Co-located Substance Use Treatment and HIV Prevention and Primary Care Services,New York State, 1990–2002: A Model for Effective Service Delivery to a High-Risk Population |
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Authors: | Jeffrey Rothman Diane Rudnick Marc Slifer Bruce Agins Karl Heiner Guthrie Birkhead |
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Institution: | (1) Bureau of HIV Ambulatory Care, AIDS Institute, New York State Department of Health, Room 429, corner Tower, ESP, Albany, New York, USA |
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Abstract: | The New York State Department of Health (NYSDOH) AIDS Institute (AI) began an initiative in 1990 in collaboration with the
Office of Alcoholism and Substance Abuse Services (OASAS) to colocate HIV prevention and clinical services at drug treatment
clinics. In 1990, the initiative began funding drug treatment programs to provide HIV counseling, testing, and prevention
services. HIV primary care was added the following year. Program implementation and development are described. An analysis
is included of HIV counseling and testing data for the period 1990–2002 and quality of care data for five standardized quality
measures with comparisons to data from other clinical settings. In the first 13 years of the initiative 168,340 HIV-antibody
tests were conducted including 52,562 tests of injection drug users (IDUs) identifying 14,612 HIV-infected persons; the seroprevalence
was 8.68%. By the end of 2000, the HIV primary care caseload peaked at 3,815 patients. Quality of primary medical care services
among participating drug treatment programs has consistently matched or exceeded that provided in more conventional health
care settings such as the hospitals and community health centers that were used as a basis for comparison. Colocating HIV
primary care within substance use treatment is an effective strategy for providing accessible high-quality HIV prevention
and primary care services.
Rothman is with the Bureau of HIV Ambulatory Care, AIDS Institute, New York State Department of Health, Albany, New York,
USA; Rudnick and Slifer are with the Substance Abuse Unit, AIDS Institute, New York, NY, USA; Agins is with the Office of
the Medical Director, AIDS Institute, New York, NY, USA; Heiner is with the Karl Heiner Statistical Consulting, Ltd., Schenectady,
New York, USA; Birkhead is with the AIDS Institute, Albany, New York, USA. |
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Keywords: | Colocated Drug treatment Injection drug use Substance abuse |
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