Health care utilization among young adult injection drug users in Harlem, New York

Purpose: This cross-sectional study investigated the predictors for and pat terns of health care utilization among young adult injection drug users (ID Us). Methods: The subjects were 206 IDUs, ages 18-29, who were street-recru ited from Harlem, New York. Participants were interviewed about their drug use, health conditions, and use of services such as health care, needle exc hange programs (NEPs), and drug treatment in the preceding 6 months. Data w ere analyzed using logistic regression. Results: Health insurance was assoc iated with use of health care both among NEP users [AOR (adjusted odds rati o) 10.66] and non-NEP users (AOR 2.45). Use of health care was independentl y associated with drug treatment (AOR 2.58), being gay/bisexual (AOR 3.86), and negatively associated with injecting cocaine (AOR 0.56). Half the part icipants (49%) had used health care in the previous 6 months: 48% were unin sured. Many participants who did not use health services reported a conditi on that would have warranted medical care. Implications: Health insurance w as strongly associated with use of health care, particularly among those wh o attend NEPs. Young adult IDUs may benefit from increased efforts to help them arrange and maintain health insurance coverage, potentially at NEPs. N EPs may be connecting young IDUs with health insurance to medical care thro ugh referrals. (C) 2001 Elsevier Science Inc. All rights reserved.