Nonmedical prescription drug users in private vs. public substance abuse treatment: a cross sectional comparison of demographic and HIV risk behavior profiles

Abstract

BackgroundLittle is known regarding the demographic and behavioral characteristics of nonmedical prescription drug users (NMPDUs) entering substance abuse treatment settings, and information on the HIV-related risk profiles of NMPDUs is especially lacking. Participation in substance abuse treatment provides a critical opportunity for HIV prevention and intervention, but successful initiatives will require services appropriately tailored for the needs of NMPDUs.MethodsThis paper compares the HIV risk profiles of NMPDUs in public (n = 246) and private (n = 249) treatment facilities. Participants included in the analysis reported five or more recent episodes of nonmedical prescription drug use, a prior HIV negative test result, and current enrollment in a substance abuse treatment facility. A standardized questionnaire was administered by trained interviewers with questions about demographics, HIV risk, and substance use.ResultsPrivate treatment clients were more likely to be non-Hispanic White, younger, and opioid and heroin users. Injection drug use was higher among private treatment clients, whereas public clients reported higher likelihood of trading or selling sex. Public treatment clients reported higher rates of HIV testing and availability at their treatment facilities compared to private clients.ConclusionsFindings suggest differing demographics, substance use patterns, profiles of HIV risk and access to HIV testing between the two treatment samples. Population tailored HIV interventions, and increased access to HIV testing in both public and private substance treatment centers, appear to be warranted.

Opioid Use Trajectories, Injection Drug Use, and Hepatitis C Virus Risk Among Young Adult Immigrants from the Former Soviet Union Living in New York City

“…Again, these rates appear comparable to, and in the middle range of, those reported in the recent literature for other groups of young PWID which have found syringe-sharing rates ranging from 23%–49% and rates of secondary equipment sharing ranging from 35%–67%. 28,41,44,46 In this literature, as in present sample, rates of secondary equipment sharing typically exceed rates of syringe-sharing, and cookers appear to be the most frequently shared piece of injection paraphernalia. 28,41,44,46 Another concerning finding is participants’ low rate of SEP utilization which appears to differentiate the present sample from many other groups of PWID, such as the street-based, often homeless youth who are the focus of much existing research on young injectors 43,44 .…”

“…28,41,44,46 In this literature, as in present sample, rates of secondary equipment sharing typically exceed rates of syringe-sharing, and cookers appear to be the most frequently shared piece of injection paraphernalia. 28,41,44,46 Another concerning finding is participants’ low rate of SEP utilization which appears to differentiate the present sample from many other groups of PWID, such as the street-based, often homeless youth who are the focus of much existing research on young injectors 43,44 . For example, whereas 88% of young San Francisco PWID in the long-running UFO study reported using SEP services in the past month, only 40% of FSU injectors reported using an SEP in the past year, the same proportion as reported obtaining syringes from fellow injectors.…”

“…3 While historically an over-representation of males has also been characteristic of young heroin-using populations, this demographic composition has shifted in recent decades such that nearly equal numbers of women are now seeking treatment for opioid use. 19 Nevertheless, males continue to comprise about a 55–65% majority in research samples of prescription drug misusers 17,18,41,42 and an even stronger majority (approximately 70%) in samples of young PWID. 43–45 Further research with larger samples is necessary to establish whether a more marked preponderance of males among opioid-using youth may be a distinctive attribute of FSU immigrants.…”

Injection and sexual HIV/HCV risk behaviors associated with nonmedical use of prescription opioids among young adults in New York City

“…Notably, two new studies conducted with PO misusers in treatment for opioid dependence found that certain subgroups – specifically, polydrug users and younger, White individuals –were more likely to report engaging in sexual risk behavior (Meade et al, 2014; O’Grady, Surratt, Kurtz & Levi-Minzi, 2014). …”

A mixed methods study of HIV-related services in buprenorphine treatment

“…In the multivariate models, physicians treating greater percentages of such patients reported using fewer risk assessment practices, were less likely to deliver HIV education, and were less likely to recommend HIV testing. Epidemiological studies have shown that many individuals who misuse prescription opioids do inject these substances [ 51 – 53 ], so perceptions of limited HIV risk among those who use prescription opioids may result in missed opportunities for intervention. Focusing on individuals who inject opioids may be targeting those at highest risk, but individuals who do not inject still face risks if they engage in risky sexual behaviors.…”