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Nguemo Djiometio JB, Djiadeu P, Mbuagbaw L, Njoroge I, Nelson LE, Kahan M. Individuals' experiences of the integration of substance use/addiction and HIV/AIDS services in community settings: a qualitative systematic review protocol. JBI Evid Synth 2021; 18:2687-2693. [PMID: 32740031 DOI: 10.11124/jbisrir-d-19-00391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objectives of this systematic review are: i) to identify, appraise, and synthesize the best available evidence on individuals' experiences of the integration of substance use/addiction and HIV/AIDS services in community settings, and ii) to identify barriers to and facilitators of the integration of the services. INTRODUCTION The integration of drug use treatment and HIV services has shown to improve HIV prevention, decrease HIV infection and progression, while improving access to social and support services among substance users. Combined pharmacological and behavioral drug use treatments have been proven to diminish behaviors that increase HIV risk, decrease incidence of the disease, and improve adherence to antiretroviral therapy among individuals who use drugs and are HIV-positive. INCLUSION CRITERIA The populations of interest in this review include patients who have experienced integrated substance use/addiction and HIV services, as well as health care professionals and policy makers who have been involved in developing or implementing integrated substance use/addiction and HIV/AIDS services. Eligible studies will focus on the views, attitudes, understandings, and perceptions of patients, health care professionals, and policy makers resulting from experience in developing or implementing strategies that have or could inform the integration of substance use/addiction and HIV/AIDS services in community settings. METHODS Searches will be conducted in MEDLINE, Embase, PsycINFO, and CINHAL. The search for unpublished studies will include OpenGrey, Grey Matters, New York Academy of Medicine's Grey Literature Report, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform. Selected studies will be critically appraised by two independent reviewers for methodological quality. Data will be extracted and then synthesized following the JBI meta-aggregative approach. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020185858.
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Affiliation(s)
- Joseph B Nguemo Djiometio
- Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University, Toronto, ON, Canada.,Substance Use Service/META:PHI, Women's College Hospital, Toronto, ON, Canada
| | - Pascal Djiadeu
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Irene Njoroge
- Substance Use Service/META:PHI, Women's College Hospital, Toronto, ON, Canada
| | - LaRon E Nelson
- Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada.,School of Nursing, Yale University, New Haven, CT, USA
| | - Meldon Kahan
- Substance Use Service/META:PHI, Women's College Hospital, Toronto, ON, Canada
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Detels R, Wu J, Wu Z. Control of HIV/AIDS can be achieved with multi-strategies. GLOBAL HEALTH JOURNAL 2019. [DOI: 10.1016/j.glohj.2019.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Guise A, Seguin M, Mburu G, McLean S, Grenfell P, Islam Z, Filippovych S, Assan H, Low A, Vickerman P, Rhodes T. Integrated opioid substitution therapy and HIV care: a qualitative systematic review and synthesis of client and provider experiences. AIDS Care 2017; 29:1119-1128. [PMID: 28281354 DOI: 10.1080/09540121.2017.1300634] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
People who use drugs in many contexts have limited access to opioid substitution therapy and HIV care. Service integration is one strategy identified to support increased access. We reviewed and synthesized literature exploring client and provider experiences of integrated opioid substitution therapy and HIV care to identify acceptable approaches to care delivery. We systematically reviewed qualitative literature. We searched nine bibliographic databases, supplemented by manual searches of reference lists of articles from the database search, relevant journals, conferences, key organizations and consultation with experts. Thematic synthesis was used to develop descriptive themes in client and provider experiences. The search yielded 11 articles for inclusion, along with 8 expert and policy reports. We identify five descriptive themes: the convenience and comprehensive nature of co-located care, contrasting care philosophies and their role in shaping integration, the limits to disclosure and communication between clients and providers, opioid substitution therapy enabling HIV care access and engagement, and health system challenges to delivering integrated services. The discussion explores how integrated opioid substitution therapy and HIV care needs to adapt to specific social conditions, rather than following universal approaches. We identify priorities for future research. Acceptable integrated opioid substitution therapy and HIV care for people who use drugs and providers is most likely through co-located care and relies upon attention to stigma, supportive relationships and client centred cultures of delivery. Further research is needed to understand experiences of integrated care, particularly delivery in low and middle income settings and models of care focused on community and non-clinic based delivery.
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Affiliation(s)
- Andy Guise
- a Department of Global Public Health , University of California San Diego , San Diego , USA.,b Department of Public Health and Policy , London School of Hygiene and Tropical Medicine , London , UK
| | - Maureen Seguin
- c Centre for Research on Drugs and Health Behaviour , London School of Hygiene and Tropical Medicine , London , UK
| | - Gitau Mburu
- d Program Impact Unit , International HIV/AIDS Alliance , Brighton , UK.,e Department of Health Research , University of Lancaster , Lancaster , UK
| | - Susie McLean
- d Program Impact Unit , International HIV/AIDS Alliance , Brighton , UK
| | - Pippa Grenfell
- c Centre for Research on Drugs and Health Behaviour , London School of Hygiene and Tropical Medicine , London , UK
| | - Zahed Islam
- f Management Sciences for Health , Dhaka , Bangladesh
| | - Sergii Filippovych
- g Treatment, Procurement and Supply Management Department , International HIV/AIDS Alliance Ukraine , Kyiv , Ukraine
| | - Happy Assan
- h Tanzanian Network of People who Use Drugs , MDM Drop in centre , Dar es Salaam , Tanzania
| | - Andrea Low
- i International Center for AIDS Care and Treatment Programs , Columbia University , New York , USA
| | - Peter Vickerman
- j School of Social and Community Medicine , University of Bristol , Bristol , UK
| | - Tim Rhodes
- c Centre for Research on Drugs and Health Behaviour , London School of Hygiene and Tropical Medicine , London , UK
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Aharonovich E, Stohl M, Ellis J, Amrhein P, Hasin D. Commitment strength, alcohol dependence and HealthCall participation: effects on drinking reduction in HIV patients. Drug Alcohol Depend 2014; 135:112-8. [PMID: 24332577 PMCID: PMC3918435 DOI: 10.1016/j.drugalcdep.2013.11.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 11/18/2013] [Accepted: 11/19/2013] [Indexed: 12/31/2022]
Abstract
BACKGROUND The role of three factors in drinking outcome after brief intervention among heavily drinking HIV patients were investigated: strength of commitment to change drinking, alcohol dependence, and treatment type: brief Motivational Interview (MI) only, or MI plus HealthCall, a technological extension of brief intervention. METHODS HIV primary care patients (N=139) who drank ≥4 drinks at least once in the 30 days before study entry participated in MI-only or MI+HealthCall in a randomized trial to reduce drinking. Patients were 95.0% minority; 23.0% female; 46.8% alcohol dependent; mean age 46.3. Outcome at end of treatment (60 days) was drinks per drinking day (Timeline Follow-Back). Commitment strength (CS) was rated from MI session recordings. RESULTS Overall, stronger CS predicted end-of-treatment drinking (p<.001). After finding an interaction of treatment, CS and alcohol dependence (p=.01), we examined treatment×CS interactions in alcohol dependent and non-dependent patients. In alcohol dependent patients, the treatment×commitment strength interaction was significant (p=.006); patients with low commitment strength had better outcomes in MI+HealthCall than in MI-only (lower mean drinks per drinking day; 3.5 and 4.6 drinks, respectively). In non-dependent patients, neither treatment nor CS predicted outcome. CONCLUSIONS Among alcohol dependent HIV patients, HealthCall was most beneficial in drinking reduction when MI ended with low commitment strength. HealthCall may not merely extend MI effects, but add effects of its own that compensate for low commitment strength. Thus, HealthCall may also be effective when paired with briefer interventions requiring less skill, training and supervision than MI. Replication is warranted.
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Affiliation(s)
- Efrat Aharonovich
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, United States; Department of Psychiatry, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, United States.
| | - Malka Stohl
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
| | - James Ellis
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
| | - Paul Amrhein
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
| | - Deborah Hasin
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032,Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 180 Ft. Washington Avenue, New York, NY 10032,Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032
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Feldman MB, Weinberg GS, Wu E. Evaluation of a system designed to link people living with HIV/AIDS with mental health services at an AIDS-service organization. EVALUATION AND PROGRAM PLANNING 2012; 35:133-138. [PMID: 22054533 DOI: 10.1016/j.evalprogplan.2011.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Revised: 08/18/2011] [Accepted: 08/25/2011] [Indexed: 05/31/2023]
Abstract
This study evaluated the Rapid Response System, an initiative designed to link people living with HIV/AIDS with mental health services at an AIDS service organization. Data were extracted from agency records for 314 clients who had contact with the Rapid Response System over a 6-month period. Of the 281 clients who scheduled an appointment for an evaluation to initiate mental health services, 64% completed the evaluation. In the multivariate analysis, Latinos were significantly less likely than whites to complete the mental health evaluation. Further, there was a significant decrease in the likelihood of completing the mental health evaluation as the number of days between the Rapid Response System contact and the date of the evaluation appointment increased. Strategies that reduce the period of time between the initial referral and initiation of services may facilitate linkage with mental health treatment, particularly in the context of larger multi-service organizations.
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Deren S, Hagan H, Friedman S, Des Jarlais DC, Perlman D, Gwadz M, Cleland C, Osborne A, Lunievicz J. Current and emerging research needs in studying the NYC HIV-drug use epidemic. Subst Use Misuse 2011; 46:316-9. [PMID: 21303251 PMCID: PMC4455883 DOI: 10.3109/10826084.2011.523324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
As we begin the fourth decade of the epidemic, it is clear that, as demonstrated by the articles in this Special Issue, much has been learned about factors contributing to the decline in HIV prevalence among drug users in New York. However, there are a number of outstanding research questions that remain or are emerging. Following is a summary of some of the topics requiring further research. While this summary does not represent a comprehensive list, it is based on many of the questions raised in the articles in this Special Issue and identifies some of the directions to be investigated during the next decade.
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Affiliation(s)
- Sherry Deren
- Center for Drug Use and HIV Research, College of Nursing, New York University, New York, New York, USA.
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