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Disparities in Health Services for HIV/AIDS, Hepatitis C Virus, and Sexually Transmitted Infections: Role of Substance Abuse Treatment Programs.

Journal of Addictive Medicine 2009;3(2):95-102. [doi: 10.1097/ADM.0b013e31818e2185]

Lawrence S. Brown, Jr., MD, MPH (Addiction Research and Treatment Corporation, NY Node), Steven Allan Kritz, MD (Addiction Research and Treatment Corporation, NY Node), Adashima Muhammad, MPH (Addiction Research and Treatment Corporation, NY Node), Edmund J. Bini, MD, MPH (VA New York Harbor Healthcare System, NY Node), R. Jeffrey Goldsmith, MD (Cincinnati Veterans Affairs/CinARC, OV Node), James A. Robinson, MEd (Nathan Kline Institute for Psychiatric Research, NY/LI Node), Donald Alderson, MS (New York State Psychiatric Institute, NY Node), Deborah S. Hasin, PhD (Columbia University and New York State Psychiatric Institute, LI Node)), John Rotrosen, MD (New York University, NY Node).

The prominence of healthcare disparities in public health discussions has spurred interest in the identification of those disparities, studying their causes, and pursuing possible remedies. It is well established that women and minority populations experience disparities in health and healthcare -- i.e., differences in incidence, prevalence, mortality, morbidity, other consequences of disease, related to many factors including access to services -- and that these disparities extend to issues around addiction and addiction-related infections. The findings of this report suggest that there appear to be some alignment between services offered and these health and healthcare disparities. In a cross-sectional, descriptive design, treatment program administrators across the United States within the National Drug Abuse Treatment Clinical Trials Network (protocol CTN-0012) provided information on program characteristics, the availability of infection-related services (4 medical services and 3 nonmedical services for HIV, hepatitis C virus, and sexually transmitted infections), and barriers to providing infection-related services. Of 319 programs surveyed, 269 participated. Of these, 80% provided addiction services for special populations. Programs providing addiction services designed for at least one special population were more likely to provide infection-related health services, especially HIV-related education (94% vs. 85%) and patient counseling (76% vs. 60%) and were more likely to include outpatient addiction services (86% vs. 57%) and outreach and support services (92% vs. 70%). Primary barriers to providing infection-related services included government funding, private health insurance, and patient acceptance. But despite those barriers, programs with addiction services designed for women and nonwhite ethnic/racial populations provide infection-related health services more often than programs without these specially designed addiction services. The findings of this study strongly suggest that the tailoring of substance abuse treatment is an important public health strategy in addressing both the control of these infections and perhaps in reducing some of the disparities associated with them. (Article (Peer-Reviewed), PDF, English, 2009)

Keywords: Attitudes of health personnel | Community health services | Counselors | Health services research | Hepatitis C | HIV/AIDS | Sexually transmitted diseases | Journal of Addiction Medicine (journal)

Document No: 366, PMID: 20161081, PMCID: PMC2743506

Submitted by the CTN Dissemination Librarians, 6/5/2009.

Alderson, Donald search
Bini, Edmund J. search mail
Brown, Lawrence S. Jr. search mail
Goldsmith, R. Jeffrey search mail
Hasin, Deborah S. search mail
Kritz, Steven Allan search mail
Muhammad, Adashima search
Robinson, James A. search mail
Rotrosen, John search mail
NIDA-CTN-0012 search www
All Nodes and CTPs were asked to participate in this study

Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
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