Public Health Reports. 2007 Jul-Aug;122(4):441-51.

Significance:

Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), hepatitis C virus (HCV), and sexually transmitted infections (STIs) are major public health problems among substance abusers.

We surveyed 269 substance abuse treatment programs in the United States and found that HIV/AIDS-related services are offered more frequently than HCV and STI-related services, and reimbursement was the most significant determining factor.

Abstract:

The National Drug Abuse Treatment Clinical Trials Network conducted this study to determine the availability of and factors associated with infection-related health services in substance abuse treatment settings.

In a cross-sectional descriptive design, state policies, reimbursement for providers, state level of priority, and treatment program characteristics were studied via written surveys of administrators of substance abuse treatment programs and of state health and substance abuse departments.

Data from health departments and substance abuse agencies of 48 states and from 269 substance abuse treatment programs revealed that human immunodeficiency virus/acquired immunodeficiency syndrome-related services are more frequent than hepatitis C virus or sexually transmitted infection-related services, and that non-medical services are more frequent than medical services.

While the availability of infection-related health services is associated with medical staffing patterns, addiction pharmacotherapy services, and state priorities, reimbursement was the most significant determining factor. These findings suggest that greater funding of these health services in substance abuse treatment settings, facilitated by supportive state policies, represents an effective response to the excess morbidity and mortality of these substance use-related infections.

PMID: 17639646