ArticleThe Journal of infectious diseases2020
Healthcare Access and Utilization Among Persons Who Inject Drugs in Medicaid Expansion and Nonexpansion States: 22 United States Cities, 2018.
Article in The Journal of infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Barriers and facilitators to primary care engagement for people who inject drugs: A systematic review.Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2023Pooled it
- Informing the Equitable Implementation of Hepatitis C Interventions: Cost-Effectiveness Modeling in Rural Populations of People Who Inject Drugs.PharmacoEconomics · 2026Article
- Gender Differences in Adverse Childhood Experiences, Psychological Distress, and Substance Use Disorder Among Persons who Inject Drugs in Northeast Georgia, USA: A Moderated Mediation Analysis.Journal of child & adolescent trauma · 2026Article
- Infectious disease complications associated with opioid use disorder at a southern county hospital: a retrospective chart review.BMC infectious diseases · 2026Article
- Clinical and demographic characteristics of participants in a hepatitis C treatment trial in rural Kentucky: How policies around treatment access may impact elimination efforts in the United States.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Bacterial and fungal infections in persons who inject drugs.Clinical microbiology reviews · 2025Review
- Modeling the impact of changing drug markets and structural determinants on HCV and/or HIV transmission among people who inject drugs in the United States: A rural and urban comparison.The International journal on drug policy · 2025Article
- "You don't have the right resources to let it hurt": How structural vulnerabilities shape opioid withdrawal experiences among a community sample of people who inject drugs in Los Angeles, California.Harm reduction journal · 2025Article
- Considerations for equitable distribution of digital healthcare for people who use drugs.BMC health services research · 2025Observational
- Influence of insurance type on healthcare utilization among rural people who use drugs.Drug and alcohol dependence · 2025Article
- Common Bacterial Infections in Persons Who Inject Drugs.Medicines (Basel, Switzerland) · 2025Review
- State Medicaid Policies Governing Access to Medications for Opioid Use Disorder (MOUD) and MOUD Treatment Use in a Large Sample of People Who Inject Drugs in 20 U.S. States.Substance use & misuse · 2025Article
- Past-Year HIV Testing, Current Antiretroviral Therapy Use, and Participation in Services for People Who Inject Drugs.AIDS and behavior · 2024Article
- Continuing Low Awareness and Use of Pre-exposure Prophylaxis (PrEP) for HIV among People Who Inject Drugs (PWID), San Francisco, 2022.AIDS and behavior · 2024Article
- Understanding healthcare engagement for people who inject drugs.Research in nursing & health · 2024Article
- Funding and Delivery of Syringe Services Programs in the United States, 2022.American journal of public health · 2024Article
- Association of Medicaid expansion with health insurance, unmet need for medical care and substance use disorder treatment among people who inject drugs in 13 US states.Addiction (Abingdon, England) · 2024Article
- Correlates of Recent HIV Testing Among People Who Inject Drugs in Rural Areas: A Multi-site Cross-Sectional Study, 2018-2020.AIDS and behavior · 2024Article
- Hepatitis C Treatment Initiation Among US Medicaid Enrollees.JAMA network open · 2023Article
- Harm Reduction: A Missing Piece to the Holistic Care of Patients Who Inject Drugs.Open forum infectious diseases · 2023Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundMedicaid expansion under the Affordable Care Act increased insurance coverage, access to healthcare, and substance use disorder treatment, for many Americans. We assessed differences in healthcare access and utilization among persons who inject drugs (PWID) by state Medicaid expansion status.
methodsIn 2018, PWID were interviewed in 22 US cities for National HIV Behavioral Surveillance. We analyzed data from PWID aged 18-64 years who reported illicit use of opioids (n = 9957) in the past 12 months. Poisson regression models with robust standard errors were used to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were used to examine differences by Medicaid expansion status in indicators of healthcare access and utilization.
resultsPersons who inject drugs in Medicaid expansion states were more likely to have insurance (87% vs 36%; aPR, 2.3; 95% CI, 2.0-2.6), a usual source of healthcare (53% vs 34%; aPR, 1.5; 95% CI, 1.3-1.9), and have used medication-assisted treatment (61% vs 36%; aPR, 1.4; 95% CI, 1.1-1.7), and they were less likely to have an unmet need for care (21% vs 39%; aPR, 0.6; 95% CI, 0.4-0.7) than those in nonexpansion states.
conclusionsLow insurance coverage, healthcare access, and medication-assisted treatment utilization among PWID in some areas could hinder efforts to end the intertwined human immunodeficiency virus and opioid overdose epidemics.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.