Primary Care Use among HIV Positive Inpatients at an Inner City Public Hospital: The Impact of Crack Cocaine Use

Abstract

We studied factors associated with HIV care utilization in symptomatic HIV-positive crack-using and non-using patients at a public hospital in Miami, Florida. A bedside survey conducted with 89 HIV-positive crack-users and 93 HIV-positive non-users examined health care knowledge, perceived health status, drug use, and HIV care patterns. A multi-nominal model was utilized to calculate the adjusted odds ratio (AOR) of three levels of care: currently receiving care (having seen an HIV provider in the past 4 months), having dropped out of care (having seen an HIV provider at least once but not in the past 4 months), and never having seen an HIV provider. Crack use and homelessness were associated with having dropped out of care. Better knowledge of HIV, living with HIV for a longer time, and being employed were associated with currently being in care. Attention to socioeconomic factors and substance abuse rehabilitation is needed to improve treatment outcomes.