HIV/AIDS services in substance use disorder treatment programs within the clinical trials network

Abstract

s / Drug and Alcohol Dependence 140 (2014) e86–e168 e107 ment prior to implementation of TRIP (Standard Practice Group); 255 clients entered treatment after TRIP implementation began and received Standard enhanced by TRIP. ANCOVAs were used to examine Time 2 differences by TRIP, Gender, and Attention groups, controlling for demographic and judgment measures at Time 1. Results: Compared to Standard Practice, adolescents receiving TRIP scoredhigher onDecision-Making (DM), evenafter controlling for Gender, Drug use Severity, Age, Juvenile Justice Involvement, Attention, andDMatTime1. Premeditation (thinkingbefore acting) was marginally higher among TRIP clients without attention difficulties. Perceived control over drug use decisions was lower in the TRIP group (among all males and among females without attention difficulties), suggesting greater personal insight into their ability to resist drug use in social situations. Conclusions: Findings suggest that TRIP promotes positive judgment and decision-making among adolescents, and that effectiveness varies by background characteristics such as gender and attention difficulties. Future studies should examine which specific elements of TRIP aremost relevant for improving decisionmaking and test explanatory models of how changes in judgment and decision-making affect treatment motivation, retention, and engagement. Financial support: NIDA R01DA013093. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.307 HIV/AIDS services in substance use disorder treatment programs within the clinical trials network Hannah K. Knudsen1, P.M. Roman2 1 University of Kentucky, Lexington, KY, United States 2 University of Georgia, Athens, GA, United States Aims: Previous research on HIV/AIDS-related services in substance use disorder (SUD) treatment has generally focused on the availability of HIV testing with less consideration of other prevention and supportive services. This study examines the adoption of HIV/AIDS-related services in treatment programs affiliated with NIDA’s Clinical Trials Network (CTN), with comparisons between opioid treatment programs (OTPs) and SUD treatment programs. Methods: Face-to-face interviews were conducted in 2011–2012 with administrators and clinical directors of 167 treatment programs that were members of NIDA’s CTN (response rate =79.9%). Dichotomous indicators measured whether programs: (1) conducted HIV risk assessments at treatment intake; (2) offered HIV education/prevention; (3) had adopted on-site HIV testing; (4) offered support groups for people with HIV/AIDS; and (5) provided on-site medical monitoring for people with HIV/AIDS (e.g., monitoring HAART compliance). Results: HIV risk assessment (86.2%) and HIV prevention/education (79.1%) were widely adopted by treatment programs in the CTN. About 54.7% of programs offered on-site HIV testing, consisting of 30.8% of programs using rapid HIV tests and another 23.9% using non-rapid tests. Fewer programs providedHIV support groups (22.9%) and medical monitoring for people with HIV/AIDS (24.8%). Opioid treatment programs were more likely than other SUD programs to offer on-site HIV testing (79.2% vs. 50.4%, p< .01) and support groups for people with HIV/AIDS (41.7% vs. 19.6%, p< .05). Conclusions: Although most treatment programs assess risk behaviors and offer HIV prevention/education, only half of the treatment programs within the NIDA CTN provide on-site HIV testing, which is a critical strategy for ensuring that patients receive their test results. Testing services have becomewidespread, however, within opioid treatment programs, which may reflect heightened concerns regarding the transmission of HIV/AIDS through injection drug use for their patient population. Financial support: Supported by the National Institute on Drug Abuse (R01DA14482). http://dx.doi.org/10.1016/j.drugalcdep.2014.02.308 Long-lasting sensitization induced by a single exposure to morphine: Age-related differences in mice