Disparities in Health Services for HIV/AIDS, Hepatitis C Virus, and Sexually Transmitted Infections: Role of Substance Abuse Treatment Programs

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Abstract

Objectives:

This report focused upon the availability of infection-related health services in substance abuse treatment programs with and without addiction services tailored for special populations (women and non-white populations).

Methods:

In a cross-sectional, descriptive design, treatment program administrators across the United States within the National Drug Abuse Treatment Clinical Trials Network provided information on program characteristics, the availability of infection-related services (4 medical services and 3 nonmedical services for human immunodeficiency virus, hepatitis C virus, and sexually transmitted infections), and barriers to providing infection-related services.

Results:

Of 319 programs, 269 submitted surveys (84% response rate). Of these, 80% provided addiction services for special populations. Programs providing addiction services designed for at least one special population, were more likely to provide infection-related health services, especially human immunodeficiency virus-related education (94% vs 85%, P = 0.05) and patient counseling (76% vs 60%, P = 0.03) and were more likely to include outpatient addiction services (86% vs 57%, P < 0.001) and outreach and support services (92% vs 70%, P = 0.01). Barriers to providing infection-related services included funding (cited by 48.3%–74.7% of programs), health insurance (cited by 28.9%–60.8% of programs), and patient acceptance (cited by 23.2%–54.3% of programs).

Conclusions:

Despite many barriers, infection-related healthcare is available in programs with addiction treatment services tailored for special populations, especially for African Americans and Latino Americans. Tailoring substance abuse treatment along with reducing barriers to infection-related care represent public health interventions with potential to reduce the burdens and disparities associated with these infections.

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