1. Patients initiating care at one substance use disorder clinic had high rates of HCV and several other sexually transmitted infections.
2. Comprehensive infection prevention, screening and treatment may be helpful at such facilities.
Evidence Rating Level: 2 (Good)
Compared to the general United States of America (USA) population, people with active substance use disorder (SUD) have higher rates of sexually transmitted as well as blood-borne infections. Some causes of this include needle sharing and riskier sexual behaviors. Many persons with SUD use low barrier to access programs (LBAPs) to obtain medication for their treatment of addiction. LBAPs may thus be an effective avenue to screen and treat for these infections among this population.
This study was a retrospective, cross-sectional chart review of all new patients at an LBAP in Boston, Massachusetts, USA who presented from Jan 1, 2017 to September 20, 2017. Participants were included in the data if they were a new patient or had not received care for at least 4 weeks (n=393). Minors and those who did not complete a full intake form were excluded. Patients recorded a substance use history and completed an intake laboratory panel, which included blood and urine tests related to sexually transmitted and blood-borne infections.
In this study, high baseline rates of HIV (2.3%), HCV (38.4%), and chronic HBV (0.5%) were noted amongst patients. In addition, 61 new, active infections of HIV, HCV, HBS, syphilis, gonorrhea, and chlamydia were also found through screening across 55 unique patients. Finally, many patients were identified to not be vaccinated (and thuss not immune) to HBV or HAV. However, this study was limited, especially its focus on one clinic in an urban setting, which may not be generalizable. Nonetheless, this study suggests that LBAPs may be a good way to screen, and potentially even treat certain infections amongst those with SUD.
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