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AIDS symptomatology and patterns of health care utilization among drug injectors in Puerto Rico

Rafaela R. Robles, EdD, C. Amalia Marrero, MPH, Juan C. Reyes, EdD, Héctor M. Colón, PhD, Tomás D. Matos, MS, José M. Calderón, MS, and Elizabeth W. Shepard, PA-C, MPH. Center for Addiction Studies, School of Medicine, Universidad Central del Caribe, PO Box 60327, Bayamón, PR 00960-6032, 787-785-4211, rrobles@uccaribe.edu

Background: Most studies of health care use related to HIV/AIDS among drug users have been conducted among known HIV/AIDS patients, omitting drug users who have clinical symptomatology but do not necessarily know their HIV/AIDS status. This study examined the association of AIDS symptomatology and other health-related variables with patterns of health care utilization among drug injectors. Methods: Data were collected through personal interviews with 400 drug injectors recruited in poor neighborhoods in Puerto Rico. The main independent variable, number of AIDS-related symptoms (CDC guidelines), was dichotomized as 1-7 symptoms or ≥8 symptoms. Health utilization outcome variables included use, within the 6 months prior to the interview, of emergency services (reported by 21.5% of sample), general medical services (22.0%), and specialist services (9.1%). Results: Multivariate logistic regression analyses showed that drug injectors reporting ≥8 AIDS-related symptoms, and those diagnosed with alcohol abuse or dependence, were significantly more likely to use emergency services. Those reporting ≥8 AIDS-related symptoms were also more likely to use general medical services. Use of specialist services was higher among drug injectors reporting ≥16 depression symptoms (CES-D scale). Drug injectors who reported positive lifestyles were more likely to use general medical services. Conclusions: These results suggest the need for greater provision of general medical services that address alcohol problems and depression among drug users, to help decrease the use of emergency services. Encouraging positive lifestyles may also help reduce health care costs by augmenting general medical care and reducing more expensive services such as emergency care.

Learning Objectives: At the conclusion of the session the participant will be able to

Keywords: Injection Drug Users, Health Care Utilization

Presenting author's disclosure statement:
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.

International Health and HIV/AIDS Research

The 132nd Annual Meeting (November 6-10, 2004) of APHA