Research studies conducted over the last 20 years have found
some associations between substance abuse treatment, reductions in HIV
transmission risk behaviors, and increased protection from HIV infection.1,
2 In 2003, the estimated rate of AIDS cases in the United
States was 14.5 per 100,000 population and approximately 27 percent of
persons living with AIDS were exposed to HIV through injection drug use.3,
4
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. In 2004, 13,454 substance
abuse treatment facilities responded to N-SSATS. This report uses the 2004
N-SSATS to examine the availability of HIV services including HIV testing;
HIV or AIDS education, counseling, or support; or specially designed
treatment programs for persons with HIV or AIDS among substance abuse
treatment programs in the United States.
Availability of HIV Services
HIV education/counseling/support services were
provided more often in substance abuse treatment facilities than HIV testing or
special programs or groups for people with HIV/AIDS. Almost one-third (31
percent) of substance abuse treatment facilities offered HIV testing, 56 percent
offered HIV education/counseling/support groups, and 12 percent offered special
programs or groups for persons with HIV/AIDS.
Service Availability by Facility Operation
Twenty percent of facilities operated5
by private for-profit organizations provided HIV testing in 2004, 44 percent
provided HIV education/counseling/support, and 10 percent offered special
programs or groups for persons with HIV/AIDS (Table 1). Among facilities
operated by private non-profit organizations, 33 percent provided HIV testing,
60 percent provided HIV education/counseling/support, and 13 percent offered
special programs or groups for persons with HIV/AIDS. State government operated
facilities were more likely to provide HIV/AIDS-related services than local
government or private facilities: 57 percent of State-operated facilities
provided HIV testing, 72 percent provided HIV education/counseling/support, and
15 percent offered special programs or groups for persons with HIV/AIDS.
Among Federally-operated facilities, those operated by the Department of
Veterans Affairs (VA) were more likely to offer HIV testing and
education/counseling/support than other Federally operated facilities: 94
percent of VA facilities offered HIV testing and 86 percent offered HIV
education/counseling/support services.
|
Table 1. Percent of Facilities Offering HIV Services, by
Facility Operation: 2004 |
|
Facility Operation |
Percent Offering HIV Testing |
Percent Offering HIV
Education/ Counseling/Support |
Percent Offering Special
Programs/Groups for Persons with HIV/AIDS |
|
Private for-Profit (n=3,488) |
20 |
44 |
10 |
|
Private non-Profit (n=8,053) |
33 |
60 |
13 |
|
State Government (n=458) |
57 |
72 |
15 |
|
Local Government (n=956) |
34 |
58 |
9 |
|
Federal Government (n=327) |
75 |
65 |
9 |
|
Dept. of Veterans Affairs (n=185) |
94 |
86 |
11 |
|
Dept. of Defense (n=102) |
54 |
26 |
3 |
|
Indian Health Service (n=34) |
44 |
68 |
11 |
|
Other (n=6) |
33 |
50 |
25 |
|
Tribal Government (n=172) |
23 |
56 |
8 |
|
|
| Source:
2004 SAMHSA National Survey of Substance Abuse Treatment
Services (N-SSATS). |
Service Availability by Type of Care
The availability of HIV services varied widely by
the type of care6
offered at facilities (Figure 1). Among facilities offering outpatient services,
facilities offering outpatient methadone maintenance were most likely to offer
HIV/AIDS services: 65 percent of these facilities offered HIV testing and 90
percent offered HIV education/counseling/support (Table 2). Among facilities
offering residential services, 46 percent offered HIV testing and 70 percent
offered HIV education/counseling/support. Among facilities offering hospital
inpatient services, 76 percent offered HIV testing and 59 percent offered HIV
education/counseling/support.
|
Figure 1. Availability of HIV Services, by Type of Care: 2004 |
|
| Source:
2004 SAMHSA National Survey of Substance Abuse Treatment
Services (N-SSATS). |
|
Table 2. Percent of Facilities Offering HIV Services, by Type of
Care: 2004 |
|
Type of Care* |
Percent Offering HIV Testing |
Percent Offering HIV
Education/
Counseling/
Support |
Special Programs/Groups for
Persons with HIV/AIDS |
|
Outpatient (n=10,853) |
27 |
54 |
11 |
|
Regular Outpatient (n=9,649) |
24 |
52 |
10 |
|
Intensive Outpatient (n=5,643) |
31 |
58 |
11 |
|
Methadone Maintenance (n=925) |
65 |
90 |
32 |
|
Residential (n=3,680) |
46 |
70 |
16 |
|
Short Term (n=1,524) |
54 |
73 |
16 |
|
Long Term (n=3,027) |
45 |
71 |
18 |
|
Hospital Inpatient (1,073) |
76 |
59 |
12 |
|
Treatment (n=724) |
77 |
61 |
15 |
|
Detoxification (n=874) |
79 |
57 |
10 |
|
|
* In
N-SSATS, types of care are not mutually exclusive, as treatment
facilities can offer more than one type of care.
Source: 2004 SAMHSA National Survey of Substance Abuse Treatment
Services (N-SSATS). |
Facility Size
The size of the facility as measured by the
number of clients in treatment on March 31, 2004, was associated with the
availability of HIV/AIDS services (Table 3).7,
8 Large facilities were more likely to offer HIV/AIDS services than
smaller facilities. Thirty-two percent of large facilities servicing outpatient
clients offered HIV testing compared to 25 percent of small outpatient
facilities. Among large residential facilities, 54 percent of facilities offered
HIV testing compared to 38 percent of small residential facilities. For hospital
inpatient facilities, 81 percent of large facilities offered HIV testing
compared to 73 percent of small facilities.
|
Table 3. Percent of Facilities Offering HIV Services, by Type of
Care and Facility Size: 2004 |
|
Type of Care/Facility Size |
Percent Offering HIV Testing |
Percent Offering
HIV Education/
Counseling/Support |
Special Programs/Groups for
Persons with HIV/AIDS |
|
Outpatient |
|
|
|
|
Small (≤ 48 clients) |
25 |
47 |
9 |
|
Large (> 48 clients) |
32 |
61 |
13 |
|
Residential |
|
|
|
|
Small (≤ 19
clients) |
38 |
64 |
12 |
|
Large (> 19 clients) |
54 |
78 |
21 |
|
Hospital Inpatient |
|
|
|
|
Small (≤ 8 clients) |
73 |
52 |
9 |
|
Large (> 8 clients) |
81 |
70 |
17 |
|
|
| Source:
2004 SAMHSA National Survey of Substance Abuse Treatment
Services (N-SSATS). |
End Notes
1 Metzger, D. S., &
Navaline, H. (2003). Human immunodeficiency virus prevention and the potential
of drug abuse treatment. Clinical Infectious Diseases, 37(Suppl 5),
S451–6.
2 Sorensen, J. L., &
Copeland, A. L. (2000). Drug abuse treatment as an HIV prevention strategy: a
review. Drug Alcohol Depend. 59(1):17–31.
3 Centers for
Disease Control and Prevention. (2004). HIV/AIDS surveillance report, 2003
(Vol. 15). Retrieved May 16, 2005 from
http://www.cdc.gov/hiv/stats/hasrlink.htm.
4 Centers for
Disease Control and Prevention. (2003). Characteristics of persons living with
AIDS and HIV, 2001. HIV/AIDS surveillance supplemental report, 9(2).
Retrieved May 16, 2005, from
http://www.cdc.gov/hiv/stats/hasrsupp92/Authorship.htm.
5 Facility
operation indicates the type of organization (private for-profit or private
non-profit) or level of government (Federal, State, Tribal, or
local/county/community) responsible for the operation of the facility.
6 The types of
care are outpatient, non-hospital residential, and hospital inpatient.
Outpatient care includes outpatient detoxification, outpatient methadone
maintenance, outpatient day treatment or partial hospitalization (20 or more
hours per week), intensive outpatient treatment (a minimum of 2 hours per day on
3 or more days per week), and regular outpatient treatment (fewer hours per week
than intensive). Non-hospital residential care includes residential
detoxification, residential short-term treatment (30 days or less), and
residential long-term treatment (more than 30 days). Hospital inpatient care
includes inpatient detoxification and inpatient treatment.
7 Facility size
was divided into two values: less than or equal to the median number of clients
on March 31, 2004, compared to greater than the median number of clients on that
date.
8 The number of
clients in treatment in the 2004 N-SSATS were defined as: 1) hospital
inpatient and non-hospital residential clients receiving substance abuse
services at the facility on March 31, 2004; and 2) outpatient clients who were
seen at the facility for a substance abuse treatment or detoxification service
at least once during the month of March 2004, and who were still enrolled in
treatment as of March 31, 2004.
The Drug and Alcohol
Services Information System (DASIS) is an integrated data system
maintained by the Office of Applied Studies, Substance Abuse and Mental
Health Services Administration (SAMHSA). One component of DASIS is the
National Survey of Substance Abuse Treatment Services (N-SSATS), an
annual survey of all facilities in the United States, both public and
private, that provide substance abuse treatment. N-SSATS was formerly
known as the Uniform Facility Data Set (UFDS).
The DASIS Report is prepared by the Office of Applied Studies,
SAMHSA; Synectics for Management Decisions, Inc., Arlington, Virginia;
and by RTI International in Research Triangle Park, North Carolina (RTI
International is a trade name of Research Triangle Institute).
Information and data for this report are based on data reported to
N-SSATS for the survey reference date March 31, 2004.
Access the latest TEDS reports at:
http://www.oas.samhsa.gov/dasis.htm
Access the latest TEDS public use files at:
http://www.oas.samhsa.gov/SAMHDA.htm
Other substance abuse reports are available at:
http://www.oas.samhsa.gov
|
| The DASIS Report is
published periodically by 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
Office of Applied Studies are available on-line:
http://www.oas.samhsa.gov. Citation of the source is appreciated.
For questions about this report please e-mail:
shortreports@samhsa.hhs.gov
|
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This page was last updated on May 16, 2008.
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