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Health services research: drug use and human immunodeficiency virus in the United States.

Major research findings show gaps in health services research on the prevalence and outcomes of patient- and organization-level human immunodeficiency virus (HIV) and drug abuse prevention and treatment services. The latest thrust of health services research on translational research issues includes informing and training practitioners about new, proven drug abuse treatment interventions; changing treatment organizations (creating a climate for change and building a culture to sustain change); and financing new treatments. Findings defining the direct relationship between the quality of drug abuse treatment and the patients' program completion, the perception of the staff by the patient, feelings of self-empowerment and mitigation of patient and organizational readiness, the superiority of integrated care, and the primary reasons for delays in HIV-infected substance-using patients seeking care are included. More needs to be done to increase the participation of substance abuse programs in teaching about and implementing HIV prevention and developing means to modulate or eliminate barriers to the integration of HIV and substance abuse care.