[Health services utilization according to gender in a cohort of intravenous drug users infected with HIV].

BACKGROUND AND

OBJECTIVE

Gender differences among HIV infected persons have been described in the utilization of health-care services and in their access to anti-retroviral and prophylactic treatments. The aim of this study was to determine the characteristics of the health service utilization according to gender in a cohort of intravenous drug users (IVDU) with HIV infection.

PATIENTS AND METHOD: Prospective cohort study of 926 IVDU who tested positive for HIV infection in their first visit between January 1987 and December 1996. These participants generated 3,429 visits in different health-care centers. Odds ratio (OR) and their 95% confidence intervals (95%CI) were estimated by multiple logistic regression analysis using robust methods.

RESULTS

Out of 926 subjects, 25.4% were women. Although there were not clear differences by sex in the use of health-care centers, we observed that since the introduction of highly active antiretroviral treatments (HAART) men have had fewer hospital admission than women (OR = 0.50; 95%CI: 0.25-0.99). Moreover, once HAART was started, men received higher prescriptions of antiretroviral treatment than women (OR = 1.30; 95%CI: 0.97-1.24), as well as a higher number of prescriptions for prevention of tuberculosis (OR = 2.22; 95%CI: 1.24-4.16) and Pneumocystis carinii pneumonia (PCP) (OR = 1.50; 95%CI: 1.17-1.91). These associations were attenuated when sociodemographic and clinical status variables were taken into account, except for PCP treatment.

CONCLUSION

No relevant differences according to gender were observed in the care of HIV disease. The benefits of HAART may have a minor impact among women in the short term, depending on prescriptions and the other variables considered. These findings must be confirmed by studies with longer follow-up periods.