Sociodemographic and access-related correlates of health-care utilization among African American injection drug users: The BESURE study

Allysha C. Maragh-Bass, Christine Powell, Ju Park, Colin Flynn, Danielle German

Research output: Contribution to journalArticlepeer-review


Persons who inject drugs (PWID) may have less access to, and utilization of, health-care services, and African American PWID may be less likely than other racial groups to utilize health care in the United States. The present study evaluated the prevalence of health-care utilization (HCU) among a cohort of African American PWID in Baltimore. Data were from the 2012 Baltimore National HIV Behavioral Surveillance study. Participants were adult PWID and recruited using respondent-driven sampling (RDS). They completed a comprehensive sociobehavioral survey and voluntary HIV test with trained study interviewers. Analyses included descriptive and bivariate statistics to examine the prevalence of HCU, defined as seeing a health-care provider in the past year. Poisson regression assessed correlates of HCU. Participants were 61% male; 23% self-reported HIV seropositivity. Nearly 90% reported unemployment and/or disability; HCU prevalence was 85%. Significant negative correlates of HCU included age and higher injection frequency; positive correlates included previous incarceration and moderate financial stability. Interaction analyses showed unemployed publicly insured individuals had 30% higher HCU than unemployed and uninsured individuals (χ2 = 2.52; p <.05). There is a need to improve health-care utilization among PWID. High prevalence of disability was still found, despite insurance coverage and access to care in this population. While the recent Affordable Care Act has increased health-care coverage and access, our results suggest that is only a first step to improving health outcomes among PWID; targeted intervention to integrate these individuals is still needed.

Original languageEnglish (US)
Pages (from-to)344-362
Number of pages19
JournalJournal of Ethnicity in Substance Abuse
Issue number3
StatePublished - Jul 3 2017


  • African Americans
  • health disparities
  • health-care utilization
  • injection drug use

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health(social science)


Dive into the research topics of 'Sociodemographic and access-related correlates of health-care utilization among African American injection drug users: The BESURE study'. Together they form a unique fingerprint.

Cite this