Aletraris Lydia, Roman Paul M
Owens Institute for Behavioral Research, 112 Barrow Hall, University of Georgia, Athens GA, 30602 USA.
Owens Institute for Behavioral Research, 106 Barrow Hall, University of Georgia, Athens GA, 30602, USA.
J Subst Abuse Treat. 2015 Oct;57:1-8. doi: 10.1016/j.jsat.2015.04.005. Epub 2015 Apr 13.
The provision of HIV education and testing in substance use disorder (SUD) treatment programs is an important public health strategy for reducing HIV incidence. For many at-risk individuals, SUD treatment represents the primary point of access for testing and receiving HIV-related services. This study uses two waves of nationally representative data of 265 privately-funded SUD treatment programs in the U.S. to examine organizational and patient characteristics associated with offering a dedicated HIV/AIDS treatment track, onsite HIV/AIDS support groups, and onsite HIV testing. Our longitudinal analysis indicated that the majority of treatment programs reported providing education and prevention services, but there was a small, yet significant, decline in the number of programs providing these services. Programs placed more of an emphasis on providing information on the transmission of HIV rather than on acquiring risk-reduction skills. There was a notable and significant increase (from 26.0% to 31.7%) in programs that offered onsite HIV testing, including rapid HIV testing, and an increase in the percentage of patients who received testing in the programs. Larger programs were more likely to offer a dedicated HIV/AIDS treatment track and to offer onsite HIV/AIDS support groups, while accredited programs and programs with a medical infrastructure were more likely to provide HIV testing. The percentage of injection drug users was positively linked to the availability of specialized HIV/AIDS tracks and HIV/AIDS support groups, and the percentage of female clients was associated with the availability of onsite support groups. The odds of offering HIV/AIDS support groups were also greater in programs that had a dedicated LGBT track. The findings suggest that access to hospitals and medical care services is an effective way to facilitate adoption of HIV services and that programs are providing a needed service among a group of patients who have a heightened risk of HIV transmission. Nonetheless, the fact that fewer than one third of programs offered onsite testing, and, of the ones that did, fewer than one third of their patients received testing, raises concern in light of federal guidelines.
在物质使用障碍（SUD）治疗项目中提供艾滋病病毒（HIV）教育和检测是降低HIV发病率的一项重要公共卫生策略。对于许多高危个体而言，SUD治疗是进行检测及获得HIV相关服务的主要途径。本研究利用来自美国265个私人资助的SUD治疗项目的两波具有全国代表性的数据，来考察与提供专门的HIV/AIDS治疗路径、现场HIV/AIDS支持小组及现场HIV检测相关的机构和患者特征。我们的纵向分析表明，大多数治疗项目报告称提供了教育和预防服务，但提供这些服务的项目数量出现了小幅但显著的下降。项目更侧重于提供有关HIV传播的信息，而非培养降低风险的技能。提供现场HIV检测（包括快速HIV检测）的项目显著增加（从26.0%增至31.7%），且项目中接受检测的患者比例也有所上升。规模较大的项目更有可能提供专门的HIV/AIDS治疗路径并设立现场HIV/AIDS支持小组，而获得认证的项目以及具备医疗基础设施的项目更有可能提供HIV检测。注射吸毒者的比例与专门的HIV/AIDS治疗路径及HIV/AIDS支持小组的可及性呈正相关，女性客户的比例与现场支持小组的可及性相关。设有专门的 LGBT 治疗路径的项目提供HIV/AIDS支持小组的可能性也更大。研究结果表明，利用医院和医疗服务是促进采用HIV服务的有效途径，并且这些项目正在为一群HIV传播风险较高的患者提供所需服务。尽管如此，鉴于联邦指南，不到三分之一的项目提供现场检测，而且在提供现场检测的项目中，接受检测的患者不到三分之一，这引发了关注。
