Substance Use Treatment Utilization Among Women with and without HIV Öffentlichkeit
Fujita, Ayako (Spring 2023)
Published
Abstract
Introduction
Substance use (SU) contributes to poor health outcomes, yet limited data exist to inform
strategies to optimize SU treatment among people living with HIV. We describe SU and SU
treatment utilization among women with and without HIV in the Women’s Interagency HIV
Study (WIHS).
Methods
We included data from women enrolled in WIHS from 2013-2020. Current SU was selfreported,
non-medical use of drugs in the past year, excluding use of only marijuana. Substance
use treatment utilization was self-reported use of a drug treatment program in the past year.
Multivariable regression models were used to investigate associations between participant
characteristics and SU treatment.
Results
Among 2559 women (1802 women living with HIV (WWH), 757 women without HIV), 14%
reported current SU. Among those with current SU (n=367), 71% reported crack/cocaine
followed by 40% reporting opioids, and 42% reported any treatment in the past year. The most
common treatments were methadone (64%), Narcotics Anonymous (29%), inpatient (28%), and
outpatient programs (16%). Among women using opioids (n= 147), 67% reported methadone use
in the past year compared to 5% using buprenorphine/naloxone. Multivariable analysis showed
lower odds of treatment utilization among women with current SU with concurrent alcohol use
(OR 0.24, 95% CI 0.12-0.48 for >7 drinks/week) or marijuana use (OR 0.31, 95% CI 0.18-0.54).
Visiting a psychiatrist/counselor was associated with higher odds of treatment (OR 2.46, 95% CI
1.34-4.50). Among WWH, SU treatment was not associated with HIV-related clinical outcomes.
Conclusions
Substance use treatment utilization was high, especially for methadone use. Our results highlight
opportunities for accessing SU treatment for WWH, such as the need to prioritize buprenorphine
and comprehensive, wraparound services in HIV care settings.
Table of Contents
INTRODUCTION .......................................................................................................................... 1
BACKGROUND ............................................................................................................................ 2
METHODS ..................................................................................................................................... 5
RESULTS ..................................................................................................................................... 11
DISCUSSION ............................................................................................................................... 16
CONCLUSION ............................................................................................................................. 21
REFERENCES ............................................................................................................................. 22
TABLES AND FIGURES ............................................................................................................ 27
TABLE 1. .................................................................................................................................... 28
TABLE 2. .................................................................................................................................... 30
TABLE 3. .................................................................................................................................... 31
TABLE 4. .................................................................................................................................... 32
TABLE 5. .................................................................................................................................... 34
TABLE 6 ..................................................................................................................................... 35
FIGURE 1 .................................................................................................................................... 37
FIGURE 2 .................................................................................................................................... 38
FIGURE 3 .................................................................................................................................... 39
FIGURE 4. ....................................................................................................................................40
About this Master's Thesis
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