Injection Drug Use and Healthcare Utilization in Patients Newly Diagnosed With HIV

Objectives: To determine recent trends in: (1) human immunodeficiency virus (HIV) diagnoses, (2) the proportion of patients newly diagnosed with HIV with injection drug use (IDU) and (3) patients' patterns of healthcare utilization in the year before diagnosis at an urban, academic medical center. Methods: We performed a cross sectional study of patients newly diagnosed with HIV at a healthcare system in southern New Jersey between January 1st, 2014 and December 31st, 2019. Patients 18 years or older with HIV diagnosed during the study period were included. Demographics, comorbidities, HIV test results, and healthcare utilization data were collected from the electronic medical record. Results: Of 192 patients newly diagnosed with HIV, 36 (19%) had documented IDU. New HIV diagnoses doubled from 22 to 47 annual cases between 2014 and 2019. The proportion of patients with newly diagnosed HIV and documented IDU increased from 9% in 2014 to 32% in 2019, chi-square test for linear trend P value = 0.001. Eighty-nine percent of patients with IDU had at least one contact with the healthcare system in the year before diagnosis compared to 63% of patients without IDU, P value 0.003. The median (interquartile range IQR) number of healthcare visits was 7 [2 - 16] for patients with IDU versus 1 [0 - 3] for patients without IDU, P < 0.001. Conclusions: We observed an increase in new HIV diagnoses with an increase in the proportion of newly diagnosed patients with IDU. Patients with newly diagnosed HIV and IDU had high rates of health care utilization in the year before diagnosis presenting an opportunity for intervention.