Availability of Screening for Blood-Borne Viruses, Sexually Transmitted Infections, and HIV Pre-Exposure Prophylaxis...

Stimulant misuse is associated with greater incidence of HIV, Hepatitis C virus (HCV), and sexually transmitted infections (STIs). Substance use treatment facilities are an important site of care for people with stimulant use disorder (StUD). Accessible testing for HIV, HCV, and STIs, and HIV treatment, pre-exposure prophylaxis (PrEP), and HCV treatment are essential for controlling these syndemics.

We conducted a cross-sectional analysis of the 2024 National Substance Use and Mental Health Services Survey (N-SUMHSS) to describe availability of HIV, HCV, and STI testing, and HIV treatment, PrEP, and HCV treatment at substance use treatment facilities treating StUD. In addition, we compared the percentage of facilities with each service available between 2021 and 2024.

Of included facilities (N = 12,118), HIV testing was available at 36.2%, HCV testing at 35.1%, STI testing at 31.0%. HIV treatment was available at 15.9%, PrEP at 11.2%, and HCV treatment at 17.9% of facilities. Of facilities that did not offer HIV or HCV testing, 9.50% and 8.60% had the capacity to collect blood samples, respectively. Of facilities without available STI testing, 87.2% had the capacity to collect urine samples. There were 759 facilities with HIV and 1063 with HCV treatment without PrEP availability. Between 2021 and 2024, the percentage with each service increased, however, the gaps between service availability also remained constant.

Few substance use treatment facilities provided HIV, HCV, and STI testing, PrEP, and treatment. Yet, many collect biospecimens required for testing or management of PrEP. Expansion of these services and colocation with treatment facilities are crucial strategies for prevention, early diagnosis, and timely treatment of HIV, HCV, and STI in individuals with StUD.