HIV screening among substance-abusing veterans in care.
Calls for screening for HIV infection among individuals with substance use disorders, including alcohol use, are increasing. We investigated HIV screening and its predictors in the Veterans Health Administration (VA) system among such individuals in care. Our primary outcome was retrospective evidence of screening for HIV infection, adjusting for patient demographics and important comorbid disease. Of the 371,749 sample patients with histories of substance use disorders using VA services, 20% had evidence of HIV screening. Screening was lowest among those with alcohol use disorders alone (11%) and highest among those treated in substance use programs (28%) or receiving inpatient care (28%). The findings suggest a low recognition of substance use disorders (especially alcohol use) as risk factors for HIV. Quality improvement initiatives to increase risk factor recognition and screening among patients with substance use disorders will yield benefits in the fight against HIV.
VA HSR&D Center for Health Quality, Outcomes and Economic Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA 01730, USA. ndookeran@partners.org
Nameeta M
NM
Dookeran
James F
JF
Burgess
Candice C
CC
Bowman
Matthew Bidwell
MB
Goetz
Steven M
SM
Asch
Allen L
AL
Gifford
D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000150:complications*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D011787:Quality of Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000150:complications*; D014481:United States; D014493:United States Department of Veterans Affairs / Q000592:standards; D014728:Veterans / Q000706:statistics & numerical data