Association Between Primary Care Provider Status and Preventive Health Care Among People Who Inject Drugs

Abstract

Introduction: People who inject drugs (PWID) are at increased risk for preventable, communicable infections, such as hepatitis B. Preventive care, such as hepatitis B vaccination, is often delivered through primary care providers (PCPs). However, PWID may not have access to PCPs and, therefore, may receive preventive care through other sites. We aimed to characterize PCP and preventive care use among PWID in Maine. Methods: This is a cross-sectional study of PWID hospitalized with infections associated with injection drug use in Maine from January 2019 to May 2020. Descriptive analyses were used to identify characteristics of participants, rates of screening, and vaccination of participants with and without PCPs. Logistic regression analyses were performed to explore the relationship between PCP status and delivery of preventive services for PWID. Hepatitis B vaccination was an outcome of interest. Results: Of 101 participants, 68 (67%) had a PCP. Overall rates of hepatitis C (93%) and HIV (85%) screening were high and did not differ based on PCP status. More participants with PCPs had previously received a hepatitis B vaccination (62% of those with PCPs, 33% of those without PCPs; P = .006). Only half of those with PCPs recalled receiving a hepatitis B vaccination through a PCP office. Having a PCP was predictive of having received the hepatitis B vaccination (adjusted odds ratio, 3.59; 95% CI, 1.27-7.58; P = .014). Conclusions: Many PWID in Maine engage with PCPs and preventive care. Results from this study call for enhanced delivery of preventive services and linkages to care for PWID.