, 13 (22%) cited methadone clinics, 4 (7%) other. No health insurance was the most frequently cited reason (48%) for lacking regular health care source. 20% reported needing to see a doctor (past 6 months) but not doing so. 18 DUs (16%) lanced their own skin abscesses (range 1-20 times). 6 (5%) acquired street antibiotics to treat abscesses. 28/47 (60%),13 (28%),5 (11%) women had routine gynecological exams in the past 1, 2-3,>3 years. Those with health insurance (86% vs 14%, p < 0.001) and nonwhite DUs (65% vs 41%, p=0.06) more frequently had regular health care source; 16% of insured DUs did not have a regular health care source. Neither insurance status nor having a regular health care source was associated with lancing own skin abscesses (both p=0.9). Conclusion: Half of DUs attending a SEP lack a regular health care source. Lack of active health insurance appears to be an important barrier. Some DUs engage in various forms of self treatment. Efforts to increase engagement of active DUs at SEPs in ongoing health care are needed.

Learning Objectives: At the end of this presentation the participants in this session will: 1)Develop an understanding of the frequency with which active drug users are engaged in on-going health care; 2)Acquire an understanding of issues affecting access to longitudinal health care among drug users.

Keywords: Access to Health Care, Injection Drug Users

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA