Availability of substance use screening and treatment within HIV clinical sites across seven geographic regions within the IeDEA consortium
Year: 2024
Type: article
Study design: Observational Study
Abstract: 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.
Authors: Kathryn E. Lancaster, Melissa Stockton, Molly Remch, C. William Wester, Denis Nash, Ellen Brazier, Adebola Adedimeji, Robert Finlayson, Aimee Freeman, Breanna Hogan, Charles Kasozi, Edith Kamaru Kwobah, Jayne Lewis Kulzer, Tuti Merati, Judiacel Tine, Armel Poda, Regina Succi, Christelle Twizere, Mpho Tlali, Per von Groote, E. Jennifer Edelman, Angela M. Parcesepe
Institutions: Wake Forest University Health Sciences, Wake Forest University, University of North Carolina at Chapel Hill, Vanderbilt University Medical Center, City University of New York, Albert Einstein College of Medicine, Johns Hopkins University, Masaka Hospital, University of California, San Francisco, Udayana University, Centre Hospitalier National Universitaire de Fann, Nazi Boni University, Universidade Federal de São Paulo, Republic of Burundi, University of Cape Town, University of Bern, Yale University
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,070
Awards: Emory Specialized Center of Research Excellence (SCORE) on Sex Differences, IeDEA Asia-Pacific Research Collaboration, North American AIDS Cohorts on Collaboration and Design (NAACCORD), Central Africa International Epidemiology databases to Evaluate AIDS, The University of North Carolina Center for AIDS Research, Harmonist: A Scalable Toolkit for Standardizing and Coordinating Data Sharing Across International Research Networks, East Africa International Epidemiology Database to evaluate AIDS (IeDEA) Regional Consortium, Caribbean, Central, and South America network for HIV Epidemiology (CCASAnet), International Epidemiology Databases to EvaluateAIDS (IeDEA) Renewal 4, International epidemiology Databases to Evaluate AIDS (IeDEA) Southern Africa.
OpenAlex ID: W4390891999