Longitudinal correlates of health care-seeking behaviors among HIV-seropositive injection drug users

How can we intervene to improve health care utilization?

James D. Wilkinson, Wei Zhao, Julia H. Arnsten, Amy Ruth Knowlton, Yuko Mizuno, Starley B. Shade, Marc N. Gourevitch, Scott Santibanez, Lisa R. Metsch

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To identify modifiable factors associated with health care utilization by HIV-negative seropositive injection drug users (IDUs). METHODS: We analyzed longitudinal data from 966 participants in a randomized controlled trial of a behavioral intervention designed to address medical care, adherence, and risk reduction. The outcomes of this study were usual place for care (clinic vs. emergency room) and frequency of primary care visits. RESULTS: Results of multiple logistic regression analysis showed that increase in "importance of HIV care scale" score (odds ratio [OR] = 2.99; P <0.001), empowerment (OR = 3.53; P <0.001), utilization of case management (OR = 3.07; P = 0.007), and having a stable residence (OR = 2.63; P = 0.008) were significantly associated with participants being "clinic users." Increase in importance of HIV care scale score (OR = 5.65; P = 0.01) increased empowerment (OR = 2.42; P = 0.005), taking greater control of one's health (OR = 2.17; P = 0.001), having health insurance (OR = 2.58; P = 0.003), utilization of case management (OR = 3.14; P = 0.027), and CD4 count ≥200 cells/mm (OR = 2.09; P = 0.007) were significantly associated with reporting 2 or more primary HIV care visits in the past 6 months. CONCLUSIONS: Future interventions for this population may be strengthened by addressing the importance of HIV primary care; empowering participants with respect to the health care system; and promoting linkages to case management, health insurance, and local housing programs.

Original languageEnglish (US)
JournalJournal of Acquired Immune Deficiency Syndromes
Volume46
Issue numberSUPPL. 2
DOIs
StatePublished - Nov 2007

Fingerprint

Patient Acceptance of Health Care
Drug Users
Odds Ratio
HIV
Injections
Case Management
Primary Health Care
Health Insurance
Risk Reduction Behavior
CD4 Lymphocyte Count
Hospital Emergency Service
Randomized Controlled Trials
Logistic Models

Keywords

  • AIDS
  • Health care utilization
  • HIV
  • Intravenous
  • Substance abuse

ASJC Scopus subject areas

  • Virology
  • Immunology

Cite this

Longitudinal correlates of health care-seeking behaviors among HIV-seropositive injection drug users : How can we intervene to improve health care utilization? / Wilkinson, James D.; Zhao, Wei; Arnsten, Julia H.; Knowlton, Amy Ruth; Mizuno, Yuko; Shade, Starley B.; Gourevitch, Marc N.; Santibanez, Scott; Metsch, Lisa R.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 46, No. SUPPL. 2, 11.2007.

Research output: Contribution to journalArticle

Wilkinson, James D. ; Zhao, Wei ; Arnsten, Julia H. ; Knowlton, Amy Ruth ; Mizuno, Yuko ; Shade, Starley B. ; Gourevitch, Marc N. ; Santibanez, Scott ; Metsch, Lisa R. / Longitudinal correlates of health care-seeking behaviors among HIV-seropositive injection drug users : How can we intervene to improve health care utilization?. In: Journal of Acquired Immune Deficiency Syndromes. 2007 ; Vol. 46, No. SUPPL. 2.
@article{ab41e2819a8940fc9ac15502baeffafa,
title = "Longitudinal correlates of health care-seeking behaviors among HIV-seropositive injection drug users: How can we intervene to improve health care utilization?",
abstract = "OBJECTIVE: To identify modifiable factors associated with health care utilization by HIV-negative seropositive injection drug users (IDUs). METHODS: We analyzed longitudinal data from 966 participants in a randomized controlled trial of a behavioral intervention designed to address medical care, adherence, and risk reduction. The outcomes of this study were usual place for care (clinic vs. emergency room) and frequency of primary care visits. RESULTS: Results of multiple logistic regression analysis showed that increase in {"}importance of HIV care scale{"} score (odds ratio [OR] = 2.99; P <0.001), empowerment (OR = 3.53; P <0.001), utilization of case management (OR = 3.07; P = 0.007), and having a stable residence (OR = 2.63; P = 0.008) were significantly associated with participants being {"}clinic users.{"} Increase in importance of HIV care scale score (OR = 5.65; P = 0.01) increased empowerment (OR = 2.42; P = 0.005), taking greater control of one's health (OR = 2.17; P = 0.001), having health insurance (OR = 2.58; P = 0.003), utilization of case management (OR = 3.14; P = 0.027), and CD4 count ≥200 cells/mm (OR = 2.09; P = 0.007) were significantly associated with reporting 2 or more primary HIV care visits in the past 6 months. CONCLUSIONS: Future interventions for this population may be strengthened by addressing the importance of HIV primary care; empowering participants with respect to the health care system; and promoting linkages to case management, health insurance, and local housing programs.",
keywords = "AIDS, Health care utilization, HIV, Intravenous, Substance abuse",
author = "Wilkinson, {James D.} and Wei Zhao and Arnsten, {Julia H.} and Knowlton, {Amy Ruth} and Yuko Mizuno and Shade, {Starley B.} and Gourevitch, {Marc N.} and Scott Santibanez and Metsch, {Lisa R.}",
year = "2007",
month = "11",
doi = "10.1097/QAI.0b013e31815767a4",
language = "English (US)",
volume = "46",
journal = "Journal of Acquired Immune Deficiency Syndromes",
issn = "1525-4135",
publisher = "Lippincott Williams and Wilkins",
number = "SUPPL. 2",

}

TY - JOUR

T1 - Longitudinal correlates of health care-seeking behaviors among HIV-seropositive injection drug users

T2 - How can we intervene to improve health care utilization?

AU - Wilkinson, James D.

AU - Zhao, Wei

AU - Arnsten, Julia H.

AU - Knowlton, Amy Ruth

AU - Mizuno, Yuko

AU - Shade, Starley B.

AU - Gourevitch, Marc N.

AU - Santibanez, Scott

AU - Metsch, Lisa R.

PY - 2007/11

Y1 - 2007/11

N2 - OBJECTIVE: To identify modifiable factors associated with health care utilization by HIV-negative seropositive injection drug users (IDUs). METHODS: We analyzed longitudinal data from 966 participants in a randomized controlled trial of a behavioral intervention designed to address medical care, adherence, and risk reduction. The outcomes of this study were usual place for care (clinic vs. emergency room) and frequency of primary care visits. RESULTS: Results of multiple logistic regression analysis showed that increase in "importance of HIV care scale" score (odds ratio [OR] = 2.99; P <0.001), empowerment (OR = 3.53; P <0.001), utilization of case management (OR = 3.07; P = 0.007), and having a stable residence (OR = 2.63; P = 0.008) were significantly associated with participants being "clinic users." Increase in importance of HIV care scale score (OR = 5.65; P = 0.01) increased empowerment (OR = 2.42; P = 0.005), taking greater control of one's health (OR = 2.17; P = 0.001), having health insurance (OR = 2.58; P = 0.003), utilization of case management (OR = 3.14; P = 0.027), and CD4 count ≥200 cells/mm (OR = 2.09; P = 0.007) were significantly associated with reporting 2 or more primary HIV care visits in the past 6 months. CONCLUSIONS: Future interventions for this population may be strengthened by addressing the importance of HIV primary care; empowering participants with respect to the health care system; and promoting linkages to case management, health insurance, and local housing programs.

AB - OBJECTIVE: To identify modifiable factors associated with health care utilization by HIV-negative seropositive injection drug users (IDUs). METHODS: We analyzed longitudinal data from 966 participants in a randomized controlled trial of a behavioral intervention designed to address medical care, adherence, and risk reduction. The outcomes of this study were usual place for care (clinic vs. emergency room) and frequency of primary care visits. RESULTS: Results of multiple logistic regression analysis showed that increase in "importance of HIV care scale" score (odds ratio [OR] = 2.99; P <0.001), empowerment (OR = 3.53; P <0.001), utilization of case management (OR = 3.07; P = 0.007), and having a stable residence (OR = 2.63; P = 0.008) were significantly associated with participants being "clinic users." Increase in importance of HIV care scale score (OR = 5.65; P = 0.01) increased empowerment (OR = 2.42; P = 0.005), taking greater control of one's health (OR = 2.17; P = 0.001), having health insurance (OR = 2.58; P = 0.003), utilization of case management (OR = 3.14; P = 0.027), and CD4 count ≥200 cells/mm (OR = 2.09; P = 0.007) were significantly associated with reporting 2 or more primary HIV care visits in the past 6 months. CONCLUSIONS: Future interventions for this population may be strengthened by addressing the importance of HIV primary care; empowering participants with respect to the health care system; and promoting linkages to case management, health insurance, and local housing programs.

KW - AIDS

KW - Health care utilization

KW - HIV

KW - Intravenous

KW - Substance abuse

UR - http://www.scopus.com/inward/record.url?scp=37349079878&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=37349079878&partnerID=8YFLogxK

U2 - 10.1097/QAI.0b013e31815767a4

DO - 10.1097/QAI.0b013e31815767a4

M3 - Article

VL - 46

JO - Journal of Acquired Immune Deficiency Syndromes

JF - Journal of Acquired Immune Deficiency Syndromes

SN - 1525-4135

IS - SUPPL. 2

ER -