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Addiction Psychiatry 2018 Journal of Addiction Research & Therapy
ISSN: 2155-6105 Page 40
August 13-14, 2018
Madrid, Spain
8th International Conference on
Addiction Psychiatry
Despite significant advances in health outcomes in the patients
living with HIV (PLWH) population, those with substance use
disorders have continued to face barriers at every level of care.
These patients have delayed diagnosis, decreased access to care
and adherence to antiretroviral therapy, increased risk behavior,
and inferior medical outcomes. Integration of HIV and substance
use disorder care has been shown to improve retention in care,
leading to improved outcomes. In particular, treatment of patients
with opioid use disorder and HIV with medication assisted
treatment, such as methadone or buprenorphine has been shown
to improve retention in care, improve adherence to antiretroviral
therapy and decrease risky transmission behavior. The Cooper
early intervention program (EIP) is located within Camden, NJ,
and provides HIV/AIDS care and treatment services to part of the
Philadelphia Eligible Metropolitan Area, a Part A planning region
that includes the southwestern area of New Jersey. Preliminary
2017 data from internal reporting suggested that 186 out of
924 (20.1%) active HIV+ patients were identified as having a
substance use disorder over the previous 5 years. Of the 186
patients, only 107 exhibited durable viral suppression, in stark
contrast to EIP’s overall viral load suppression rate of 86.98%.
This identified cohort of patients could be indicative of chronic
medication nonadherence frequently observed in these patients.
In 2017, EIP integrated addiction medicine services to provide
support for PLWH with co-occurring substance abuse issues.
The mission for this enhanced treatment adherence program
aligns with the national goals to develop a coordinated response
against the largest barrier to achieving viral suppression. Since
its inception, addictions medicine has linked approximately 17
PLWH to care. Our goal is to achieve a 50% improvement in viral
suppression, thus reaching the 90–90–90 targets launched by
the United Nations Program on HIV/AIDS (UNAIDS).
Recent Publications
1. Meyer J E, Althoff A L and Alice F L (2013) Optimizing
care for HIV-infected people who use drugs: Evidence-
based approaches to overcoming healthcare
disparities. Clin Infect Dis 57(9):1309-1317
2. Batkis M F, Treisman G J and Angelino A F (2010)
Integrated opioid use disorder and HIV treatment:
Rationale, clinical guidelines for addiction treatment,
and review of interactions of antiretroviral agents and
opioid agonist therapies. AIDS Patient Care STDS
24:15–22.
3. LucasGM, ChaudhryA, HsuJ, et al. (2010) Clinic-based
treatment of opioid-dependent HIV-infected patients
versus referral to an opioid treatment program: A
randomized trial. Ann Intern Med. 152:704–11.
4. Chitsaz E, Meyer J P, Krishnan A, et al. (2013)
Contribution of substance use disorders on HIV
treatment outcomes and antiretroviral medication
adherence among HIV-infected persons entering jail.
AIDS Behav. DOI: 10.1007/s10461-013-0506-0.
5. Van Asten L C, Boufassa F, Schiffer V, et al. (2003)
Limited effect of highly active antiretroviral therapy
among HIV-positive injecting drug users on the
population level. Eur J Public Health 13:347–9.
Biography
Rachel Haroz is an Assistant Professor in the Department of Emergency
Medicine at Cooper Medical School of Rowan University. She is board
certified in Emergency Medicine, Medical Toxicology and Addiction
Medicine; she obtaining her BA in Biology fromBrandeis University, MD from
Tufts University and completed a residency in Emergency Medicine and
fellowship in Medical Toxicology. She has spent the last 17 years working
in inner city emergency departments, mostly in the Camden area where
opioid intoxication, abuse and dependency are rampant. She helps staff the
Outreach Clinic at the Urban Health Institute at Cooper University Hospital
in Camden New Jersey, an addiction medicine specialty clinic dedicated
to treating patients with substance use disorders as well as the Early
Intervention Program Clinic – a clinic dedicated to the care of patients with
HIV and substance use disorders.
Adopting an integrated care model for patients with HIV and
substance use disorders
Rachel Haroz
Cooper University Hospital, USA
Rachel Haroz, J Addict Res Ther 2018, Volume 9
DOI: 10.4172/2155-6105-C2-039