title: Substance abuse treatment utilization among adults living with HIV/AIDS and alcohol or drug problems.
abstract: This is a prospective cohort study to identify factors associated with receipt of substance abuse treatment (SAT) among adults with alcohol problems and HIV/AIDS. Data from the HIV Longitudinal Interrelationships of Viruses and Ethanol study were analyzed. Generalized estimating equation logistic regression models were fit to identify factors associated with any service utilization. An alcohol dependence diagnosis had a negative association with SAT (adjusted odds ratio [AOR] = 0.36, 95% confidence interval [95% CI] = 0.19-0.67), as did identifying sexual orientation other than heterosexual (AOR = 0.46, CI = 0.29-0.72) and having social supports that use alcohol/drugs (AOR = 0.62, CI = 0.45-0.83). Positive associations with SAT include presence of hepatitis C antibody (AOR = 3.37, CI = 2.24-5.06), physical or sexual abuse (AOR = 2.12, CI = 1.22-3.69), social supports that help with sobriety (AOR = 1.92, CI = 1.28-2.87), homelessness (AOR = 2.40, CI = 1.60-3.62), drug dependence diagnosis (AOR = 2.64, CI = 1.88-3.70), and clinically important depressive symptoms (AOR = 1.52, CI = 1.08-2.15). While reassuring that factors indicating need for SAT among people with HIV and alcohol problems (e.g., drug dependence) are associated with receipt, nonneed factors (e.g., sexual orientation, age) that should not decrease likelihood of receipt of treatment were identified.
authors.affiliation: Loyola University Chicago, Chicago, IL 60611, USA. jorwat@luc.edu
authors.forename: John
authors.initials: J
authors.lastname: Orwat
authors.forename: Richard
authors.initials: R
authors.lastname: Saitz
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Tompkins
authors.forename: Debbie M
authors.initials: DM
authors.lastname: Cheng
authors.forename: Michael P
authors.initials: MP
authors.lastname: Dentato
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Samet
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000453:epidemiology*; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000534:rehabilitation; D000553:Ambulatory Care; D015984:Causality; D015331:Cohort Studies; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012114:Residential Treatment; D012725:Sexual Behavior; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation* / Q000628:therapy