Correlates of self-efficacy to disclose injection drug use to HIV primary care providers among a sample of HIV seropositive injection drug users

Background: HIV disease remains a chronic yet manageable disease that disproportionally impacts marginalized populations such as injection drug users. This research sought to identify correlates of perceived self-efficacy to disclose drug use to one's HIV primary care provider (DISDR) among a sample of HIV-positive injection drug users (IDUs). Methods: This study uses cross-sectional and longitudinal data collected as part of the multi-site, CDC-funded study entitled "Intervention Research for HIV-positive Injection Drug Users" (INSPIRE). The relationship between identified correlates and DISDR was evaluated among a longitudinal cohort (N=814) to determine whether it persists longitudinally. Potential correlates consisted of individual characteristics (socio-demographic, health care service utilization, sex/drug- use behaviors, and psychosocial characteristics). It was postulated that selected variables from these domains would be associated with DISDR. Results: Baseline and longitudinal data suggest a positive association between self-efficacy to disclose injection drug use to one's HIV primary care provider and the following variables: patient-provider relationship, attendance of a drug treatment program during the previous six months, “taking control of one's healthcare,” and social support. However, current receipt of HIV medications and being recruited from the city of Miami were negatively associated with reporting a high DISDR. Conclusions: These findings will potentially inform interventions that can improve HIV treatment among drug users and inform policymakers and stakeholders regarding the importance of providing comprehensive HIV care in conjunction with substance abuse treatment options to achieve optimal health outcomes.