Provider barriers to prescribing HAART to medically-eligible HIV-infected drug users.

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Bibliographic Details
Title: Provider barriers to prescribing HAART to medically-eligible HIV-infected drug users.
Authors: Loughlin, A. (AUTHOR), Metsch, L. (AUTHOR), Gardner, L. (AUTHOR), Anderson-mahoney, P. (AUTHOR), Barrigan, M. (AUTHOR), Strathdee, S. (AUTHOR)
Source: AIDS Care. May2004, Vol. 16 Issue 4, p485-500. 16p.
Subjects: HIV infections, Drug abuse, Population, Social services, Mental health, Antiviral agents
Abstract: We aimed to identify factors associated with a medical provider's resistance to prescribing HAART to medically-eligible HIV-infected illicit drug users. In four US cities, a mailed, self- administered survey queried 420 HIV care providers about patients' characteristics and barriers to care. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were estimated using logistic regression. Providers identified as resistant to prescribing HAART to medically-eligible HIV-infected illicit drug users were more likely to be non-physicians (AOR = 1.89, 95% CI: 1.04-3.46), to work in populations with a high prevalence of both mental illness (AOR =2.42; 95% CI: 1.11-5.26) and injection drug use (AOR = 1.82 95% CI: 1.02-3.25) and were deterred from prescribing HAART by patients' limited ability to keep appointments, (AOR =3.19; 95% CI: 1.39-7.37), alcoholism (AOR = 1.92; 95% CI: 1. 04-3. 55) and homelessness (AOR = 1.81; 95% CI: 1.07-3.06). Providers working in populations with a high injection drug use prevalence commonly reported higher prevalence of non-injection drug use, alcohol problems and mental illness, and higher antiretroviral therapy refusal rates within their patient populations. Our findings underscore the challenges to providers who treat HIV-infected drug users and suggest that their care and treatment would benefit from on-site drug treatment, mental health and social services. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
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Abstract:We aimed to identify factors associated with a medical provider's resistance to prescribing HAART to medically-eligible HIV-infected illicit drug users. In four US cities, a mailed, self- administered survey queried 420 HIV care providers about patients' characteristics and barriers to care. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were estimated using logistic regression. Providers identified as resistant to prescribing HAART to medically-eligible HIV-infected illicit drug users were more likely to be non-physicians (AOR = 1.89, 95% CI: 1.04-3.46), to work in populations with a high prevalence of both mental illness (AOR =2.42; 95% CI: 1.11-5.26) and injection drug use (AOR = 1.82 95% CI: 1.02-3.25) and were deterred from prescribing HAART by patients' limited ability to keep appointments, (AOR =3.19; 95% CI: 1.39-7.37), alcoholism (AOR = 1.92; 95% CI: 1. 04-3. 55) and homelessness (AOR = 1.81; 95% CI: 1.07-3.06). Providers working in populations with a high injection drug use prevalence commonly reported higher prevalence of non-injection drug use, alcohol problems and mental illness, and higher antiretroviral therapy refusal rates within their patient populations. Our findings underscore the challenges to providers who treat HIV-infected drug users and suggest that their care and treatment would benefit from on-site drug treatment, mental health and social services. [ABSTRACT FROM AUTHOR]
ISSN:09540121
DOI:10.1080/09540120410001683411