Veterans living with HIV rarely get opioid addiction treatment in a timely manner after receiving a diagnosis, according to a new Portland State University-OHSU joint study.
The study, “Predictors of timely opioid agonist treatment initiation among veterans with and without HIV,” found that only 4.9% of veterans seeking addiction treatment received care within 30 days. The low rate of care applied to veterans with HIV and a matched sample without.
However, slow access to addiction treatment for veterans with HIV has a greater negative impact. Timely access is tied to reduced risk behavior — such as needle sharing — as well as giving the patient better control over their health. Medications like methadone and buprenorphine are the most effective treatment for opioid addiction.
“One major thing that should come out of this research is a reduction of barriers to access addiction treatment,” said study author Jessica Wyse, who is an OHSU-PSU School of Public Health research assistant professor.
Their findings were published in the May edition of the journal Drug and Alcohol Dependence. In addition to limited timely access to medication for veterans with HIV, the study found that for patients with a psychiatric diagnosis or who live in rural areas, the rate of access is even worse.
“We want to get as many people as possible into opioid addiction treatment,” Wyse said. “And medication is the most effective treatment we have for opioid use disorder — which is an epidemic.”
Wyse said past studies have considered what portion of the veteran population received medication after seeking treatment for their opioid addiction, but those studies did not consider how an HIV diagnosis factored into patient care.
Although the study cannot pinpoint why this group of Veterans faces barriers to treatment, Wyse suggested that, within VA, medications for opioid use disorder are not generally prescribed in primary care settings or infectious disease clinics, where patients diagnosed with HIV often receive care.
A similar barrier exists for patients with a psychiatric diagnosis, she added.
“Securing care and breaking down barriers for those seeking care is important,” she said.
It is important to note, Wyse said, that the situation within the Veteran’s Administration (VA) has been improving.
In 2019, 35% of VA patients are getting medication to treat opioid addiction within a year.
“But this is a totally different population, it’s a more disadvantaged population,” Wyse said of veterans with HIV. “The study underscores that among these particularly vulnerable patients, there are some major hurdles.”
The good news, she added, is that VA researchers are tightly connected to VA operations partners. Wyse said this means their research could lead to institutional changes and improved access to care for patients.