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APHA Scientific Session and Event Listing

Melissa A. Green, MPH¹, Frank M. Lombard, LCSW², Rae Jean Proescholdbell, PhD², Stephanie Bouis, MSW, LCSW³, Kathryn Whetten, MPH, PhD⁴, Katherine Cooper, MSW, LCSW⁵, Laura Musselwhite, MSW, LCSW⁵, and Evelyn Byrd Quinlivan, MD⁶. (1) Health Inequalities Program, Duke University, 110 Swift Ave, Ste 2, Box 90392, Durham, NC 27705, 919-416-4977, mgreen@hpolicy.duke.edu, (2) Center for Health Policy - Health Inequalities Program, Duke University, 302 Towerview Road, Rubenstein Hall, Durham, NC 27708, (3) Duke Addictions Program (DAP), Duke University, 2218 Elder St, DUMC Box 3516, Durham, NC 27705, (4) Center of Health Policy, Duke University, 302 Towerview Rd, Durham, NC 27708, (5) Dept of Medicine, Infectious Disease, University of North Carolina at Chapel Hill, CB#7030, First Floor, 101 Manning Drive, Chapel Hill, NC 27599-7030, (6) School of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill, 130 Mason Farm Road, CB 7030, Chapel Hill, NC 27599

Background: Alcohol and substance addiction (SA) are significant factors in medical treatment of patients living with HIV/AIDS. This study investigates the impact of integration process and the effect on patient health outcomes for an integrated SA and medical treatment model for PLWHA in the Southeast.

Methods: We integrated HIV and SA treatment services by co-locating behavioral health providers in 4 HIV clinics (2 university clinics and 2 community clinics). 187 PLWHA, receiving HIV treatment in the clinics, screened positive for SA and were enrolled in SA treatment. Qualitative interviews about the integration process were conducted with providers and staff (medical providers, behavioral health providers, peer educators, benefit advocates, social workers, and health educators) at each site.

Results: At baseline, 71% of participants were male, 80.7% were African American, and mean age was 43 years. Reported drug use at baseline included alcohol (44.9%), crack (32%), marijuana (28%), and heroin (2%). Provision of integrated medical and SA services to PLWHA is challenging but possible. Integration of care was achieved differently at each site. Through increased communication, providers developed informal cross-trained networks. Provision of care to diverse patients was possible. Cohort data includes employment, education, drug use, recent mental and physical health treatment, and risky behaviors.

Conclusions: Integrated HIV and SA treatment was feasible in different clinical settings (university and community), and required a tailored approach at each clinical site. Programs that deliver integrated behavioral interventions require multi-system buy-in to be successful, and may facilitate optimal health outcomes.

Learning Objectives: By the end of the session, participants will be able to

• List the key aspects of integration of HIV/SA treatment at site level.
• Identify changes that occur throughout program implementation.
• Describe the factors that aid and challenge integrated HIV/SA treatment.

Keywords: HIV/AIDS, Substance Abuse Treatment

Related Web page: www.hpolicy.duke.edu

Presenting author's disclosure statement:

Not Answered