215281 HIV/AIDS-related health services in substance abuse treatment programs

Monday, November 8, 2010 : 4:30 PM - 4:50 PM

Lawrence S. Brown Jr., MD, MPH, FASAM , Division of Medical Services, Research and Information Technology, Addiction Research and Treatment Corporation, Brooklyn, NY
Steven Kritz, MD , Division of Medical Services, Research and Information Technology, Addiction Research and Treatment Corporation, Brooklyn, NY
Edmund J. Bini, MD, MPH , Division of Gastroenterology, VA NY Harbor Healthcare System and NYU School of Medicine, New York, NY
James Robinson, MEd , Nathan Kline Institute for Psychiatric Research, Orangeburg, NY
John Rotrosen, MD , Department of Psychiatry, New York University School of Medicine, New York, NY
     
Issues: In a cross-sectional, descriptive, hypothesis-generating design, 269 of 319 treatment program administrators within the National Drug Abuse Treatment Clinical Trials Network provided information utilizing a standardized survey regarding program characteristics, patient characteristics, and availability of HIV services for 3 categories of patients: 6 services for all patients, 6 for newly admitted patients, and 11 for HIV infected patients.

Description: The range of HIV-related services provided on-site or via contractual arrangements varied from 10% (Pneumococcal vaccination) to 86% (drug testing). HIV antibody testing was provided by 57% of programs co-located in hospitals, medical schools, and universities, as compared to 35% of programs in family health or mental health facilities, 30% of free-standing agencies, and 50% in other settings (p=0.045). Compared to programs without outpatient pharmacotherapy, programs providing outpatient pharmacotherapy provided a higher mean number of HIV-related services for all patients, for newly admitted patients, and for HIV-infected patients (all p<0.0001). HIV-related services were significantly more available in programs where patients engaged in high risk sexual behaviors and had higher HIV infection rates.

Lessons Learned: The results of this study provide a plausible mechanism of how substance abuse treatment reduces HIV transmission via the availability of HIV prevention and medical services, and provides the basis for future hypothesis-testing examining the utilization, effectiveness, and cost-effectiveness of HIV-related health services in substance abuse treatment.

Recommendations: Given the public health significance of HIV disease and the role of substance use in its transmission, further studies are imperative.

Learning Areas:
Administration, management, leadership
Protection of the public in relation to communicable diseases including prevention or control
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe availability of HIV-related services in substance abuse treatment programs

Keywords: Substance Abuse Treatment, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the Principal Investigator for the study described in this abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3379.0: HIV/AIDS and Hepatitis in Substance Use Settings