Factors Associated with Substance-Abuse Treatment Utilization among Patients Living with HIV/AIDS Who Use Alcohol and Other Drugs

Use of alcohol and other drugs (AOD) is prevalent in the general population but is disproportionately higher among patients living with HIV/AIDS, among whom it is associated with medication nonadherence, poor treatment outcomes, and engagement in HIV/AIDS risk behaviors. This analysis explored the factors associated with self-reported substance-abuse treatment utilization in a prospective cohort of individuals living with HIV/AIDS with AOD problems ranging from risky use to dependence (N=369). The Anderson model was used to identify independent variables potentially associated with substance-abuse treatment utilization.
 

• Twelve percent of the sample met criteria for current alcohol dependence, while 43% met criteria for current drug dependence.

• The following factors had an inverse relationship with substance-abuse treatment utilization:
• alcohol dependence (adjusted odds ratio [AOR], 0.36).
• sexual orientation other than heterosexual (AOR, 0.46).
• social supports who use AOD (AOR, 0.62).
• The following factors were directly associated with substance-abuse treatment utilization:
• hepatitis-C positive (AOR, 3.37).
• history of physical or sexual abuse (AOR, 2.12).
• social supports promoting sobriety (AOR, 1.92).
• homelessness (AOR, 2.40).
• drug dependence (AOR, 2.64).
• depressive symptoms (AOR, 1.52).

Comments:

This study identified several non-need factors associated with substance-abuse treatment utilization including sexual orientation, history of physical or sexual abuse, depression, homelessness, and characteristics of social support. Although treatment utilization was self-reported and these associations do not reflect causality, the findings may inform development of strategies to motivate this population both to engage in substance abuse treatment and to make use of resources provided by treatment providers.

Jeanette M. Tetrault, MD

Reference:

Orwat J, Saitz R, Tompkins CP, et al. Substance abuse treatment utilization among adults living with HIV/AIDS and alcohol or drug problems. J Subst Abuse Treat. 2011;41(3):233–242.