A mixed methods study of HIV-related services in buprenorphine treatment
Abstract Background Opioid use disorder (OUD) is a major risk factor in the acquisition and transmission of HIV. Clinical practice guidelines call for the integration of HIV services in OUD treatment. This mixed methods study describes the integration of HIV services in buprenorphine treatment and e...
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| Format: | Article |
| Language: | English |
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BMC
2017-08-01
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| Series: | Substance Abuse Treatment, Prevention, and Policy |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13011-017-0122-5 |
| _version_ | 1819267491854024704 |
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| author | Hannah K. Knudsen Jennifer Cook Michelle R. Lofwall Sharon L. Walsh Jamie L. Studts Jennifer R. Havens |
| author_facet | Hannah K. Knudsen Jennifer Cook Michelle R. Lofwall Sharon L. Walsh Jamie L. Studts Jennifer R. Havens |
| author_sort | Hannah K. Knudsen |
| collection | DOAJ |
| description | Abstract Background Opioid use disorder (OUD) is a major risk factor in the acquisition and transmission of HIV. Clinical practice guidelines call for the integration of HIV services in OUD treatment. This mixed methods study describes the integration of HIV services in buprenorphine treatment and examines whether HIV services vary by prescribers’ medical specialty and across practice settings. Methods Data were obtained via qualitative interviews with buprenorphine experts (n = 21) and mailed surveys from US buprenorphine prescribers (n = 1174). Survey measures asked about screening for HIV risk behaviors at intake, offering HIV education, recommending all new patients receive HIV testing, and availability of on-site HIV testing. Prescribers’ medical specialty, practice settings, caseload demographics, and physician demographics were measured. Multivariate models of HIV services were estimated, while accounting for the nesting of physicians within states. Results Qualitative interviews revealed that physicians often use injection behaviors as the primary indicator for whether a patient should be tested for HIV. Interviews revealed that HIV-related services were often viewed as beyond the scope of practice among general psychiatrists. Surveys indicated that prescribers screened for an average of 3.2 of 5 HIV risk behaviors (SD = 1.6) at intake. About 62.0% of prescribers delivered HIV education to patients and 53.2% recommended HIV testing to all new patients, but only 32.3% offered on-site HIV testing. Addiction specialists and psychiatrists screened for significantly more HIV risk behaviors than physicians in other specialties. Addiction specialists and psychiatrists were significantly less likely than other physicians to offer on-site testing. Physicians in individual medical practice were significantly less likely to recommend HIV testing and to offer onsite testing than physicians in other settings. Conclusions Buprenorphine treatment providers have not uniformly integrated HIV-related screening, education, and testing services for patients. Differences by medical specialty and practice setting suggest an opportunity for targeting efforts to increase implementation. |
| first_indexed | 2024-12-23T21:18:01Z |
| format | Article |
| id | doaj.art-974bfcd4e64542e598431004f6efe1ab |
| institution | Directory Open Access Journal |
| issn | 1747-597X |
| language | English |
| last_indexed | 2024-12-23T21:18:01Z |
| publishDate | 2017-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Substance Abuse Treatment, Prevention, and Policy |
| spelling | doaj.art-974bfcd4e64542e598431004f6efe1ab2022-12-21T17:30:51ZengBMCSubstance Abuse Treatment, Prevention, and Policy1747-597X2017-08-0112111310.1186/s13011-017-0122-5A mixed methods study of HIV-related services in buprenorphine treatmentHannah K. Knudsen0Jennifer Cook1Michelle R. Lofwall2Sharon L. Walsh3Jamie L. Studts4Jennifer R. Havens5Department of Behavioral Science and Center on Drug and Alcohol Research, University of KentuckyDepartment of Behavioral Science and Center on Drug and Alcohol Research, University of KentuckyDepartment of Behavioral Science and Center on Drug and Alcohol Research, University of KentuckyDepartment of Behavioral Science and Center on Drug and Alcohol Research, University of KentuckyDepartment of Behavioral Science, University of KentuckyDepartment of Behavioral Science and Center on Drug and Alcohol Research, University of KentuckyAbstract Background Opioid use disorder (OUD) is a major risk factor in the acquisition and transmission of HIV. Clinical practice guidelines call for the integration of HIV services in OUD treatment. This mixed methods study describes the integration of HIV services in buprenorphine treatment and examines whether HIV services vary by prescribers’ medical specialty and across practice settings. Methods Data were obtained via qualitative interviews with buprenorphine experts (n = 21) and mailed surveys from US buprenorphine prescribers (n = 1174). Survey measures asked about screening for HIV risk behaviors at intake, offering HIV education, recommending all new patients receive HIV testing, and availability of on-site HIV testing. Prescribers’ medical specialty, practice settings, caseload demographics, and physician demographics were measured. Multivariate models of HIV services were estimated, while accounting for the nesting of physicians within states. Results Qualitative interviews revealed that physicians often use injection behaviors as the primary indicator for whether a patient should be tested for HIV. Interviews revealed that HIV-related services were often viewed as beyond the scope of practice among general psychiatrists. Surveys indicated that prescribers screened for an average of 3.2 of 5 HIV risk behaviors (SD = 1.6) at intake. About 62.0% of prescribers delivered HIV education to patients and 53.2% recommended HIV testing to all new patients, but only 32.3% offered on-site HIV testing. Addiction specialists and psychiatrists screened for significantly more HIV risk behaviors than physicians in other specialties. Addiction specialists and psychiatrists were significantly less likely than other physicians to offer on-site testing. Physicians in individual medical practice were significantly less likely to recommend HIV testing and to offer onsite testing than physicians in other settings. Conclusions Buprenorphine treatment providers have not uniformly integrated HIV-related screening, education, and testing services for patients. Differences by medical specialty and practice setting suggest an opportunity for targeting efforts to increase implementation.http://link.springer.com/article/10.1186/s13011-017-0122-5BuprenorphineOpioid use disorder treatmentHIV/AIDS testingHIV prevention |
| spellingShingle | Hannah K. Knudsen Jennifer Cook Michelle R. Lofwall Sharon L. Walsh Jamie L. Studts Jennifer R. Havens A mixed methods study of HIV-related services in buprenorphine treatment Substance Abuse Treatment, Prevention, and Policy Buprenorphine Opioid use disorder treatment HIV/AIDS testing HIV prevention |
| title | A mixed methods study of HIV-related services in buprenorphine treatment |
| title_full | A mixed methods study of HIV-related services in buprenorphine treatment |
| title_fullStr | A mixed methods study of HIV-related services in buprenorphine treatment |
| title_full_unstemmed | A mixed methods study of HIV-related services in buprenorphine treatment |
| title_short | A mixed methods study of HIV-related services in buprenorphine treatment |
| title_sort | mixed methods study of hiv related services in buprenorphine treatment |
| topic | Buprenorphine Opioid use disorder treatment HIV/AIDS testing HIV prevention |
| url | http://link.springer.com/article/10.1186/s13011-017-0122-5 |
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