{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T17:38:53Z","timestamp":1760204333792},"reference-count":21,"publisher":"American Public Health Association","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[1991,10]]},"abstract":"<jats:p> BACKGROUND. Intravenous drug users (IVDUs) with human immunodeficiency virus (HIV) infection and AIDS often have no health insurance or rely on public programs to finance their health care. We examined the independent contributions of HIV serostatus, clinical symptoms, CD4 cell counts, and health insurance to utilization of health services among 1881 intravenous drug users in Baltimore, Maryland. METHODS. Participants in an ongoing natural history study of HIV were informed of HIV serostatus and seropositives were informed of CD4 cell counts; 6 months later, participants were administered a questionnaire concerning self-reported use of health services, insurance coverage, and HIV-related symptoms. RESULTS. Of 1881 participants, 67% had health insurance (including Medicaid), 48% had at least one outpatient visit, and 12% had at least one inpatient visit within the prior 6 months. The proportion of the study population that was HIV-1 seropositive was 32%. In multivariate analysis, the single most important predictor of health care utilization was the presence of two or more HIV-related clinical symptoms. HIV positive serostatus alone or known low CD4 counts were not significantly associated with use of health care services. CONCLUSIONS. These data suggest that HIV seropositive IVDUs are not receiving recommended preventive care. Additional efforts will be needed to ensure that HIV-seropositive drug users participate in currently recommended protocols for early treatment of asymptomatic HIV-1 infection. <\/jats:p>","DOI":"10.2105\/ajph.81.10.1285","type":"journal-article","created":{"date-parts":[[2008,11,29]],"date-time":"2008-11-29T13:17:08Z","timestamp":1227964628000},"page":"1285-1290","source":"Crossref","is-referenced-by-count":85,"title":["Utilization of health services in a cohort of intravenous drug users with known HIV-1 serostatus."],"prefix":"10.2105","volume":"81","author":[{"given":"L","family":"Solomon","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Frank","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Vlahov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Astemborski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"844","reference":[{"key":"p_1","unstructured":"National Institute on Drug Abuse. AIDS and Intravenous Drug Abuse among Minorities. Rockville, MD: USDepartmentof Health and Human Services, 1989."},{"key":"p_2","doi-asserted-by":"publisher","DOI":"10.1089\/aid.1.1986.2.249"},{"key":"p_3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1989.03420180101039"},{"key":"p_4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1989.03420160030008"},{"key":"p_5","doi-asserted-by":"publisher","DOI":"10.1126\/science.3340847"},{"key":"p_6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1990.03450100051024"},{"key":"p_7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1987.03400100077024"},{"key":"p_8","doi-asserted-by":"crossref","unstructured":"Iglehart JK. Financing the struggle against AIDS. N EnglJ MetL 1987;317:180-184.","DOI":"10.1056\/NEJM198707163170333"},{"key":"p_9","doi-asserted-by":"crossref","unstructured":"Scitovsky AA. The economic impact of AIDS in the United States. Health Aff 1988;Fall:7:32-45.","DOI":"10.1377\/hlthaff.7.4.32"},{"key":"p_10","first-page":"1","volume":"38","author":"Centers for Disease Control","year":"1989","journal-title":"MMWR"},{"key":"p_12","unstructured":"Vlahov D, Anthony JC, Munoz A, etal. The ALIVE study: a longitudinal study of HIV-1 infection in IVDUs; description of methods. In: Amsel S, Genser SG, Hartsock PI, eds. Longiudiua Studies ofHW Infecton amngIVD Us. Washington, DC: NIDA Research Monograph; 1990; Senes No. 109, 1991."},{"key":"p_13","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.77.8.4914"},{"key":"p_14","doi-asserted-by":"crossref","unstructured":"Volberding PA, Lagakos SW, Koch MA, etal. Zidovudine in asymptomatic human immunodeficiency virus infection: a controlled trial in persons with fewer than 500 CD4-positive cells per cubic millimeter. N EnglJMedL 1990;322:941-949.","DOI":"10.1056\/NEJM199004053221401"},{"key":"p_15","doi-asserted-by":"crossref","unstructured":"Brown BW, Hollander M. Statistics: A Biomedical Introducfion New York: John Wiley and Sons; 1977.","DOI":"10.1002\/9780470316474"},{"key":"p_16","doi-asserted-by":"crossref","unstructured":"Maddala GS. Limited-Dependent and Qualitative Vanables in Econometncs. Cambridge, England: Cambridge University Press; 1983.","DOI":"10.1017\/CBO9780511810176"},{"key":"p_17","doi-asserted-by":"publisher","DOI":"10.2307\/2526423"},{"key":"p_18","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-198505000-00009"},{"key":"p_19","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198112173052504"},{"key":"p_20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198905113201905"},{"key":"p_21","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-103-5-755"},{"key":"p_22","doi-asserted-by":"crossref","unstructured":"Dans PE, Matriciccinai RM, Otter SE, Reuland DS. Intravenous drug abuse and one academic health center. JAMA4. 1990; 263:3173-3176.","DOI":"10.1001\/jama.263.23.3173"}],"container-title":["American Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ajph.aphapublications.org\/doi\/pdf\/10.2105\/AJPH.81.10.1285","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T18:23:13Z","timestamp":1652120593000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajph.aphapublications.org\/doi\/full\/10.2105\/AJPH.81.10.1285"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1991,10]]},"references-count":21,"journal-issue":{"issue":"10","published-print":{"date-parts":[[1991,10]]}},"alternative-id":["10.2105\/AJPH.81.10.1285"],"URL":"https:\/\/doi.org\/10.2105\/ajph.81.10.1285","relation":{},"ISSN":["0090-0036","1541-0048"],"issn-type":[{"value":"0090-0036","type":"print"},{"value":"1541-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[1991,10]]}}}