This project will conduct a randomized controlled trial of a case management service intended to improve the treatment of substance abusers with HIV disease.
The specific aims are to determine the effect of case management on patient outcomes (reducing unsafe sex and substance use, maintaining physical health, improving psychological status, and improving quality of living situation), assess its cost-effectiveness, and identify predictors of treatment participation and retention. Subjects will be adult substance abusers with HIV disease, recruited at a hospital-based emergency department and medical outpatient clinics, randomly assigned to receive intensive case management versus usual care (brief contact and referral). Assessments will occur before randomization, with follow-up assessments 6, 12, and 18 months later. The hypotheses are that subjects in case management will show improvement relative to those receiving usual care on a range of measures, and will demonstrate more cost-effective use of health care programs, e.g. fewer emergency room visits and fewer hospitalizations, coupled with greater participation in social services and substance abuse treatment programs. To identify predictors of participation and retention in case management, the study will gather information about the treatment process at regular intervals. Finally, the project will complete a treatment manual that can be used in other settings. The study is a services research effort to assess innovative models of linking drug abuse treatment with health care, as a means of reducing the costs of care and improving the health care delivery system for substance abusers with HIV disease.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA008753-03
Application #
2121469
Study Section
Special Emphasis Panel (SRCD (44))
Project Start
1993-09-30
Project End
1998-07-31
Budget Start
1995-08-01
Budget End
1996-07-31
Support Year
3
Fiscal Year
1995
Total Cost
Indirect Cost
Name
University of California San Francisco
Department
Type
Schools of Medicine
DUNS #
073133571
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Masson, C L; Sorensen, J L; Phibbs, C S et al. (2004) Predictors of medical service utilization among individuals with co-occurring HIV infection and substance abuse disorders. AIDS Care 16:744-55
Sorensen, James L; Dilley, James; London, Julie et al. (2003) Case management for substance abusers with HIV/AIDS: a randomized clinical trial. Am J Drug Alcohol Abuse 29:133-50
Sorensen, James L; Masson, Carmen L; Perlman, David C (2002) HIV/hepatitis prevention in drug abuse treatment programs: guidance from research. Sci Pract Perspect 1:4-11
Sorensen, J L; Jacob, C; Dilley, J et al. (2000) Causes of death among substance users with HIV disease. AIDS 14:2047-9
Sorensen, J L; Copeland, A L (2000) Drug abuse treatment as an HIV prevention strategy: a review. Drug Alcohol Depend 59:17-31
Sorensen, J L; Midkiff, E E (2000) Bridging the gap between research and drug abuse treatment. J Psychoactive Drugs 32:379-82
Sorensen, J L; Mascovich, A; Wall, T L et al. (1998) Medication adherence strategies for drug abusers with HIV/AIDS. AIDS Care 10:297-312
Sorensen, J L (1996) Methadone treatment for opiate addicts. BMJ 313:245-6
Sorensen, J L; Miller, M S (1996) Impact of HIV risk and infection on delivery of psychosocial treatment services in outpatient programs. J Subst Abuse Treat 13:387-95;discussion 439
Schwartz, B; Dilley, J; Sorensen, J L (1994) Case management of substance abusers with HIV disease. J Case Manag 3:173-8