Limited access to HIV risk-reduction services in South African substance abuse treatment facilities

Abstract

Background: Although HIV risk-reduction service provision is an important indicator of substance abuse service quality, the extent to which these services are provided in South African substance abuse treatment facilities is unknown.

Aims: To examine (i) the extent to which South African substance abuse treatment services provide HIV risk-reduction services to clients and (ii) whether the provision of these services varies by type of facility and by geographic region.

Method: Cross-sectional surveys of substance abuse treatment services were conducted in Gauteng and KwaZulu-Natal provinces (2006–2007) and the Central and Northern region of the country (2007–2008). Questions on the availability of testing for HIV and co-occurring infectious diseases, opioid substitution treatment (OST), and harm-reduction interventions for injection drug users were included within the larger survey questionnaire. Response rates of 84% and 83% were obtained for each survey, respectively.

Results: Less than half of the facilities surveyed provide HIV counselling and testing services to clients or test clients for co-occurring infectious diseases. Less than one-third conduct harm-reduction interventions among injection drug users and OST is largely unavailable. Facilities that offer residential/inpatient services and employ medically trained staff are more likely to offer clients HIV risk-reduction services than outpatient services or services without medically trained staff.

Conclusions: Findings point to the limited availability of HIV risk-reduction services within South African substance abuse treatment facilities. Recommendations are made to enhance access to these services.