Inability to access addiction treatment and risk of HIV infection among injection drug users recruited from a supervised injection facility.
BACKGROUND
Treatment for drug addiction is effective in reducing the harms of injection drug use, including infection with HIV and/or hepatitis C. We sought to examine the prevalence and correlates of being unable to access addiction treatment in a representative sample of injection drug users randomly recruited from a supervised injection facility.


METHODS
Using generalized estimating equations, we determined the prevalence and factors associated with being unable to access addiction treatment.


RESULTS
Between 1 July 2004 and 30 June 2006, 889 individuals completed at least one interview and were included in this analysis. At each interview, approximately 20% of respondents reported trying but being unable to access any type of drug or alcohol treatment in the previous 6 months. Being unable to access treatment was independently associated with recent incarceration, daily use of heroin and borrowing used syringes. In a secondary question, the majority of individuals reported waiting lists were the reason for being unable to access treatment.


CONCLUSIONS
Given the independent association between inability to access addiction treatment and elevated HIV risk behavior, these results suggest expanding addiction treatment may contribute significantly to HIV prevention efforts in this population.
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada. uhri-ew@cfenet.ubc.ca
M-J S
MJ
Milloy
Thomas
T
Kerr
Ruth
R
Zhang
Mark
M
Tyndall
Julio
J
Montaner
Evan
E
Wood
D000328:Adult; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D011446:Prospective Studies; D018570:Risk Assessment; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D015819:Substance Abuse, Intravenous / Q000628:therapy*