Under One Roof – An Integrated Clinic for Substance Use Disorder and Viral Hepatitis/HIV Treatment

Abstract

Introduction: Integration of viral hepatitis/HIV care and substance use disorder (SUD) treatment has been shown to improve patient outcomes, but data are lacking in rural states like Maine. Our study objective was to assess the baseline characteristics and outcomes of patients with SUD who receive combined substance use and viral hepatitis/HIV treatment at a recently established “Bridge Program” in our rural state. Methods: We conducted a retrospective chart review of patients enrolled in the Bridge Program between January 2020 and November 2021. We then performed a descriptive analysis of demographics, health characteristics, preventive services, and treatment outcomes. Results: A total of 14 patients were enrolled in the Bridge Program, of which 13/14 (93%) had hepatitis C, and 3/14 (21%) had HIV. When indicated, 100% of participants received appropriate medication for addiction treatment (buprenorphine/naloxone or naltrexone), naloxone kits, and hepatitis A and B vaccinations. Among patients with hepatitis C, 12/13 (92%) started antiviral treatment, of which 10/12 (83%) either achieved treatment cure or are receiving ongoing treatment. Discussion: Integrated care models can successfully treat SUD and HIV/viral hepatitis as co-occurring medical conditions. These models must consider approaches to reduce the number of visits and travel time required for optimal treatment, and enhance recovery by consistently prescribing evidence-based medication for SUD. Conclusions: Our study shows how an integrated clinic model in a rural state can provide comprehensive care, including SUD treatment, naloxone prescribing, vaccinations, and, importantly, high rates of successful hepatitis C/HIV treatment.