Availability of substance use screening and treatment within HIV clinical sites across seven geographic regions within the IeDEA consortium.

Autor: Lancaster KE; Wake Forest University School of Medicine, Winston-Salem, NC, USA. Electronic address: klancast@wakehealth.edu., Stockton M; University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Remch M; University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Wester CW; Vanderbilt University Medical Center, Nashville, TN, USA., Nash D; City University of New York (CUNY), New York, NY, USA., Brazier E; City University of New York (CUNY), New York, NY, USA., Adedimeji A; Albert Einstein College of Medicine, Bronx, NY, USA., Finlayson R; Taylor Square Private Clinic, Syndey, Australia., Freeman A; Johns Hopkins University, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Hogan B; Johns Hopkins University, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Kasozi C; Masaka Regional Referral Hospital, Masaka City, Uganda., Kwobah EK; Moi Teaching and Referral Hospital, Eldoret, Kenya., Kulzer JL; University of California San Francisco (UCSF), San Francisco, CA, USA., Merati T; Udayana University, Badung, Indonesia., Tine J; Centre Hospitalier National Universitaire de Fann, Dakar, Senagal., Poda A; Université Polytechnique de Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso., Succi R; Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil., Twizere C; Centre National de Référence en Matière de VIH/SIDA au Burundi, Bujumbura, Burundi., Tlali M; University of Cape Town, Cape Town, South Africa., Groote PV; Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland., Edelman EJ; Yale Schools of Medicine and Public Health, New Haven, CT, USA., Parcesepe AM; University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Jazyk: angličtina
Zdroj: The International journal on drug policy [Int J Drug Policy] 2024 Feb; Vol. 124, pp. 104309. Date of Electronic Publication: 2024 Jan 15.
DOI: 10.1016/j.drugpo.2023.104309
Abstrakt: Background: Overwhelming evidence highlights the negative impact of substance use on HIV care and treatment outcomes. Yet, the extent to which alcohol use disorder (AUD) and other substance use disorders (SUD) services have been integrated within HIV clinical settings is limited. We describe AUD/SUD screening and treatment availability in HIV clinical sites participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium.
Methods: In 2020, 223 IeDEA HIV clinical sites from 41 countries across seven geographic regions completed a survey on capacity and practices related to management of AUD/ SUD. Sites provided information on AUD and other SUD screening and treatment practices.
Results: Sites were from low-income countries (23%), lower-middle-income countries (38%), upper-middle income countries (17%) and high-income counties (23%). AUD and SUD screening using validated instruments were reported at 32% (n=71 located in 12 countries) and 12% (n=27 located in 6 countries) of the 223 sites from 41 countries, respectively. The North American region had the highest proportion of clinics that reported AUD screening (76%), followed by East Africa (46%); none of the sites in West or Central Africa reported AUD screening. 31% (n=69) reported both AUD screening and counseling, brief intervention, psychotherapy, or Screening, Brief Intervention, and Referral to Treatment; 8% (n=18) reported AUD screening and detox hospitalization; and 10% (n=24) reported both AUD screening and medication. While the proportion of clinics providing treatment for SUD was lower than those treating AUD, the prevalence estimates of treatment availability were similar.
Conclusions: Availability of screening and treatment for AUD/SUD in HIV care settings is limited, leaving a substantial gap for integration into ongoing HIV care. A critical understanding is needed of the multilevel implementation factors or feasible implementation strategies for integrating screening and treatment of AUD/SUD into HIV care settings, particularly for resource-constrained regions.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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