“No more falling through the cracks”: A qualitative study to inform measurement of integration of care of HIV and opioid use disorder

Barriers and facilitators to a novel low-barrier hydromorphone distribution program in Vancouver, Canada: a qualitative study

“…Our finding that participant engagement was facilitated by co-location with the OPS demonstrates the acceptability of low-threshold public health interventions among PWUD, as well as a crucial potential setting for the expansion of these programs across Canada and, pending their implementation, the US. This is supported by studies showing the acceptance and uptake of non-traditional, community-based health programs (e.g., integrated HIV treatment) among PWUD ( Altice et al, 2003 ; Oldfield et al, 2019 ). The recent ruling permitting the nation’s first safe injection site to open in Philadelphia demonstrates the potential for further implementation and scale up of similar interventions in the US, though local political factors are currently impeding these interventions ( Levenson and del Valle, 2020 ).…”

Integration of care for HIV and opioid use disorder

“…By focusing specifically on OUD and not all substance use disorders, this review facilitates comparison across models and strategies (for example, medications versus behavioral interventions). This review is timely given the evolving burden of OUD in the US, the interplay between the OUD epidemic and HIV transmission globally [8,9,77,78], and the need for integrated care for these two disorders [10,23,33].…”

“…Although care for people with or at risk for HIV and OUD can be complex [11], integrating HIV-and OUD-related care is feasible in HIV care settings, opioid treatment settings, and other care sites like primary care or public health clinics [12][13][14][15][16][17][18][19][20][21]. Integrated care is valued by PLWH with OUD [22,23], a patient population that has demonstrated limited engagement with routine health services [24] and that is subject to overlapping forms of stigma that may obstruct care and worsen biologic and/or social outcomes [25][26][27]. International organizations, including the Joint United Nations Programme on HIV/AIDS and the World Health Organization [28,29] as well as US health reform laws [30] support the integration of substance use disorder services with primary care (including HIV primary care).…”

Coordinating Systems of Care for HIV and Opioid Use Disorder: A Systematic Review of Enablers and Barriers to Integrated Service Access, and Systems and Tools Required for Implementation

“…Overwhelmingly, the studies demonstrated that client familiarity with their provider and accordingly provider familiarity with the client and their social context are enablers of access and retention in care (Bachhuber et al, 2018;Saberi et al, 2020). The research also demonstrates that convenience and increasing service access points across communities further enables client service access (Jessop et al, 2017;Oldfield et al, 2019a;Simeone et al, 2017). Innovative models wherein trained professionals rotate across service access points either within a single facility or within a network of facilities that provide integrated care may help to increase efficiencies and convenience for clients while increasing their opportunities to interact with known and experienced providers.…”