Co-Utilization of HIV, Substance Use, Mental Health Services Among Women With Current Substance Use: Opportunities for Integrated Care?
Year: 2024
Type: article
Abstract: Background: The syndemic of HIV, substance use (SU), and mental illness has serious implications for HIV disease progression among women. We described co-utilization of HIV care, SU treatment, and mental health treatment among women with or at risk for HIV. Methods: We included data from women with or at risk for HIV (n = 2559) enrolled in all 10 sites of the Women’s Interagency HIV Study (WIHS) from 2013 to 2020. Current SU was defined as self-reported, non-medical use of drugs in the past year, excluding use of only marijuana. Tobacco and alcohol were assessed separately. We described co-utilization of SU treatment, tobacco and alcohol use treatment, HIV care, and mental health care in the past year among women who were eligible for each service. We compared service utilization by those who did/did not utilize SU treatment using Wald Chi-square tests. Results: Among women with current SU (n = 358), 42% reported utilizing SU treatment. Among those with current SU+HIV (n = 224), 84% saw their HIV provider, and 34% saw a mental health provider. Among women with current SU+heavy alcohol use (n = 95), 18% utilized alcohol use treatment; among current SU+tobacco use (n = 276), 8% utilized tobacco use treatment. Women who utilized SU treatment had higher utilization of alcohol use treatment (59% vs. 5%; P < .001) and tobacco use treatment (12% vs. 5%; P = .028). HIV care engagement was high regardless of SU treatment. Conclusions: We found high engagement in SU and HIV care, but low engagement in alcohol and tobacco use treatment. Integrated SU treatment services for women, including tobacco/alcohol treatment and harm reduction, are needed to optimize treatment engagement and HIV care continuum outcomes.
Authors: Ayako W. Fujita, Aditi Ramakrishnan, C. Christina Mehta, Oyindamola B. Yusuf, Azure B. Thompson, Steven Shoptaw, Adam W. Carrico, Adaora A. Adimora, Ellen Eaton, Mardge H. Cohen, Jennifer P. Jain, Adebola Adedimeji, Michael Plankey, Deborah L. Jones, Aruna Chandran, Jonathan A. Colasanti, Anandi N. Sheth
Institutions: Emory University, Washington University in St. Louis, SUNY Downstate Health Sciences University, University of California, Los Angeles, University of Miami, University of North Carolina at Chapel Hill, University of Alabama at Birmingham, UAB Medicine, John H. Stroger, Jr. Hospital of Cook County, University of California, San Francisco, Albert Einstein College of Medicine, Georgetown University Medical Center, Johns Hopkins University, Grady Health System
Language: English
Topic: HIV, Drug Use, Sexual Risk
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,500
Funders: Emory University, Northwestern University, Johns Hopkins University, Georgia Clinical and Translational Science Alliance, National Institutes of Health, University of California, Los Angeles, Center for AIDS Research, University of Washington, University of California, San Francisco, Center for AIDS Research, Emory University, Center for AIDS Research, University of Alabama at Birmingham, National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Institute on Drug Abuse, National Cancer Institute, National Institute on Deafness and Other Communication Disorders, National Institute of Nursing Research, National Institute of Allergy and Infectious Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Child Health and Human Development, National Center for Advancing Translational Sciences, National Institute on Minority Health and Health Disparities, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Center for AIDS Research, University of North Carolina at Chapel Hill
Awards: G1034546755, G12089860, G1296759572, G1329112180, G1400602301, G1655989834, G1666149338, G174680145, G1773452051, G1787625665, G183157880, G1849940085, G1913134163, G192128497, G196810821, G1972383081, G1982951957, G2008237588, G2099736123, G2102298910, G2127051194, G2237694255, G2285519691, G2334180555, G2440855472, G248584506, G255204022, G259661504, G2661436214, G2755707676, G2759654445, G2839061624, G2908277772, G30074556, G3046393879, G3094086834, G311558797, G319781266, G3242306066, G3418878615, G343705321, G3478320008, G350592738, G3620356906, G3630727822, G3671922257, G3869857964, G4016133911, G4044828089, G4391827178, G4535678174, G4560685369, G456742281, G483408255, G4889872267, G5078796989, G5147848267, G521591464, G5431849782, G5525419549, G5660189159, G5691055145, G5747858550, G5863844756, G5900455136, G6061749117, G6162997254, G6341392406, G6396423216, G687203789, G693265041, G6990385686, G7140729675, G7152846654, G7415795898, G775892330, G7760075911, G7807729167, Johns Hopkins Institute for Clinical and Translational Research, G8221873858, G8447668589, G8482510714, G8719507731, G8746332703, G9000010044, G9000016284, G9000025681, G9000030090, G9000030772, G9000031392, G9000037749, G9000039899, G9000041916, G9000046174, G9000050451, G9000066220, G9000080293, G9000082816, G9000088144, G9000093720, G9000102070, G9000108991, G9000126122, G9000126231, G9000132212, G9000146713, Women, Intersectionality, Substance Use and HIV ( WISH), UNC MACS/WIHS Combined Cohort Study Clinical Research Site, Surviving the HIV Epidemic (S/HE) in metropolitan Washington DC - Advancing knowledge through cohort studies, Emory Training Program in Translational Research to End the HIV Epidemic, Clinical Research Sites for the MACS/WIHS Combined Cohort Study (MACS/WIHS-CCS) - Baltimore/Wash DC Center, J. NRSA Training Core, Clinical Research Sites for the MACS/WIHS Combined Cohort Study (MACS/WIHS-CCS), UAB Center for AIDS Research (CFAR)
OpenAlex ID: W4402931992