Powelson Elisabeth, Lorvick Jennifer, Lutnick Alexandra, Wenger Lynn, Klausner Jeffery, Kral Alex H
1UC Berkeley-UCSF Joint Medical Program, Berkeley, California, USA.
Subst Use Misuse. 2014 Feb;49(3):243-52. doi: 10.3109/10826084.2013.825919. Epub 2013 Aug 23.
Methamphetamine use has increased substantially in the United States since the 1990s. Few studies have examined the healthcare service needs of women who use methamphetamine. This study describes unmet medical needs in a community-based sample of women who use methamphetamine in San Francisco, CA. Women who use methamphetamine were recruited in San Francisco and participated in a computer-assisted survey (N = 298 HIV-negative women). Multivariate analysis was performed to explore associations among sociodemographic variables, drug use, use of health and social services, and unmet healthcare need across three domains: chronic health problems, dermatologic problems, and women's preventive healthcare. Sixty-nine percent of participants reported a need for care for a chronic health condition, and 31% of them had an unmet need for care, in the last six months. Thirty-five percent of participants reported a need for dermatologic healthcare, and 66% had an unmet need for care in the last 6 months. Ninety-two percent of participants reported a need for women's preventive healthcare and 46% had an unmet need for care in the last year. Women who reported having a healthcare provider had lower odds of reporting an unmet need for a chronic health condition or women's preventive healthcare. Women who used a case manager had lower odds of having an unmet need for dermatologic care. A significant proportion of women who use methamphetamine in this sample had an unmet need for women's preventive healthcare, and overall these women had a significant unmet need for healthcare. These findings suggest that contact with a healthcare provider or a caseworker could help to expand access to healthcare for this vulnerable population.
自20世纪90年代以来,美国甲基苯丙胺的使用量大幅增加。很少有研究调查使用甲基苯丙胺的女性的医疗服务需求。本研究描述了加利福尼亚州旧金山一个以社区为基础的使用甲基苯丙胺的女性样本中未满足的医疗需求。在旧金山招募了使用甲基苯丙胺的女性,并让她们参与一项计算机辅助调查(N = 298名HIV阴性女性)。进行了多变量分析,以探讨社会人口统计学变量、药物使用、健康和社会服务的使用与三个领域未满足的医疗需求之间的关联:慢性健康问题、皮肤病问题和女性预防性医疗保健。69%的参与者报告需要治疗慢性健康状况,其中31%在过去六个月中有未满足的治疗需求。35%的参与者报告需要皮肤科医疗保健,66%在过去6个月中有未满足的治疗需求。92%的参与者报告需要女性预防性医疗保健,46%在过去一年中有未满足的治疗需求。报告有医疗服务提供者的女性报告未满足慢性健康状况或女性预防性医疗保健需求的几率较低。使用个案管理员的女性未满足皮肤科护理需求的几率较低。在这个样本中,很大一部分使用甲基苯丙胺的女性未满足女性预防性医疗保健需求,总体而言,这些女性有显著未满足的医疗需求。这些发现表明,与医疗服务提供者或个案工作者接触有助于为这一弱势群体扩大医疗保健服务的可及性。