Rights statement: This is an Accepted Manuscript of an article published by Taylor & Francis in AIDS Care on 10/03/2017, available online: http://www.tandfonline.com/10.1080/09540121.2017.1300634
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Final published version
Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - Integrated opioid substitution therapy and HIV care
T2 - a qualitative systematic review and synthesis of client and provider experiences
AU - Guise, Andy
AU - Seguin, Maureen
AU - Mburu, Gitau
AU - McLean, Susie
AU - Grenfell, Pippa
AU - Islam, Zahed
AU - Filippovych, Sergii
AU - Assan, Happy
AU - Low, Andrea J.
AU - Vickerman, Peter
AU - Rhodes, Tim
N1 - This is an Accepted Manuscript of an article published by Taylor & Francis in AIDS Care on 10/03/2017, available online: http://www.tandfonline.com/10.1080/09540121.2017.1300634
PY - 2017/9
Y1 - 2017/9
N2 - People who use drugs in many contexts have limited access to opioid substitution therapy and HIV care. Service integration is one strategy identified to support increased access. We reviewed and synthesized literature exploring client and provider experiences of integrated opioid substitution therapy and HIV care to identify acceptable approaches to care delivery. We systematically reviewed qualitative literature. We searched nine bibliographic databases, supplemented by manual searches of reference lists of articles from the database search, relevant journals, conferences, key organizations and consultation with experts. Thematic synthesis was used to develop descriptive themes in client and provider experiences. The search yielded 11 articles for inclusion, along with 8 expert and policy reports. We identify five descriptive themes: the convenience and comprehensive nature of co-located care, contrasting care philosophies and their role in shaping integration, the limits to disclosure and communication between clients and providers, opioid substitution therapy enabling HIV care access and engagement, and health system challenges to delivering integrated services. The discussion explores how integrated opioid substitution therapy and HIV care needs to adapt to specific social conditions, rather than following universal approaches. We identify priorities for future research. Acceptable integrated opioid substitution therapy and HIV care for people who use drugs and providers is most likely through co-located care and relies upon attention to stigma, supportive relationships and client centred cultures of delivery. Further research is needed to understand experiences of integrated care, particularly delivery in low and middle income settings and models of care focused on community and non-clinic based delivery.
AB - People who use drugs in many contexts have limited access to opioid substitution therapy and HIV care. Service integration is one strategy identified to support increased access. We reviewed and synthesized literature exploring client and provider experiences of integrated opioid substitution therapy and HIV care to identify acceptable approaches to care delivery. We systematically reviewed qualitative literature. We searched nine bibliographic databases, supplemented by manual searches of reference lists of articles from the database search, relevant journals, conferences, key organizations and consultation with experts. Thematic synthesis was used to develop descriptive themes in client and provider experiences. The search yielded 11 articles for inclusion, along with 8 expert and policy reports. We identify five descriptive themes: the convenience and comprehensive nature of co-located care, contrasting care philosophies and their role in shaping integration, the limits to disclosure and communication between clients and providers, opioid substitution therapy enabling HIV care access and engagement, and health system challenges to delivering integrated services. The discussion explores how integrated opioid substitution therapy and HIV care needs to adapt to specific social conditions, rather than following universal approaches. We identify priorities for future research. Acceptable integrated opioid substitution therapy and HIV care for people who use drugs and providers is most likely through co-located care and relies upon attention to stigma, supportive relationships and client centred cultures of delivery. Further research is needed to understand experiences of integrated care, particularly delivery in low and middle income settings and models of care focused on community and non-clinic based delivery.
KW - People who inject drugs
KW - OST
KW - HIV
KW - ART
KW - integration
U2 - 10.1080/09540121.2017.1300634
DO - 10.1080/09540121.2017.1300634
M3 - Journal article
VL - 29
SP - 1119
EP - 1128
JO - AIDS Care
JF - AIDS Care
SN - 0954-0121
IS - 9
ER -