Bridging the gap of healthcare service utilization disparities among intravenous drug users in Denver, Colorado: A formative study

As one of society's most stigmatized populations, intravenous drug users (IDUs) experience physical, social and cultural barriers to quality healthcare similar to racial/ethnic minority populations. IDUs forgo health services, leading to disproportionately high morbidity and mortality from manageable infections. This study examined the attitudes, beliefs, and experiences of IDUs and various healthcare providers in the Metro-Denver area regarding barriers to health services, challenges to providing patient-centered care, and the necessity of IDU participation.Local qualitative and quantitative data were reviewed from several major research studies and health promotion program data from local community-based organizations. This study synthesized newly emerging and existing data from various sources and reviewed the programmatic application of this approach to empowering Denver IDUs and providers to work together. Preliminary data results show that IDUs are refusing to seek treatment for injection-related conditions or chronic conditions due to considerable dissatisfaction with systems of care and judgmental treatment. Health care providers perceive a benefit from IDU-patient service trainings. Data also show high prevalence of low health literacy, health insurance enrollment, and limited health communication skills among Denver IDUs. Barriers and perceptions have direct consequences on health status among Denver IDUs and the quality care standards for healthcare facilities. We suggest that health promotion efforts should work to increase IDU-specific cultural competency training, particularly in continuing education. We propose examination of alternative approaches towards improving self-efficacy among IDUs to take charge of their care.