Substance Use Treatment Utilization Among Women with and without HIV Open Access

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

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Laney Graduate School
Department	Clinical Research
Degree	M.S.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Medicine and Surgery
Keyword	substance use women hiv
Committee Chair / Thesis Advisor	Amita Manatunga, Emory University
Committee Members	Sophia Hussen, Emory University Jonathan Colasanti, Emory University Anandi Sheth, Emory University

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