Preexposure Prophylaxis (PrEP) for HIV Prevention at Outpatient Substance Use Treatment Facilities, United States, 2021

Author:

Bunting Samuel R.1,Vidyasagar Nitin1,Wilson Allison P.1,Hazra Aniruddha1

Affiliation:

1. Samuel Bunting is with the Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL. Nitin Vidyasagar is with the Pritzker School of Medicine, University of Chicago. Allison Wilson and Aniruddha Hazra are with the Chicago Center for HIV Elimination, University of Chicago. Aniruddha Hazra is also with the Section of Infectious Diseases, Department of Medicine, University of Chicago.

Abstract

Objectives. To determine the percentage of US outpatient substance use treatment facilities that offer HIV preexposure prophylaxis (PrEP). Methods. We used a retrospective cross-sectional design with data from the National Substance Use and Mental Health Services Survey, which was administered to directors of US outpatient substance use treatment facilities in 2021. We evaluated the percentage of outpatient substance use treatment facilities offering PrEP and factors associated with the likelihood of offering PrEP. Results. We included 12 182 outpatient substance use treatment facilities. Of these, 637 (5.2%) offered PrEP. Offering HIV treatment (adjusted odds ratio [AOR] = 45.3; 95% confidence interval [CI] = 36.0, 56.9) and offering programs for LGBTQ (lesbian, gay, bisexual, transgender, and queer or questioning) people (AOR = 1.3; 95% CI = 1.0, 1.6) were associated with higher likelihoods of offering PrEP. Conclusions. PrEP is highly effective and recommended for patients at risk for HIV from injection drug use. Nearly 95% of US outpatient substance use treatment facilities did not offer PrEP—a missed opportunity for harm reduction through primary HIV prevention. Public Health Implications. Diversification of the array of available HIV PrEP options and the ongoing HIV and opioid use epidemics require outpatient substance use treatment facilities to expand PrEP availability. ( Am J Public Health. 2024;114(8):833–837. https://doi.org/10.2105/AJPH.2024.307699 )

Publisher

American Public Health Association

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