The primary goal of this research project is to identify affordable and high quality care for intravenous drug using AIDS patients. To accomplish this goal we will first identify how IVDUs with AIDS search for and obtain care while diagnosed with a terminal illness. By identifying and understanding the behavioral patterns characteristic of IVDUs as they attempt to find and obtain care for AIDS, a cost-effective and humane model of health care delivery can be developed which meets the needs of this specialized population of AIDS patients. To identify patterns which are unique to male IVDUs with AIDS, comparisons will be made with gay male AIDS patients as well as with a group of female IVDUs with AIDS. Together these groups of AIDS patients will be compared to cancer patients, a group diagnosed with a disease that could result in a terminal outcome, matched on the basis of age, sex, income and ethnicity. Excess differences among the three groups of AIDS patients beyond the four variables controlled for by the matching strategy can be attributed to the effects of the AIDS diagnosis. Further, direct comparisons can be made between the three separate groups of AIDS patients and their corresponding cancer matches to determine what the effects of the AIDS diagnosis have been within each particular group. This design has been adopted so that the independent effects of an AIDS diagnosis not attributable to confounding socioeconomic variables are identified. The model of care to be developed will be designed to 1) increase access to care for IVDUs with AIDS, 2) decrease hospitalization costs; 3) strengthen family and social network ties, 4) increase ability by IVDUs to end drug problems, and, 5) prevent further HIV infection from or within this group. By examining the efforts of AIDS patients in New Jersey to obtain care, by assessing their level of satisfaction with the care that is received, and by measuring the associated costs, one gains much insight into the optimal balance between the quality and cost of different kinds of care for different kinds of AIDS patients.
