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

This study, part of protocol CTN-0012, examined availability of HIV services in substance abuse programs participating in the National Drug Abuse Treatment Clinical Trials Network (CTN), and associations between services, characteristics of programs, and patients treated. 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 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. 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. HIV-related services were significantly more available in programs where patients engaged in high risk sexual behaviors and had higher HIV infection rates.

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

Related protocols: CTN-0012