National Survey of Substance Abuse Treatment Services
December 1, 2010

HIV Services Offered by Substance Abuse Treatment Facilities

In Brief
  • In 2009, slightly more than one half (55 percent) of all substance abuse treatment facilities provided HIV/AIDS education, counseling, or support; about one quarter provided on-site HIV testing (28 percent) or early intervention for HIV (25 percent); and 9 percent provided special programs or groups for persons with HIV/AIDS

  • Non-hospital residential treatment facilities were more likely than hospital inpatient or outpatient facilities to provide HIV/AIDS education, counseling, or support; early intervention for HIV; and special programs or groups for persons with HIV/AIDS. Hospital inpatient treatment facilities (79 percent) were more likely than non-hospital residential (41 percent) and outpatient (24 percent) facilities to provide HIV testing

  • Facilities with a primary focus of general health care were more likely than facilities with a primary focus of substance abuse treatment services, mental health services, or a mix of mental health and substance abuse treatment services to provide HIV services

The Centers for Disease Control and Prevention (CDC) estimates that 19 percent of the more than 1 million people who currently live with the human immunodeficiency virus (HIV) in the United States are injection drug users. Injection drug users also represent approximately 12 percent of the estimated 56,300 new HIV cases each year in the United States.1,2

The behaviors associated with injection drug use, such as sharing needles and other drug equipment, place injection drug users at risk for spreading or contracting HIV.3 Therefore, substance abuse treatment facilities that include HIV prevention/education as part of their treatment programs and perform HIV screenings and HIV risk assessments can play a vital role in the control, prevention, and treatment of HIV.

The National Survey of Substance Abuse Treatment Services (N-SSATS) is an annual census of all known facilities in the United States, both public and private, that provide substance abuse treatment. N-SSATS collects information from facilities regarding the provision of on-site4 services that are focused on HIV or acquired immune deficiency syndrome (AIDS). These services include testing, early intervention, education programs, and the availability of special treatment programs or groups for persons with HIV/AIDS. This report uses data from the 2009 N-SSATS to examine the availability of on-site HIV services in substance abuse treatment facilities.

In 2009, 13,513 substance abuse treatment facilities responded to N-SSATS. While slightly more than one half (55 percent) of all facilities provided HIV/AIDS education, counseling, or support, about one quarter provided on-site HIV testing (28 percent) or early intervention for HIV (25 percent), and 9 percent provided special programs or groups for persons with HIV/AIDS (Figure 1).

Figure 1. Substance Abuse Treatment Facilities Providing HIV Services: 2009

Figure 1. Bar chart comparing Substance Abuse Treatment Facilities Providing HIV Services: 2009. Accessible table below.
Source: 2009 SAMHSA National Survey of Substance Abuse Treatment Services (N-SSATS).

Figure 1 Table. Substance Abuse Treatment Facilities Providing HIV Services: 2009
Service Percent
HIV or AIDS Education, Counseling, or Support 55%
HIV Testing 28%
Early Intervention for HIV 25%
Special Programs or Groups for Persons with HIV or AIDS 9%
Source: 2009 SAMHSA National Survey of Substance Abuse Treatment Services (N-SSATS).

Types of Care

Non-hospital residential facilities were more likely than hospital inpatient or outpatient facilities to provide HIV/AIDS education, counseling, or support; early intervention for HIV; and special programs or groups for persons with HIV/AIDS. Hospital inpatient facilities (79 percent) were more likely than non-hospital residential (41 percent) or outpatient (24 percent) facilities to provide HIV testing (Figure 2).

Figure 2. Substance Abuse Treatment Facilities Providing HIV Services, by Type of Care Offered: 2009

Figure 2. Bar chart comparing Substance Abuse Treatment Facilities Providing HIV Services, by Type of Care Offered: 2009. Accessible table below.
Note: In N-SSATS, types of care are not mutually exclusive, as treatment facilities can offer more than one type of care.
Source: 2009 SAMHSA National Survey of Substance Abuse Treatment Services (N-SSATS).

Figure 2 Table. Substance Abuse Treatment Facilities Providing HIV Services, by Type of Care Offered: 2009
Type of Care HIV or AIDS Education, Counseling, or Support Early Intervention for HIV HIV Testing Special Programs or Groups for Persons with HIV or AIDS
Residential (Non-Hospital) 71% 36% 41% 13%
Outpatient 52% 23% 24% 8%
Hospital Inpatient 63% 32% 79% 8%
Note: In N-SSATS, types of care are not mutually exclusive, as treatment facilities can offer more than one type of care.
Source: 2009 SAMHSA National Survey of Substance Abuse Treatment Services (N-SSATS).

Opioid Treatment Programs

Opioid Treatment Programs (OTPs) provide medication-assisted therapy with methadone and/or buprenorphine for the treatment of addiction to opiates such as heroin and prescription painkillers. Many of the patients at OTPs have a history of injection drug use. Facilities that operated OTPs were more likely than other treatment facilities to provide special programs or groups for persons with HIV/AIDS and more likely to provide early intervention for HIV or HIV/AIDS education, counseling, or support. Over one half of the approximately 1,240 facilities that operated an OTP provided HIV testing (63 percent) or HIV/AIDS education, counseling, or support (83 percent). Less than half of OTPs provided early intervention for HIV (48 percent) or special programs or groups for persons with HIV/AIDS (21 percent).

Facility Operation and Primary Focus

Facilities operated by State governments were more likely than facilities operated by other organizations or levels of government to provide HIV/AIDS education, counseling, or support. Facilities operated by the Federal Government were more likely than facilities operated by other organizations or levels of government to provide HIV testing or early intervention for HIV. The proportion of facilities offering special programs or groups for persons with HIV/AIDS ranged from 10 percent among facilities operated by private non-profit organizations to 5 percent among facilities operated by the Federal Government (Figure 3).

Figure 3. Substance Abuse Treatment Facilities Providing HIV Services, by Facility Operation: 2009

Figure 3. Bar chart comparing Substance Abuse Treatment Facilities Providing HIV Services, by Facility Operation: 2009. Accessible table below.
Source: 2009 SAMHSA National Survey of Substance Abuse Treatment Services (N-SSATS).

Figure 3 Table. Substance Abuse Treatment Facilities Providing HIV Services, by Facility Operation: 2009
Facility Operation HIV or AIDS Education, Counseling, or Support Early Intervention for HIV HIV Testing Special Programs or Groups for Persons with HIV or AIDS
Private For-Profit 44% 17% 19% 7%
Private Non-Profit 60% 28% 29% 10%
State Government 71% 34% 50% 8%
Local, County, or Community Government 60% 28% 31% 7%
Tribal Government 46% 23% 21% 9%
Federal Government 61% 38% 74% 5%
Source: 2009 SAMHSA National Survey of Substance Abuse Treatment Services (N-SSATS).

Facilities with a primary focus of general health care were more likely than facilities with a primary focus of substance abuse treatment services, mental health services, or a mix of mental health and substance abuse treatment services to provide HIV services (Figure 4).

Figure 4. Substance Abuse Treatment Facilities Providing HIV Services, by Primary Focus: 2009

Figure 4. Bar chart comparing Substance Abuse Treatment Facilities Providing HIV Services, by Primary Focus: 2009. Accessible table below.
Source: 2009 SAMHSA National Survey of Substance Abuse Treatment Services (N-SSATS).

Figure 4 Table. Substance Abuse Treatment Facilities Providing HIV Services, by Primary Focus: 2009
Primary Focus HIV or AIDS Education, Counseling, or Support Early Intervention for HIV HIV Testing Special Programs or Groups for Persons with HIV or AIDS
Substance Abuse Treatment Services 61% 28% 30% 10%
Mental Health Services 30% 10% 20% 3%
Mix of Mental Health and Substance Abuse Treatment Services 49% 22% 23% 8%
General Health Care 67% 49% 84% 11%
Other 55% 18% 28% 8%
Source: 2009 SAMHSA National Survey of Substance Abuse Treatment Services (N-SSATS).

Region

Treatment facilities in the Northeast were more likely than facilities in other regions to provide HIV testing; HIV/AIDS education, counseling, or support; special programs or groups for persons with HIV/AIDS; and early intervention for HIV (Figure 5).

Figure 5. Substance Abuse Treatment Facilities Providing HIV Services, by Region: 2009

Figure 5. Bar chart comparing Substance Abuse Treatment Facilities Providing HIV Services, by Region: 2009. Accessible table below.
Source: 2009 SAMHSA National Survey of Substance Abuse Treatment Services (N-SSATS).

Figure 5 Table. Substance Abuse Treatment Facilities Providing HIV Services, by Region: 2009
Region HIV or AIDS Education, Counseling, or Support Early Intervention for HIV HIV Testing Special Programs or Groups for Persons with HIV or AIDS
Northeast 63% 33% 36% 14%
Midwest 47% 17% 19% 5%
South 58% 25% 32% 7%
West 53% 25% 25% 8%
Source: 2009 SAMHSA National Survey of Substance Abuse Treatment Services (N-SSATS).

Discussion

Despite advances in the treatment of HIV/AIDS since the 1980s, when HIV and AIDS first emerged in the United States, nearly 20,000 people with AIDS die each year.5 There is still no cure for HIV; however, advances in HIV treatment regimens extend the lives of the people infected with the virus once they are diagnosed.

While substance abuse treatment facilities are encouraged to provide HIV prevention/education, HIV screening and testing, and counseling to their clients,6,7 the findings presented in this report indicate that in 2009 just over half (55 percent) of all facilities provided HIV/AIDS education, counseling, or support, and much smaller proportions of facilities provided other HIV services such as early intervention for HIV, HIV testing, and special programs or groups for persons with HIV/AIDS.

Substance abuse treatment providers are in an ideal position to provide HIV education and to test drug users for HIV. Incorporation of HIV services into the treatment programs at more facilities would be a cost-effective approach to delivering these services to a population at high risk for contracting and spreading HIV.

End Notes

1 Centers for Disease Control and Prevention. (2010). HIV in the United States. Retrieved from http://www.cdc.gov/hiv/resources/factsheets/us.htm You are leaving this site
2 The estimate includes the category "injection drug use" but excludes the category "male-to-male sexual contact and injection drug use."
3 Centers for Disease Control and Prevention. (2006). Questions and answers: HIV prevention. Retrieved from http://www.cdc.gov/hiv/resources/qa/prevention.htm You are leaving this site
4 Data presented in this report do not reflect the availability of off-site disease testing and interventions.
5 Centers for Disease Control and Prevention. (2010). HIV in the United States. Retrieved from http://www.cdc.gov/hiv/resources/factsheets/us.htm You are leaving this site
6 Batki, S. L., & Selwyn, P. A. (Consensus Panel Co-Chairs); Center for Substance Abuse Treatment. (2000). Primary and secondary HIV prevention. In Substance abuse treatment for persons with HIV/AIDS (Treatment Improvement Protocol [TIP] Series 37, DHHS Publication No. SMA 00-3410). Retrieved from http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=hssamhsatip&part=A65275 You are leaving this site
7 Batki, S. L., & Selwyn, P. A. (Consensus Panel Co-Chairs); Center for Substance Abuse Treatment. (2000). Medical assessment and treatment. In Substance abuse treatment for persons with HIV/AIDS (Treatment Improvement Protocol [TIP] Series 37, DHHS Publication No. SMA 00-3410). Retrieved from http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=hssamhsatip&part=A65036 You are leaving this site

Suggested Citation

Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (December 1, 2010). The N-SSATS Report: HIV Services Offered by Substance Abuse Treatment Facilities. Rockville, MD.

The National Survey of Substance Abuse Treatment Services (N-SSATS) is an annual survey of all substance abuse treatment facilities in the United States, both public and private, that are known to the Substance Abuse and Mental Health Services Administration (SAMHSA). N-SSATS is one component of the Drug and Alcohol Services Information System (DASIS), an integrated data system maintained by the Center for Behavioral Health Statistics and Quality, SAMHSA.

N-SSATS collects three types of information from facilities: characteristics of individual facilities such as services offered and types of treatment provided, primary focus of the facility, and payment options; client count information such as counts of clients served by service type and number of beds designated for treatment; and general information such as licensure, certification, or accreditation and facility website availability. In 2009, N-SSATS collected information from 13,513 facilities from all 50 States, the District of Columbia, Puerto Rico, the Federated States of Micronesia, Guam, Palau, and the Virgin Islands. Information and data for this report are based on data reported to N-SSATS for the survey reference date March 31, 2009.

The N-SSATS Report is prepared by the Center for Behavioral Health Statistics and Quality, SAMHSA; Synectics for Management Decisions, Inc., Arlington, VA; and RTI International, Research Triangle Park, NC. Information on the most recent N-SSATS is available in the following publication:

Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (2010). National Survey of Substance Abuse Treatment Services (N-SSATS): 2009. Data on substance abuse treatment facilities (DASIS Series: S-54, HHS Publication No. (SMA) 10-4579). Rockville, MD: Author.

Access the latest N-SSATS reports at:
http:/oas.samhsa.gov/dasis.htm

Access the latest N-SSATS public use files at:
http://samhsa.gov/data/SAMHDA.htm

Other substance abuse reports are available at:
http://oas.samhsa.gov

The N-SSATS Report is published periodically by the Center for Behavioral Health Statistics and Quality (formerly the Office of Applied Studies), Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report or other reports from the Center for Behavioral Health Statistics and Quality are available online: http://oas.samhsa.gov. Citation of the source is appreciated. For questions about this report, e-mail: shortreports@samhsa.hhs.gov.

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