The 130th Annual Meeting of APHA

Abstract #46048

James Walkup, PhD¹, Elizabeth Wade, BA², Kevin Moore², and Lynn Warner, MSW, PhD¹. (1) Institute for Health, Health Care Policy, and Aging Research, Rutgers University, 30 College Ave, New Brunswick, NJ 08901, 732-932-6635, jaywalks@aol.com, (2) Clinical Psychology, Rutgers University, GSAPP, Piscataway, NJ 08901

BACKGROUND: More than one third of AIDS cases are associated with injection drug use (IDU) (CDC, 2001a, 2001b). Using national survey data, D'Aunno and colleagues (1999) found an increase between 1988 and 1995 in HIV prevention practices in outpatient drug treatment settings and reported units' practices were related to client risk for HIV, resources, and organizational support.

OBJECTIVES: Extend prior research by focusing on HIV-related policies and practices in the methadone clinics of a single, high prevalence, state, served by a mixture of nonprofit and for-profit clinics.

METHODS: Site visits to a stratified random sample of methadone maintenance clinics in New Jersey, equal to approximately 2/5 of total sites. Interviews with front line and administrative staff at these sites.

RESULTS: (1) Clinics differ in scope, intensity, and integration of HIV-related services, with a minority reporting they offer no HIV-related services, despite the availability of no-cost external contracting for education and testing. (2) Clinics have adopted a variety of strategies for introducing, structuring, and maintaining HIV-related services, reflecting differences in self-defined institutional goals and definitions of client needs. (3) Clinic personnel frame accounts of existing policies and practices in accordance with a range of clinical, institutional, and public health values.

CONCLUSIONS: Survey data regarding HIV-related practices in drug treatment settings can be usefully supplemented with qualitative data regarding perspectives of participants on organizational processes at work.

Learning Objectives: At the close of the session, the learner will

• be aware of the diversity of strategies adopted in a state-wide sample of methadone clinics in a high prevalence state.
• understand complex links patterns involved in initiating and maintaining HIV-related services in methadone clinics.

Keywords: Methadone Maintenance, Providers

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.