Physician-patient communication among HIV-positive drug abusers

Background: Health communication efforts aimed at HIV-infected individuals is essential for mitigating transmission and preventing additional sexually transmitted infections. Studies show a high prevalence of drug abuse among HIV-infected individuals. Disparities may exist in physician-patient communication regarding preventive care practices. This study compares the inclusion of risk-reduction method discussions during primary care visits between HIV-positive drug and non-drug abusers. Methods: Face-to-face interviews were conducted with a diverse HIV-infected adult population attending an HIV primary-care clinic. Participants were asked about general health care utilization practices, including topics of discussion with their physician. Certain interview items address HIV prevention practices such as condom use within the past 12 months. “Drug abusers” were classified based on marijuana, crack, heroin, or methamphetamine use at least once per week within the last 6 months. Results: Among 453 participants, 58.9% were male, 62.5% were Black and 35% were Hispanic. Over one-third of participants did not graduate from high school. Twenty-two of the study participants were classified as drug abusers. There were significant differences between HIV prevention practice advice (χ2 = 6.37, p = .04) and discussions of alcohol use (χ2 = 7.41, p = .025) given by providers to patients who self-report as drug abusers and non-drug abusers. Discussion: Given that HIV-positive drug abusers are at higher risk of HIV transmission to others and acquiring new STIs, physicians should be cognizant of their patients' drug use. Efforts should be made to increase discussions about alcohol and condom use to enhance the health of HIV-infected drug abusers.