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

Proeschold-Bell, Rae Jean

Heine, Amy

Pence, Brian Wells

McAdam, Keith

Quinlivan, Evelyn Byrd

United States

2011-04-15T16:46:20Z

2010-10

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.

Version of Record

http://www.ncbi.nlm.nih.gov/pubmed/20846009

1557-7449

https://hdl.handle.net/10161/3342

eng

en_US

Mary Ann Liebert Inc

AIDS Patient Care STDS

10.1089/apc.2010.0073

AIDS Patient Care and STDs

Academic Medical Centers

Adult

Aged

Ambulatory Care Facilities

Community Health Centers

Delivery of Health Care, Integrated

Female

HIV Infections

Humans

Interviews as Topic

Male

Middle Aged

Program Evaluation

Severity of Illness Index

Substance-Related Disorders

Treatment Outcome

Young Adult

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

Journal article

Proeschold-Bell, Rae Jean|0000-0003-2008-3053

2010-10-0

10

24

http://www.ncbi.nlm.nih.gov/pubmed/20846009

651

658

10

Clinical Science Departments

Community and Family Medicine

Duke

Global Health Institute

Institutes and Provost's Academic Units

Pathology

School of Medicine

University Institutes and Centers

Published

24