“It’s Never Just About the HIV:” HIV Primary Care Providers’ Perception of Substance Use in the Era of “Universal” Antiretroviral Medication Treatment

Aimee N.C. Campbell, Margaret Wolff, Laurel Weaver, Don Des Jarlais, Susan Tross

Research output: Contribution to journalArticle

Abstract

Antiretroviral therapy (ART) is recommended for all people living with HIV (PLWH), regardless of disease status. Substance use disorders (SUD) are common barriers to successful HIV treatment; however, few studies have comprehensively explored how HIV primary care providers take SUDs into account in the context of universal ART implementation. This study uses thematic analysis of qualitative interviews to explore providers’ (N = 25) substance use assessment and factors associated with ART initiation. 64% of providers had 15 or more years of HIV treatment experience. Almost all providers agreed with the guidelines for universal ART initiation despite the presence of SUD. Still, identification and management of SUD is challenged by inconsistent assessment, providers’ misperceptions about SUD and patients’ willingness to discuss it, and lack of accessible treatment resources when SUD is identified. Greater guidance in systematic SUD assessment and management, combined with integrated addiction services, could enhance universal ART implementation among PLWH/SUD.

Original languageEnglish (US)
Pages (from-to)1006-1017
Number of pages12
JournalAIDS and Behavior
Volume22
Issue number3
DOIs
StatePublished - Mar 1 2018

Keywords

  • Antiretroviral therapy
  • HIV primary care
  • Substance use disorders

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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