The article, “Treatment Initiation, Substance Use Trajectories, and the Social Determinants of Health in Persons Living With HIV Seeking Medication for Opioid Use Disorder,” has been published in SAj.
In this commentary, the authors state that people living with HIV and opioid use disorder (OUD) are disproportionally affected by adverse socio-structural exposures negatively affecting health, which have shown inconsistent associations with uptake of medications for OUD (MOUD). Their study aimed to determine whether social determinants of health (SDOH) were associated with MOUD uptake and trajectories of substance use in a clinical trial of people seeking treatment.
In the AUTHORS’ OWN WORDS, they relate the importance of their work:
“People living with both HIV and OUD are a highly prevalent, especially marginalized, high transmission-risk group with outsized implications for ending the HIV and OUD epidemics. Therefore, we investigated associations between 5 supportive SDOH and MOUD initiation, opioid use, and other substance use over a 6-month period in persons living with HIV enrolled in an OUD treatment randomized trial. We hypothesized that increased supportive SDOH would be associated with increased likelihood of MOUD initiation and reduced substance use over the trial period.
“Interventions targeting SDOH are increasingly recognized by the National Institute on Drug Abuse and others as vital to mitigating harms of the opioid epidemic and preventing future use disorders. Our study suggests that modifiable social determinants of health, including income, education, housing, criminal justice involvement, and engagement in SUD treatment may impact MOUD initiation and opioid use outcomes among people living with HIV and OUD. These findings, when added to the body of literature showing similar associations, provide possible intervention targets for future experimental studies. Especially following the steep rise in inequalities and overdose deaths during the COVID-19 pandemic, which disproportionately affected people of color, people experiencing homelessness, and those with co-occurring conditions including HIV, results highlight the need to address SDOH as part of OUD care.”