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Background: Research describes inequities in substance use treatment, but few studies focus specifically on racial and ethnic disparities in a range of aspects of substance use treatment among women with opioid use disorder (OUD). Objective: To examine whether substance use treatment (i.e. receipt, sources, barriers) differs by race and ethnicity among women with opioid use disorder (OUD) and to identify factors associated with treatment gap (i.e. needing treatment but not receiving it). Methods: We performed cross-sectional analyses using National Survey on Drug Use and Health 2015–2019 data, restricted to non-Hispanic Black, non-Hispanic White, and Hispanic women with past-year OUD (unweighted n = 1089). We estimated the prevalence of aspects of treatment among racial and ethnic groups, and used modified Poisson regression to estimate correlates of reported treatment gap. Results: Approximately 68% of White versus 87% of Black and 81% of Hispanic women with OUD had a treatment gap (p-value 0.0034). Commonly reported barriers to treatment included prioritization, affordability, and stigma. Older age was associated with lower prevalence of treatment gap among all women [prevalence ratio (PR) = 0.83, and 95% confidence interval (CI): 0.76, 0.92], while criminal legal involvement and healthcare coverage was associated with a lower prevalence of treatment gap among Hispanic and White women only (past year arrest: Hispanic women PR = 0.38, 95% CI: 0.17, 0.86; White women PR = 0.62, 95% CI: 0.47, 0.82). Conclusions: Receipt of treatment is low among women with OUD, especially Black and Hispanic women. Intersectional intervention approaches are needed to increase access and reduce inequities. [ABSTRACT FROM AUTHOR]

Associations of incarceration with healthcare access and utilization among Black sexual minority men (BSMM) and differences in association among those with and without pre-incarceration symptoms of depression were measured. Secondary analysis using survey data from the longitudinal cohort HIV Prevention Trials Network 061 study was conducted among 1553 BSMM from six major U.S. cities from 2009 to 2011. We used modified log-binomial regression with robust standard errors to estimate associations of incarceration (reported at 6 month follow-up) on next six-month healthcare utilization and access (reported at the 12 month follow-up). We tested the significance of baseline depressive symptoms by incarceration interaction and reported differences in associations when observed. Participants with a history of incarceration were more likely to have depressive symptoms at baseline compared to those without. Recent incarceration was associated with almost twice the risk of mistrust in healthcare providers and emergency room utilization. Among men reporting depressive symptoms, a history of incarceration was associated with almost tripled risk of reporting providers do not communicate understandably. Among those with depression, one in five reported a missed visit regardless of incarceration status. [ABSTRACT FROM AUTHOR]

Black men who have sex with men (BMSM) are disproportionately incarcerated in the United States. Incarceration is a barrier to health equity and may be a risk factor for experiences of interpersonal violence. However, the effect of incarceration on experienced violence among BMSM is understudied. We examined associations between recent incarceration on subsequent experiences of race- or sexuality-based violence, intimate partner violence, or community violence. We analyzed data from the HPTN 061 study. Analysis includes data on 1,169 BMSM recruited from 6 U.S. cities who were present at baseline as well as 6- and 12-month followup interview. We tested if self-reported incarceration between baseline and 6 months was associated with self-reported outcomes between 6 and 12 months using logistic regression with inverse probability of treatment weighting and multiple imputation methods. Experienced outcomes included violence due to race or sexuality, intimate partner violence and aggression, and community violence (i.e., gang violence, robbery, shooting). Approximately 14% reported incarceration between baseline and 6 months and 90% reported experiencing violence between 6 and 12 months. In adjusted analyses, incarceration was associated with subsequent race- or sexuality-based violence [aOR (adjusted odds ratio) range: 1.25-1.41, 95% CI (confidence interval) range: 1.00-1.74], experiences of physical abuse and aggression from intimate partners (aOR: 2.35; 95% CI: 1.50, 3.70) and community violence (OR 1.82; 95% CI: 1.23, 2.72). Recent incarceration experience increased risk of exposure to future violence in this population. Mixed methods research examining mediating paths between and downstream effects of incarceration and violence on the wellbeing and health of BMSM is needed. We implore researchers to study violence and incarceration among BMSM. Practitione should implement strategies such as trauma-informed interventions, and policies strengthening the social and economic support needs of Black populations. [ABSTRACT FROM AUTHOR]

Background: Self-collected sexually transmitted infection (STI) specimens are an effective strategy to increase screening uptake and useful for research studies. Self-directed collection, in which the individual collects the specimen and mails it to the laboratory for testing, does not involve contact with clinic/research staff, and may be valuable post-Covid as telemedicine and online research gain popularity. People who use illicit opioids (PWUIO) have elevated STI risk and unmet healthcare needs, and selfcollection may be valuable, yet little research has assessed self-collection in this population. Methods: Within a cohort study among PWUIO in New York City, we conducted a substudy from November 2021-August 2022 assessing sexual health with a one-time online survey; participants could opt-in to receive a self-collection kit (n=120). If elected, participants were mailed a kit containing the collection method (males: urine, females: vaginal swab), pre-paid return label, self-collection and shipping instructions, and educational information on STIs. Specimens were sent to HIV/STD Core lab of the Center for AIDS research at University of North Carolina at Chapel Hill and tested for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) using nucleic acid amplification tests (Aptima Combo 2, Hologic, Inc). We measured the number of kits requested, delivered, mailed by participants to the lab, and CT/GC positive. We assessed sociodemographic and STI risk factors correlated with requesting a kit. Results: Of 120 participants, 118 had valid study identification numbers. Sixty-three kits were requested (Figure), with 41 delivered; the remaining were not delivered due to no address provided, invalid addresses, and duplicate requests. Of the 41 kits delivered, 3 were sent to the lab for testing, of which one had a positive result for CT and GC; the positive result was reported to the participant and health department. Younger participants, those with past-year sex trade and casual partnerships, and those who experienced relationship violence were more likely to request a kit. Conclusion: While STI self-collection may be desirable for some PWUIO, particularly those at high STI risk, there may be barriers in obtaining and/or returning specimens. Research is needed to understand feasibility and acceptability of selfdirected methods for STI screening among PWUIO. [ABSTRACT FROM AUTHOR]