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Journal of Public Health Advance Access published online on September 23, 2009
Journal of Public Health, doi:10.1093/pubmed/fdp089
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© The Author 2009, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved

Inability to access addiction treatment and risk of HIV infection among injection drug users recruited from a supervised injection facility{dagger}


M.-J.S. Milloy, Research Assistant1,2
Thomas Kerr, Research Scientist1,3
Ruth Zhang, Senior Statistician1
Mark Tyndall, Research Scientist1,3
Julio Montaner, Director1,3
Evan Wood, Research Scientist1,3

1 British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada, V6Z 1Y6
2 School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
3 Department of Medicine, University of British Columbia, Vancouver, BC, Canada


Address correspondence to E-mail: uhri-ew{at}cfenet.ubc.ca


  Abstract

Background Treatment for drug addiction is effective in reducing the harms of injection drug use, including infection with HIV and/or hepatitis C. We sought to examine the prevalence and correlates of being unable to access addiction treatment in a representative sample of injection drug users randomly recruited from a supervised injection facility.

Methods Using generalized estimating equations, we determined the prevalence and factors associated with being unable to access addiction treatment.

Results Between 1 July 2004 and 30 June 2006, 889 individuals completed at least one interview and were included in this analysis. At each interview, ~20% of respondents reported trying but being unable to access any type of drug or alcohol treatment in the previous 6 months. Being unable to access treatment was independently associated with recent incarceration, daily use of heroin and borrowing used syringes. In a secondary question, the majority of individuals reported waiting lists were the reason for being unable to access treatment.

Conclusion Given the independent association between inability to access addiction treatment and elevated HIV risk behavior, these results suggest expanding addiction treatment may contribute significantly to HIV prevention efforts in this population.

Keywords: alcohol and drug treatment, GEE, HIV, injection drug user, supervised injection facility

{dagger} A preliminary version of this manuscript was presented as a poster at the AIDS 2008 Conference in Mexico City, Mexico, 3 August to 8 August 2008.


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