371P
HIV/AIDS AND HOSPITAL UTILIZATION AMONG RECENTLY INCARCERATED INJECTION DRUG USERS
IL Goldstone1, T Kerr2, C Lai2, W Small2, J Montaner2, M Tyndall2
¹British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Providence Health Care, University of British Columbia; 2BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia
Background: The high rates of bloodborne pathogens and hospitalization among incarcerated injection drug users (IDU) have prompted questions about the potential utility of a forensic unit as part of the proposed redevelopment of St Paul's Hospital. The objectives of this analysis include examining the relationship between incarceration and hospitalization among IDU, and identifying factors associated with hospital utilization recently incarcerated IDU.
Methods: Community Health and Safety Evaluation (CHASE) Project is a prospective cohort that has enrolled 3158 downtown eastside residents between January 2003 and April 2004. Participants completed a brief baseline questionnaire. Survey data is linked to external health databases. Descriptive and univariate statistics were used to examine the association between incarceration and hospitalization, and factors associated with hospitalization among those recently incarcerated.
Results: Of 3158 participants, 1129 self-identified as IDU. Of these, 311 (28%) were women, and 349 (31%) reported being incarcerated in the previous six months at the time of their interview. Among those who reported recent incarceration, 110 (31.5%) reported being hospitalized in the previous six months. In univariate analyses, incarceration was associated with being hospitalized in the previous six months (OR=1.56, 95%CI: 1.17–2.06, p=0.002). Factors associated with hospitalization among recently incarcerated IDU included: HIV positivity (OR=1.73, 95%CI: 1.01–2.97, p=0.047), using HIV medications (OR=2.73, 95%CI: 1.38–5.40, p=0.004) and having a regular doctor (OR=1.62, 95%CI: 1.01–2.61, p=0.046). Having "slept outdoors" was marginally associated with hospitalization (OR=1.53, 95%CI: 0.96–2.43, p=0.075)
Conclusion: In this study, recent incarceration was associated with hospitalization among IDU. HIV positivity and use of HIV medications were associated with hospitalization among recently incarcerated IDU. These findings indicate the need for further consideration of the relationship between incarceration, HIV disease, and hospitalization and related interventions.