Citation
Lancaster, Kathryn E.; Stockton, Melissa A.; Remch, Molly; Wester, C. William; Nash, Denis; Brazier, Ellen; Adedimeji, Adebola; Finlayson, Robert; Freeman, Aimee; & Hogan, Breanna, et al. (2024). Availability of Substance Use Screening and Treatment within HIV Clinical Sites across Seven Geographic Regions within the IEDEA Consortium. International Journal of Drug Policy, 124, 104309.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.
URL
http://dx.doi.org/10.1016/j.drugpo.2023.104309Reference Type
Journal ArticleYear Published
2024Journal Title
International Journal of Drug PolicyAuthor(s)
Lancaster, Kathryn E.Stockton, Melissa A.
Remch, Molly
Wester, C. William
Nash, Denis
Brazier, Ellen
Adedimeji, Adebola
Finlayson, Robert
Freeman, Aimee
Hogan, Breanna
Kasozi, Charles
Kwobah, Edith Kamaru
Kulzer, Jayne Lewis
Merati, Tuti
Tine, Judiacel
Poda, Armel
Succi, Regina
Twizere, Christelle
Tlali, Mpho
Groote, Per von
Edelman, E. Jennifer
Parcesepe, Angela M.