ArticleBMC public health2018
Perceived access and barriers to care among illicit drug users and hazardous drinkers: findings from the Seek, Test, Treat, and Retain data harmonization initiative (STTR).
Article in BMC public health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers.
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Who cites it
42 citing papers in PubMed, 67 citations in OpenAlex.
- A randomized control trial of a combined community health worker and re-entry intervention for people with HIV recently released from jail who use substances.Journal of substance use and addiction treatment · 2023Trial
- A community approach to promote healthcare services for people living with HIV who use drugs in Vietnam.International journal of STD & AIDS · 2022Trial
- Impact of structurally transphobic policy environment on harmful alcohol and substance use among transgender and nonbinary adults.Scientific reports · 2025Article
- Health service needs, use, and barriers among formerly incarcerated women survivors of sexual violence.European journal of psychotraumatology · 2025Article
- Understanding motives for illicit medicinal cannabis use: an exploratory analysis in a medical cannabis program.Journal of cannabis research · 2025Article
- Diabetes Screening in the Emergency Department: Development of a Predictive Model for Elevated Hemoglobin A1c.Journal of diabetes research · 2025Article
- Colorectal Cancer Screening Among Individuals With a Substance Use Disorder: A Retrospective Cohort Study.AJPM focus · 2024Article
- Users' Acceptability and Perceived Efficacy of mHealth for Opioid Use Disorder: Scoping Review.JMIR mHealth and uHealth · 2024Article
- Barriers to and facilitators of screening for cervical and breast cancer: Experiences of non-adherent women with current or previous drug use.Preventive medicine reports · 2024Article
- Client perspectives on primary care integration in a rural-serving behavioral health center.Journal of integrated care (Brighton, England) · 2024Article
- Unraveling substance abuse among Malawian street children: A qualitative exploration.PloS one · 2024Article
- Staphylococcus aureus bacteremia in alcoholics.PloS one · 2024Article
- Article
- Uptake of SARS-CoV-2 vaccination among structurally-marginalized people who use drugs in Vancouver, Canada.Scientific reports · 2023Article
- Trends in the Prevalence of Hepatitis C Infection During Pregnancy and Maternal-Infant Outcomes in the US, 1998 to 2018.JAMA network open · 2023Article
- Treatment barriers among young adults living with a substance use disorder in Tshwane, South Africa.Substance abuse treatment, prevention, and policy · 2022Article
- Using nominal group technique to identify barriers and facilitators to preventing HIV using combination same-day pre-exposure prophylaxis and medications for opioid use disorder.Harm reduction journal · 2022Article
- Testing for Drug-Related Infectious Diseases and Determinants among People Who Use Drugs in a Low-Resource Setting: A Respondent-Driven Cross-Sectional Survey.Tropical medicine and infectious disease · 2022Article
- A qualitative study of service engagement and unmet needs among unstably housed people who inject drugs in Massachusetts.Journal of substance abuse treatment · 2022Article
- Stigma and ART initiation among people with HIV and a lifetime history of illicit drug use in Saint-Petersburg, Russia-A prospective cohort analysis.The International journal on drug policy · 2022Article
Corrections and comments
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Authors and funding
9 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundIllicit drug use (DU) and hazardous drinking (HD) among marginalized populations may be associated with greater barriers to care.
methodsWe used baseline data on the participants of the Seek, Test, Treat, and Retain data harmonization initiative. DU includes use of any illicit drugs within the past 6 months. HD was defined as scores ≥8 for men and ≥ 7 for women on Alcohol Use Disorders Identification Test within the past 12 months. Social support scores were assigned by summing scores from individual questions related to social support. Two outcomes for multivariable regression models and mediation analysis were perceived access to care and perceived barriers to care scores, calculated from summated points from individual questions within each domain. All models were adjusted for age, gender, race/ethnicity, and social support and stratified by HIV status.
resultsAmong 1403 illicit drug users and 4984 non-drug users, the mean age was 39.6 ± 12.2 years old, 71% were male, 57% African Americans, and 39% Hispanic/Latinos. Over 25% reported difficulties in covering medical costs and finding transportation to health care facilities and greater proportions of drug users and hazardous drinkers reported these issues than non-DU/non-HD. In multivariable models, DU and HD were both independently associated with having greater barriers to care (β: 0.49 (95% confidence interval: 0.19 to 0.79) p < 0.01; 0.31 (0.18 to 0.45) < 0.01) in HIV-negative participants. Neither DU nor HD was strongly associated with barriers to care for HIV-positive participants. Social support was associated with better perceived access to care and fewer barriers to care in the HIV-negative participants.
conclusionThe current study found that financial burdens of care, logistical difficulties in accessing care, and low social support were common challenges among individuals using illicit drugs and/or drinking hazardously. Addressing structural barriers and strengthening social support may be important strategies to improve health care among marginalized populations, regardless of HIV status.
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