Effectiveness of an Embedded Infectious Disease Screening, Treatment, and Prevention Intervention Within an Inpatient Substance Use Treatment Program.

Background: People with substance use disorders (SUDs) are at higher risk for infectious diseases (IDs). Co-locating ID screening services within inpatient SUD treatment programs may decrease barriers to care; however, the impact of such screening has not been evaluated.

Methods: We conducted an effectiveness study evaluating comprehensive ID screening within an 18-bed inpatient SUD program. During usual care (September 2021-June 2022), ID screening was completed at the discretion of the admitting psychiatrist. During the intervention (September 2022-June 2023), an ID-trained nurse met with patients to support completion of screening for HIV, viral hepatitis (hepatitis A [HAV], B [HBV], and C [HCV]), latent tuberculosis [LTBI], and sexually transmitted infections [STI]. Hepatitis vaccinations, HIV preexposure prophylaxis, and/or ID treatments were offered during admission.

Results: Demographics were similar between the groups (n = 261, usual care; n = 207, intervention). Screening for ≥1 ID increased significantly during the intervention (60.2% vs 90.8%, < .001), with the greatest increases in HAV (6.1% vs 90.3%, < .001), HBV (8.8% vs 91.3%, < .001), and LTBI (1.9% vs 67.8%, < .001). HAV and HBV vaccinations increased from 0% to 58% and 71%, respectively. HCV viremia was identified in 15 usual care and 19 intervention patients, of whom 0% and 36.8% initiated direct-acting antiviral therapy within 2 weeks of testing. STIs were identified in 9.2% and 13.5% ( = .09) of the patients in the usual care and intervention groups.

Conclusions: Comprehensive ID screening within inpatient SUD programs can increase uptake of testing and facilitate low-barrier delivery of preventive and therapeutic treatment.