ABSTRACT: Policies of name-based HIV reporting, partner notification (PN), and criminalization of non-disclosure of HIV positive status
to sexual partners remain controversial. The views of people living with HIV (PLH) are critical to the success of these three
initiatives, but have been understudied. Thus, we interviewed 76 PLH about these policies. Themes arose of potential public
health benefits (e.g., epidemiological surveillance and notification of possible exposure) and costs (e.g., deterrence of
testing); threats to privacy, civil rights and relationships; government mistrust; and beliefs that prevention is an individual,
not governmental responsibility. Misperceptions about the intent, content and scope of these policies, and past experiences
of discrimination, shaped these attitudes. To enhance development and implementation of HIV prevention strategies, the views
of PLH must be taken into account, and education campaigns need to address misperceptions and mistrust. These data shed light
on difficulties in developing and implementing policies that may affect sexual behavior, and have critical implications for
Sexuality Research and Social Policy: Journal of NSRC 04/2012; 1(3):38-57. · 0.72 Impact Factor
ABSTRACT: Background and Objectives: Associations of insurance coverage and source of care with use of human immunodeficiency virus (HIV)-related health, mental health, and substance abuse services are examined in a large, diverse, highly active antiretroviral therapy-era cohort.
Methods: Adults who were infected with HIV (n = 3818) were interviewed in clinics and community agencies in Los Angeles, Milwaukee, New York, and San Francisco regarding drug use behaviors, health status, and health care utilization.
Results: Most participants were insured by Medicaid. During the previous 3 months, 90% of privately insured, 87% of publicly insured, and 78% of uninsured participants had visited any provider. Publicly and privately insured participants were similar in receipt of antiretrovirals, prophylaxis against Pneumocystis carinii pneumonia, substance abuse services, and antidepressants. Uninsured participants were less likely to receive antiretrovirals but were more likely to use substance abuse services. Participants with no usual source of care were less likely to receive PCP prophylaxis.
Conclusions: A lack of insurance is associated with barriers to care, but the advantage of private over public coverage appears smaller than in previous studies. PCP prophylaxis, substance abuse treatment, and antidepressants remain markedly underutilized. Educational initiatives about these treatments targeting providers and patients are indicated.
Medical Care 03/2005; 43(4):401-410. · 3.41 Impact Factor
ABSTRACT: To examine predictors of the current level of substance use and reductions in seriousness of substance use among adults living with HIV.
Cross-sectional survey. Setting: Four major metropolitan areas of the United States.
Three thousand eight hundred six adults living with HIV.
Self-reported substance use, depression, and quality of life from audio computer assisted self-interviewing and computer assisted personal interviewing structured assessments.
Recent substance use of persons living with HIV was classified as frequent (40%), occasional (32%), or abstinent (28%). Participants using drugs at a frequent level identified as heterosexual, had public insurance, and had higher levels of depression. Participants who reduced from a lifetime high seriousness in substance use were female, older, and knew their HIV status for a longer period of time.
Screening and identification of substance use should be included in all treatment settings and community-based organizations serving adults living with HIV.
Drug and Alcohol Dependence 03/2005; 77(2):129-38. · 3.38 Impact Factor