Association of Urban-Rural Residence and Concurrent HIV Infection and Opioid Use Disorder Among Medicare Beneficiaries—United States, 2020

• Published in: Journal of health care for the poor and underserved Vol. 33; no. 2; pp. 918 - 933
• Main Authors: Chang, Man-Huei, Moonesinghe, Ramal, Truman, Benedict I
• Format: Journal Article
• Language: English
• Published: United States Johns Hopkins University Press 01.05.2022
• Subjects: Aged; Beneficiaries; Drug abuse; Fee-for-Service Plans; Government programs; Health risks; HIV; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Male; Medicare; Narcotics; Opioid-Related Disorders - epidemiology; Opioids; Risk factors; Rural areas; Rural Population; Sexually transmitted diseases; STD; Substance use disorder; United States - epidemiology; Urban areas; United States
• ISSN: 1049-2089; 1548-6869; 1548-6869
• DOI: 10.1353/hpu.2022.0072

Published research provides minimal insights into variation by urban or rural residence of HIV infection risk and injection drug use. We used the 2020 Medicare claims data to assess the association of urban-rural residence and concurrent HIV infection and opioid use disorder (OUD), adjusted for demographic risk factors, among Medicare beneficiaries (MBs) with fee-for-service claims paid during 2020. Medicare beneficiaries with both HIV infection and OUD were more likely than those without to be aged ≤64 years, male, Black, residing in the U.S. Northeast, residing in an urban county, and to have one or more comorbid condition. Medicare beneficiaries who lived in urban counties had higher odds (adjusted odds ratio 4.04; 95% confidence interval 3.72, 4.39) of having HIV and OUD than those who lived in rural counties. Urban-rural residence was associated with concurrent HIV infection and OUD, independent of age, sex, race/ethnicity, and comorbidity among MBs with claims paid during 2020.