Provider Discussions May Improve Substance Abuse Treatment in HIV-infected Persons
Substance abuse treatment (SAT) is a critical component in preventing the spread of HIV infection and is associated with improved HIV outcomes. This study examined factors associated with SAT, including patient–provider discussions of substance abuse, among people with HIV. Researchers conducted interviews with 951 HIV-infected adults receiving care at 14 sites in the HIV Research Network, a consortium of HIV research centers. Seventy-one percent of respondents reported current (past 6- month) (36%) or lifetime (35%) drug use.
Twenty-four percent of current or former users reported receiving SAT in the preceding 6 months.
Less than half (46%) of current or former users reported discussing substance use with their provider, with current users having such discussions more frequently than former users (56% versus 35%, p<.001).
Patients who participated in such discussions were more than twice as likely to have received SAT than those who did not (odds ratio, 2.12; confidence interval, 1.31– 3.41).
Current users who participated in such discussions received treatment more frequently than those who did not (26% versus 14%, p=.006). This was also true of former users (38% versus 21%, p=.002).
These findings reinforce the need to increase the opportunities for linkage between substance abuse treatment and HIV primary care. Although HIV primary care providers are faced with many demands, they should be encouraged to screen for and counsel patients about substance use.Julia H. Arnsten, MD, MPH
Korthuis PT, Josephs JS, Fleishman JA, et al. Substance abuse treatment in human immunodeficiency virus: the role of patient-provider discussions. J Subst Abuse Treat. 2008;35 (3):294–303.