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A cross-site, comparative effectiveness study of an integrated HIV and substance use treatment program.

dc.contributor.author Heine, A
dc.contributor.author McAdam, K
dc.contributor.author Pence, Brian Wells
dc.contributor.author Proeschold-Bell, RJ
dc.contributor.author Quinlivan, EB
dc.coverage.spatial United States
dc.date.accessioned 2011-04-15T16:46:20Z
dc.date.issued 2010-10
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/20846009
dc.identifier.uri https://hdl.handle.net/10161/3342
dc.description.abstract Co-occurrence of HIV and substance abuse is associated with poor outcomes for HIV-related health and substance use. Integration of substance use and medical care holds promise for HIV patients, yet few integrated treatment models have been reported. Most of the reported models lack data on treatment outcomes in diverse settings. This study examined the substance use outcomes of an integrated treatment model for patients with both HIV and substance use at three different clinics. Sites differed by type and degree of integration, with one integrated academic medical center, one co-located academic medical center, and one co-located community health center. Participants (n=286) received integrated substance use and HIV treatment for 12 months and were interviewed at 6-month intervals. We used linear generalized estimating equation regression analysis to examine changes in Addiction Severity Index (ASI) alcohol and drug severity scores. To test whether our treatment was differentially effective across sites, we compared a full model including site by time point interaction terms to a reduced model including only site fixed effects. Alcohol severity scores decreased significantly at 6 and 12 months. Drug severity scores decreased significantly at 12 months. Once baseline severity variation was incorporated into the model, there was no evidence of variation in alcohol or drug score changes by site. Substance use outcomes did not differ by age, gender, income, or race. This integrated treatment model offers an option for treating diverse patients with HIV and substance use in a variety of clinic settings. Studies with control groups are needed to confirm these findings.
dc.language eng
dc.language.iso en_US
dc.relation.ispartof AIDS Patient Care STDS
dc.relation.isversionof 10.1089/apc.2010.0073
dc.subject Academic Medical Centers
dc.subject Adult
dc.subject Aged
dc.subject Ambulatory Care Facilities
dc.subject Community Health Centers
dc.subject Delivery of Health Care, Integrated
dc.subject Female
dc.subject HIV Infections
dc.subject Humans
dc.subject Interviews as Topic
dc.subject Male
dc.subject Middle Aged
dc.subject Program Evaluation
dc.subject Severity of Illness Index
dc.subject Substance-Related Disorders
dc.subject Treatment Outcome
dc.subject Young Adult
dc.title A cross-site, comparative effectiveness study of an integrated HIV and substance use treatment program.
dc.type Journal article
dc.description.version Version of Record
duke.date.pubdate 2010-10-0
duke.description.issue 10
duke.description.volume 24
dc.relation.journal AIDS Patient Care and STDs
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/20846009
pubs.begin-page 651
pubs.end-page 658
pubs.issue 10
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Community and Family Medicine
pubs.organisational-group Duke
pubs.organisational-group Global Health Institute
pubs.organisational-group Institutes and Provost's Academic Units
pubs.organisational-group Pathology
pubs.organisational-group School of Medicine
pubs.organisational-group University Institutes and Centers
pubs.publication-status Published
pubs.volume 24
dc.identifier.eissn 1557-7449


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