Sexually Transmitted and Blood-borne Infections Among Patients Presenting to a Low-barrier Substance Use Disorder...

Area of Science:

• Infectious Diseases
• Public Health
• Addiction Medicine

Background:

• Patients with substance use disorders (SUD) often have complex health needs, including a higher risk for infectious diseases.
• Low-barrier-to-access programs (LBAP) are crucial for engaging this population in care.
• Understanding the specific infection-related needs of patients entering SUD treatment is vital for effective public health interventions.

Purpose of the Study:

• To assess the prevalence of human immunodeficiency virus (HIV), hepatitis B and C virus (HBV, HCV), syphilis, gonorrhea, and chlamydia among patients starting SUD care at an LBAP.
• To determine the rates of treatment and linkage to care for identified infections.
• To highlight the unmet infection-related needs within this patient population.

Main Methods:

• A retrospective review of patient records was conducted at an LBAP in Boston, MA.
• Data were collected for patients completing intake visits during a 9-month period following the implementation of a standardized laboratory panel.
• Screening tests included HIV, HBV, HCV, syphilis, gonorrhea, and chlamydia.

Main Results:

• Of 393 patients, 84.7% completed at least one screening test.
• High baseline rates were observed for current or past hepatitis C virus (HCV) (38.4%) and HIV (2.3%).
• Sixty-one new infections were identified, including 48 cases of viremic HCV, 1 HIV, 3 syphilis, 4 gonorrhea, 3 chlamydia, and 1 acute HBV. Many patients were also non-immune to HBV and HAV.

Conclusions:

• Patients initiating SUD care at LBAPs exhibit substantial and unmet infection-related needs.
• The findings underscore the necessity of integrating comprehensive infection prevention, screening, and linkage-to-treatment services within LBAPs.
• Implementing standardized protocols can improve health outcomes for individuals with substance use disorders.