title: Substance abuse treatment and hospitalization among a cohort of HIV-infected individuals with alcohol problems.
abstract: BACKGROUND
  We examined the association of substance abuse treatment services on hospitalization among participants in the HIV-Alcohol Longitudinal Cohort (HIV-ALC) study of HIV-infected individuals with a history of alcohol problems.
  
  
  METHODS
  A standardized questionnaire that inquired about demographics, substance use, use of substance abuse treatment services, and hospitalization was administered to 349 HIV-ALC participants. We defined substance abuse treatment services as any of the following in the past 6 months: 12 weeks in a half-way house or residential facility, 12 visits to a substance abuse counselor or mental health professional, or participation in any methadone maintenance program.
  
  
  RESULTS
  Almost one third of this cohort were hospitalized in the past 6 months. Substance abuse treatment was not significantly associated with hospitalization [adjusted odds ratio (AOR) 1.0; 95% confidence interval (CI) 0.7-1.5), whereas homelessness (AOR 2.3; 95% CI 1.5-3.6), injection drug use (AOR 1.7; 95% CI 1.0-2.7), severity of alcohol dependence (AOR 1.02; 95% CI 1.00-1.05), CD4 cell count (AOR 0.999; 95% CI 0.998-1.00), and HIV RNA (AOR 1.1; 95% CI 1.0-1.2) were independently associated with increased odds of hospitalization over time.
  
  
  CONCLUSIONS
  Engagement in substance abuse treatment was not associated with a decrease in hospital use by HIV-infected individuals with a history of alcohol problems. The period of substance abuse treatment may present an opportunity to address health care utilization patterns of HIV-infected individuals.
authors.affiliation: Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. anita@hivnet.ubc.ca
authors.forename: Anita
authors.initials: A
authors.lastname: Palepu
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Horton
authors.forename: Nicole
authors.initials: N
authors.lastname: Tibbetts
authors.forename: Seville
authors.initials: S
authors.lastname: Meli
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Samet
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006208:Halfway Houses; D006703:Ill-Housed Persons; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000523:psychology; D008691:Methadone / Q000627:therapeutic use; D009294:Narcotics / Q000627:therapeutic use; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000534:rehabilitation / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D009294:Narcotics; D008691:Methadone