PMID- 35007957
OWN - NLM
STAT- MEDLINE
DCOM- 20220202
LR  - 20221221
IS  - 1879-0046 (Electronic)
IS  - 0376-8716 (Print)
IS  - 0376-8716 (Linking)
VI  - 231
DP  - 2022 Feb 1
TI  - Safer in care: A pandemic-tested model of integrated HIV/OUD care.
PG  - 109241
LID - S0376-8716(21)00736-5 [pii]
LID - 10.1016/j.drugalcdep.2021.109241 [doi]
AB  - BACKGROUND: Rural, poor, persons with HIV (PWH) and substance use are among the 
      most vulnerable to SARS-CoV-2 and related health service disruptions. The 
      objective of the study was to evaluate the health outcomes and utilization of PWH 
      at an Outpatient-based Opioid Treatment (OBOT) Clinic. METHODS: We evaluated a 
      clinic-based cohort at the University of Alabama at Birmingham HIV clinic from 
      November 2018 to May 2021. We compared HIV outcomes of OBOT patients, who are 
      highly vulnerable, to the overall clinic. We stratified OBOT patients according 
      to comorbid stimulant use disorder and compared clinic utilization and viral load 
      suppression in the 6 months before and after the safer at home mandate (May 2020) 
      in Alabama. RESULTS: Of 3857 PWH, 57 were referred to OBOT, 48 attended, 45 were 
      initiated on buprenorphine, and 35 had a VL< 200 in the last 6 months. Relative 
      to the overall HIV clinic, OBOT patients were significantly less likely to remain 
      VL suppressed (90% vs 78%, p = 0.01). More patients were suppressed after OBOT 
      linkage (81%) than prior (73%). For those referred before May 2020, there was no 
      change in viral suppression before and after the safer at home order (75%). 
      Although new OBOT referrals did not increase during the pandemic, the number of 
      visits attended per month did increase from a median of 3-4 per patient. 
      CONCLUSIONS: Unlike many PWH who faced access barriers, PWH receiving care at 
      OBOT did not fall out of care but increased healthcare utilization and maintained 
      viral suppression despite the public health emergency.
CI  - Copyright (c) 2022 Elsevier B.V. All rights reserved.
FAU - Eaton, Ellen F
AU  - Eaton EF
AD  - University of Alabama at Birmingham, Division of Infectious Diseases, 1900 
      University Boulevard, Tinsley Harrison Tower, Birmingham, AL 35294, USA. 
      Electronic address: eeaton@uab.edu.
FAU - Tamhane, Ashutosh
AU  - Tamhane A
AD  - University of Alabama at Birmingham, Division of Infectious Diseases, 1900 
      University Boulevard, Tinsley Harrison Tower, Birmingham, AL 35294, USA.
FAU - Turner, Wesli
AU  - Turner W
AD  - University of Alabama at Birmingham, Division of Infectious Diseases, 1900 
      University Boulevard, Tinsley Harrison Tower, Birmingham, AL 35294, USA.
FAU - Raper, James L
AU  - Raper JL
AD  - University of Alabama at Birmingham, Division of Infectious Diseases, 1900 
      University Boulevard, Tinsley Harrison Tower, Birmingham, AL 35294, USA.
FAU - Saag, Michael S
AU  - Saag MS
AD  - University of Alabama at Birmingham, Division of Infectious Diseases, 1900 
      University Boulevard, Tinsley Harrison Tower, Birmingham, AL 35294, USA.
FAU - Cropsey, Karen L
AU  - Cropsey KL
AD  - University of Alabama at Birmingham, Division of Psychiatry and Behavioral 
      Neurobiology, SC 560, 1720 2nd Ave S, Birmingham, AL 35294-0017, USA.
LA  - eng
GR  - R01 MH124633/MH/NIMH NIH HHS/United States
GR  - P30 AI027767/AI/NIAID NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20211224
PL  - Ireland
TA  - Drug Alcohol Depend
JT  - Drug and alcohol dependence
JID - 7513587
RN  - 40D3SCR4GZ (Buprenorphine)
SB  - IM
MH  - *Buprenorphine/therapeutic use
MH  - *COVID-19
MH  - *HIV Infections/drug therapy/epidemiology
MH  - Humans
MH  - Opiate Substitution Treatment
MH  - *Opioid-Related Disorders/drug therapy
MH  - Pandemics
MH  - SARS-CoV-2
PMC - PMC9758363
OTO - NOTNLM
OT  - HIV
OT  - Opioid continuum of care
OT  - Opioid use disorder
OT  - SARS-CoV-2
EDAT- 2022/01/11 06:00
MHDA- 2022/02/03 06:00
PMCR- 2021/12/24
CRDT- 2022/01/10 20:31
PHST- 2021/08/04 00:00 [received]
PHST- 2021/11/29 00:00 [revised]
PHST- 2021/12/07 00:00 [accepted]
PHST- 2022/01/11 06:00 [pubmed]
PHST- 2022/02/03 06:00 [medline]
PHST- 2022/01/10 20:31 [entrez]
PHST- 2021/12/24 00:00 [pmc-release]
AID - S0376-8716(21)00736-5 [pii]
AID - 109241 [pii]
AID - 10.1016/j.drugalcdep.2021.109241 [doi]
PST - ppublish
SO  - Drug Alcohol Depend. 2022 Feb 1;231:109241. doi: 
      10.1016/j.drugalcdep.2021.109241. Epub 2021 Dec 24.