HIV Clinical Trial
Official title:
Integrating Buprenorphine Into the SFGH AIDS Program (Patient Evaluation Study)
The purpose of this study is to assess the feasibility, cost, and effectiveness of a model of care designed to integrate buprenorphine treatment for opioid dependence into the HIV primary care clinics at the UCSF Positive Health Program.
The UCSF Positive Health Program (formerly called the AIDS Program) at San Francisco General
Hospital (SFGH) is one of the oldest and largest HIV/AIDS clinics in the United States.
Located at the public hospital serving medically indigent residents of San Francisco, the
Positive Health Program (PHP) provides over 2,000 patient visits per month to 2,300 patients
in a comprehensive HIV primary care setting. The clinic population is disproportionately
affected by heroin and other opiate abuse problems. Opiate replacement therapy (ORT) has a
stabilizing effect in HIV-infected injecting drug users (IDU) and is associated with greater
acceptance of antiretroviral (ARV) therapy, higher ARV adherence, and greater engagement in
appropriate HIV-related health care. However, there are insufficient resources to meet the
critical substance abuse treatment needs among our opioid-dependent patients.
In partnership with the Community Behavioral Health Services (CBHS) section of the San
Francisco Department of Public Health (SFDPH), the UCSF Positive Health Program (PHP) at San
Francisco General Hospital (SFGH) has developed a model of care, which provides
opioid-dependent patients with integrated, office-based buprenorphine ORT in the HIV primary
care setting. The program also offers primary care providers with education and training on
addiction, opiate addiction treatment, and the appropriate use of buprenorphine. An
evaluation of the program is planned to examine: (1) its effects on the health and substance
use of patients; (2) program costs; and (3) what broader impact the program has on
providers, institutions, and local systems. In the patient evaluation study, eligible,
opioid-dependent patients that receive primary HIV care at the PHP will be randomly assigned
to receive buprenorphine ORT for twelve months either in the integrated HIV primary care
setting (intervention group) versus a non-integrated substance abuse treatment clinic
setting (comparison group). Data will be abstracted from medical chart reviews and will be
collected from patients using standardized instruments and satisfaction surveys.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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