WOMEN LIVING WITH DRUG-ABUSE AND HIV DISEASE - DRUG-ABUSE TREATMENT ACCESS AND SECONDARY PREVENTION ISSUES

In collaboration with the National Institute on Drug Abuse, tile Healt h Resources and Services Administration is conducting a multisite, lon gitudinal study oil issues of service needs, service utilization, and access to care for drug abusers with HIV. This article discusses acces s to drug abuse treatment and HIV secondary prevention for 116 women i nterviewed during tile study's first year in five U.S. cities. Using i nterview data from 115 service providers ill those same cities, it als o discusses drug abuse treatment availability and barriers to service expansion for drug users with HIV. Study findings indicate that there are highly significant gaps between tile drug abuse treatment services these women feel they need and those they have been able to receive; these were particularly pronounced for drug detoxification and residen tial and outpatient drug-free treatment. Women who used crack cocaine or injection drugs had particularly high levels of need for residentia l and outpatient drug abuse treatment, while women who use crack were found to have significantly less experience with the drug abuse treatm ent system than IDUs. HIV secondary prevention was also found to be a critical need for these women, many of whom were engaging in behaviors that place them at risk for reinfection, infection with other disease s, and transmission to others. Providers indicated that lack of fundin g was the major barrier to expanding services for this population; oth er barriers, such as lack of ancillary services and transportation, we re also noted. Two positive findings were that many drug abuse treatme nt agencies in these cities provide a wide range of ancillary services and that many different kinds of agencies offer drug abuse treatment services.