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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. - PowerPoint PPT Presentation
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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,
USA2Department Health Promotion & Behavior, University of Georgia, Athens, GA,
USA
Paper presented at the XVIII International Conference on AIDS, Vienna, Austria
July 18-23, 2010
Trends in and Determinants of the Availability of HIV Prevention Services
in Substance Abuse Treatment Facilities, United States, 2002 – 2008
National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention
Division of HIV/AIDS Prevention
• 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)
BACKGROUND
MAJOR FINDINGS: Extent and Trends
Percent of Facilities Offering HIV Prevention Services
HIV Testing
HIV/AIDS ECS*
One or
Both
2002 33.4 55.5 61.3
2003 34.0 57.2 63.1
2004 31.2 56.2 61.1
2005 31.0 54.7 59.8
2006 30.1 53.4 58.6
2007 29.7 56.0 60.5
2008 29.3 55.1 59.5
Ave. 31.3 55.4 60.6
Adj. Odds of Offering HIV Prevention Services in 2003-2008 vs. 2002 Levels
2002 2003 2004 2005 2006 2007 20080.7
0.8
0.9
1.0
1.1
1.2
1.3
HIV Testing
HIV/AIDS ECS*
* ECS = education, counseling, or support Adj. = adjusted for organizational factors
**
*
* **
ns nsns
****
****
**
• 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/detox prog. • Were accredited by prof. organization • Were licensed by state agency
FINDINGS: Organizational Determinants
HIV prevention services were more likely to be offered in facilities that
Potential Underlying Factors
Lower Profit Motivation
Multiple Funding Sources
Capacity to Leverage
Longer Opportunity
Oversight / Regulation
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
For more information please contact Centers for Disease Control and Prevention1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: [email protected] Web: www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
For details, please visit:Poster No: MOPDC103
Or send an e-mail to:Mesfin S. Mulatu, PhD, [email protected]
National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention
Place Descriptor Here
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