Social factors related to antiretroviral therapy use in injection drug users

This study applied a behavioral model of health services use that included health-related attitudes and indicators of social contact and support to use of antiretroviral therapy “ART” in a cross-sectional survey of 241 disadvantaged, inner-city injection drug users “IDUs”. Only 44% of this sample reported taking ART despite relatively high levels of health care utilization; ART nonuse was associated with distrust of physicians “OR = 4.76, 95 % CI 1.75-13.5”. In a logistic regression model that controlled for severity of HIV disease and access to health care, the belief that HIV medications make the respondent feel healthier “OR = 3.24, 95% CI 1.70-6.15” and increased social isolation since becoming HIV-positive “OR = 2.60, 95% CI 1.38-4.89” were correlated with ART use. These findings underscore the importance of including social and behavioral characteristics in models that attempt to explain ART use by marginalized populations.