262342 Associations of Perceived Drug Use and Race/Ethnicity Based Discrimination On Healthcare Access and Satisfaction Among People Who Use Drugs

Tuesday, October 30, 2012 : 10:30 AM - 10:50 AM

Courtney McKnight, MPH , Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
Carmen L. Masson, PhD , Department of Psychiatry, University of California San Francisco, San Francisco, CA
Enrique R. Pouget, PhD , Institute for AIDS Research, National Development and Research Institutes, New York, NY
Ashly E. Jordan, BA , Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
Lara Coffin, MPH , The Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
Randy Seewald, MD , Department of Medicine, Beth Israel Medical Center, New York, NY
James L. Sorensen, PhD , Department of Psychiatry, University of California, San Francisco, San Francisco, CA
Don C. Des Jarlais, PhD , Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
David C. Perlman, MD , Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
  
     
Background: Racial/ethnic disparities in HIV prevalence among drug users (DUs) persist in the US, and Hepatitis C (HCV) remains prevalent among DUs. Additionally, HIV and HCV testing and accessing medical care is challenging for many DUs, due to barriers including stigma and discrimination.

Methods DUs were interviewed in New York City and San Francisco regarding their perceptions of discrimination, healthcare access and satisfaction. Scales for perceived discrimination based on drug use (D-DU), perceived discrimination based on race/ethnicity (D-RE), and healthcare satisfaction (HCS) were developed. Associations of D-RE and D-DU with HCS and other indicators of healthcare access were assessed using correlations and generalized linear models.

Results The sample was 36% non-Hispanic black (NHB), 34% Hispanic (H) and 30% non-Hispanic white (NHW); 75% reported ever experiencing D-DU; 69% reported D-RE (NHB = 74%, H = 61%, NHW = 56%, p = 0.10); 64% reported D-DU often affects getting routine medical care, and 53% reported that D-RE often affects getting routine medical care. D-RE was positively correlated with D-DU (r = 0.52). In bivariate analysis, D-DU (F = 6.8, p < 0.05) and D-RE (F= 5.0, p < 0.05) were negatively associated with having a regular doctor, and D-RE was negatively correlated with HCS (r = -0.21, p < 0.05). In multivariable analyses HCS was negatively associated with D-RE (F = 6.9, p < 0.01).

Conclusions Preliminary findings indicate that perceptions of D-RE and D-DU in accessing healthcare were common, and perceptions of D-RE were associated with healthcare access, particularly for NHB.

Learning Areas:
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe how perceived drug user and racial/ethnic discrimination effect healthcare access and satisfaction.

Keywords: Drug Use, Health Care Access

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have served as Project Director and Co-Investigator on several federally funded studies investigating the intersection of health and drug use.
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.

Back to: 4082.0: Accessing Care for Co-occurring Drug Use & Infectious Disease