The Receipt of Substance Use Disorder Treatment Among Individuals Under Community Supervision at Risk for HIV

Objectives: Individuals under community supervision (e.g., probation and parole) have high rates of illicit substance use (ISU) and substance use disorders (SUDs), increasing their risk for numerous health issues, including HIV transmission. While SUD treatment can reduce substance use and HIV transmission risk, gaps remain in our understanding of its receipt among community-supervised individuals at risk for HIV. Methods: Using baseline data from the Southern Pre-Exposure Prophylaxis Study (SPECS), we examined the prevalence and demographic characteristics associated with SUD treatment receipt among community-supervised individuals at risk for HIV. Two participant subsets from SPECS were analyzed: those with a history of ISU (n = 346) and, among these participants, those specifically reporting a history of illicit opioid use (IOU; n = 211). Results: A high prevalence of SUD treatment receipt was found among participants reporting ISU (58.7%) and IOU (73.9%). Among participants with a history of ISU, Black non-Hispanic individuals had a significantly lower prevalence of treatment receipt than White non-Hispanic individuals (aPR = 0.68, 95% CI: 0.51, 0.90, p = 0.007). Among participants reporting IOU, White non-Hispanic individuals were 2.7 (95% CI: 1.2, 6.3) times more likely to receive medication for an SUD than individuals of any other race or ethnicity. Conclusions: Study findings highlight missed opportunities to engage people on community supervision who are at risk for HIV in evidence-based SUD care. Targeted efforts are needed to promote the adoption of medications for opioid use disorders (MOUDs) among individuals under community supervision, particularly for racially minoritized populations.