208951 Access to health care, testing and prevention service utilization among injection drug users in Dallas, Texas

Tuesday, November 10, 2009: 1:30 PM

Praveen R. Pannala, MD, MPH , TB/HIV/STD Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX
Sonia I. Arbona, PhD , TB/HIV/STD Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX
M. Aaron Sayegh, PhD, MPH , TB/HIV/STD Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX
Chetna Pande , University of Texas, Austin, TX
Douglas B. Kershaw , Community Prevention and Intervention Unit, University of Texas Southwestern Medical Center, Dallas, TX
Sharon K. Melville, MD, MPH , TB/HIV/STD Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX
  
Purpose: 2006 data indicates 38% people living with HIV/AIDS in Texas were not receiving HIV care. Of this group, 47% were injection drug users (IDU). This research focuses on the effect of access to care among IDU's on prevention service utilization and HIV/STI testing.

Methods: Data were collected from a snowball sample of 597 IDU's in Dallas, TX as part of the National HIV Behavioral Surveillance project. Prevalence estimates of access to care, prevention service utilization, and HIV/STI testing were calculated at 95% confidence intervals (CI) and tested for independence with Pearson's chi-square at p<.05. Results: Prevalence estimates indicate that 38% (33.6-43.2) of IDU in Dallas have no care access (no visits to a health care professional in past year) which includes never having been tested for: HIV 11% (6.7-15.4); syphilis 75% (70.4-79.7), and no receipt of hepatitis vaccination 78% (72.7-82.0). During the previous year, prevalence of IDU who did not utilize prevention services was high, which includes never having received: condoms 42% (37.3-48.1); new sterile needles 78% (73.5-82.4); kits for preparing drugs 79% (65.2-4.5). Also, 72% received HIV risk reduction counseling 72% (66.9-76.3). Among IDU with care access, 67% received an HIV test, c2 =18.86 (N=594); 74% received hepatitis vaccination, c2=18.86 (569); 75% received a syphilis test c2=8.00 (N=561). Finally, 77% received HIV risk reduction counseling, c2=16.86 (N=592).

Conclusions: Among IDU with access to care, prevention service utilization and HIV/STI testing was greater. Results suggest that access to care represents an important target for prevention efforts and disease intervention.

Learning Objectives:
1. List four indicators each for access to health care, Testing behaviors, and access to and utilization of prevention services among IDUs. 2. Discuss prevalence of access to health care, testing behaviors, and the prevalence of utilization of prevention services among IDUs in Dallas, Texas. 3. Compare testing behaviors (HIV, Syphilis, Hepatitis), and access to and utilization of prevention services among IDUs in Dallas, Texas, in terms of access to health care.

Keywords: Health Care Access, Drug Use

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been conducting HIV/AIDS research for 13 years. I have been principal investigator of the Dallas National HIV/AIDS Behavioral Surveillance site for 5 years, since the inception of the project. I have been involved in the design, implementation, data collection, data quality management, and data analysis and interpretation of the NHBS project in Texas. I have presented abstracts/data at multiple local, regional, Statewide and National scientific meetings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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