TY - JOUR
T1 - Hepatitis and HIV risk among drug-using men who have sex with men
T2 - Demonstration of Hart's law of inverse access and application to HIV
AU - Ostrow, David G.
AU - Vanable, Peter A.
AU - McKirnan, David J.
AU - Brown, Lauren
N1 - Funding Information:
This research was funded by a grant (DA-RO1-09944) from the U.S. National Insitute on Drug Abuse (NIDA) to the Howard Brown Health Center of Chicago. The authors thank the participants and the AIM staff: Jeff Arner, Douglas Bell, Lori Black-well, Tom Buckingham, Will Damon, Kellie Dyslin, Brent Hope, Marcus Moody, Porris Powell, & Jod Taywaditep. In addition, we wish to acknowledge our close friend and collaborator, Dr. Michael Ross, who first brought the concept of Hart's Law to our attention.
PY - 1999
Y1 - 1999
N2 - Objectives: The first 215 drug-using men who have sex with men (DU-MSM) evaluated for possible participation in a controlled behavioral intervention study were tested for 'Hart's law of inverse access,' which predicts that access to prevention resources varies inversely to need. Methods: Hepatitis B vaccination, mental health, and substance abuse treatment were used to measure health resource use; hepatitis B (HBV) and HIV infections and unsafe sex measured preventive care needs. Socioeconomic status indicators included education, ethnicity, and income. Results: HBV-vaccinated men were more likely to be white and college educated. HBV-infected men were more likely to be black, older, HIV-positive, and have higher rates of substance use with sex. When stratified according to socioeconomic status indicators, levels of HBV vaccination were inverse to the rates of HBV and HIV infection. This relationship was not found for psychosocial treatment utilization. Conclusions: Demonstration of Hart's law among high-risk DU-MSM has important implications for future HIV prevention efforts among high-risk individuals. Combining HIV, hepatitis, and substance abuse prevention in primary care and substance abuse treatment settings is discussed.
AB - Objectives: The first 215 drug-using men who have sex with men (DU-MSM) evaluated for possible participation in a controlled behavioral intervention study were tested for 'Hart's law of inverse access,' which predicts that access to prevention resources varies inversely to need. Methods: Hepatitis B vaccination, mental health, and substance abuse treatment were used to measure health resource use; hepatitis B (HBV) and HIV infections and unsafe sex measured preventive care needs. Socioeconomic status indicators included education, ethnicity, and income. Results: HBV-vaccinated men were more likely to be white and college educated. HBV-infected men were more likely to be black, older, HIV-positive, and have higher rates of substance use with sex. When stratified according to socioeconomic status indicators, levels of HBV vaccination were inverse to the rates of HBV and HIV infection. This relationship was not found for psychosocial treatment utilization. Conclusions: Demonstration of Hart's law among high-risk DU-MSM has important implications for future HIV prevention efforts among high-risk individuals. Combining HIV, hepatitis, and substance abuse prevention in primary care and substance abuse treatment settings is discussed.
KW - HIV epidemiology
KW - Hart's inverse care law
KW - Hepatitis B
KW - Prevention
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U2 - 10.1023/A:1022650919410
DO - 10.1023/A:1022650919410
M3 - Article
AN - SCOPUS:0033510968
SN - 1090-7173
VL - 3
SP - 127
EP - 136
JO - Journal of the Gay and Lesbian Medical Association
JF - Journal of the Gay and Lesbian Medical Association
IS - 4
ER -