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National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention

Trends in and Determinants of the Availability of HIV Prevention Services in Substance Abuse Treatment Facilities, United States, 2002 – 2008. Mesfin S. Mulatu, PhD, MPH 1 , Dionne C. Godette, PhD 2 , Kimberly R. Thomas, MPH, CHES 1 , Shubha Rao, MD, MPH 1.

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National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention

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  1. Trends in and Determinants of the Availability of HIV Prevention Services in Substance Abuse Treatment Facilities, United States, 2002 – 2008 Mesfin S. Mulatu, PhD, MPH1, Dionne C. Godette, PhD2, Kimberly R. Thomas, MPH, CHES1, Shubha Rao, MD, MPH1 1Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA 2Department Health Promotion & Behavior, University of Georgia, Athens, GA, USA Paper presented at the XVIII International Conference on AIDS, Vienna, Austria July 18-23, 2010 National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention Division of HIV/AIDS Prevention

  2. BACKGROUND • The role of substance use in HIV transmission and the contributions of substance abuse treatment (SAT) as an HIV prevention strategy are very well recognized • Research on national level trends and determinants of HIV prevention services in SAT facilities in the U.S. is limited • Objectives of the study are to answer two questions: • What are the trends of the availability HIV testing and HIV/AIDS education, counseling, or support services in U.S. SAT facilities? • What organizational factors are associated with the availability of these HIV prevention services in U.S. SAT facilities? • Data from the National Survey of Substance Abuse Treatment Services (2002-2008) were used (average N = 13,661 facilities/yr)

  3. MAJOR FINDINGS: Extent and Trends Percent of Facilities Offering HIV Prevention Services Adj. Odds of Offering HIV Prevention Services in 2003-2008 vs. 2002 Levels ** * ns ns ns * ** ** ** ** ** ** * ECS = education, counseling, or support Adj. = adjusted for organizational factors

  4. FINDINGS: Organizational Determinants • Were owned by government • Were owned by non-profit • Provided payment assistance • Received public funding • Accepted government insurance • Were larger in size • Were affiliated with hospitals • Had inpatient programs • Had residential programs • Had opiate maintenance/detoxprog. • Were accredited by prof. organization • Were licensed by state agency Lower Profit Motivation Multiple Funding Sources Capacity to Leverage Longer Opportunity Oversight / Regulation

  5. SUMMARY AND IMPLICATIONS • More than a third of U.S. SAT facilities do not offer HIV prevention services -- a major gap in reaching a population at high risk • Trends (2002 -2008) indicate that the availability of HIV prevention services is declining at worst or remaining stable at best – despite recommendations for such services by public health agencies • Organizational factors are important determinants of the availability of HIV prevention services in U.S. SAT facilities • Further research into organizational and broader contextual (e.g., policy) barriers and facilitators of offering HIV prevention services in U.S. SAT facilities may provide useful information for expanding these services

  6. CONTACTS For details, please visit: Poster No: MOPDC103 Or send an e-mail to: Mesfin S. Mulatu, PhD, MPH mmulatu@cdc.gov National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention Place Descriptor Here

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