Trends in Buprenorphine Prescribing Among Adults with Opioid Use Disorder and Coexisting HIV or Viral Hepatitis, 2015–2025

We examined buprenorphine prescribing among adults in the United States with opioid use disorder or other opioid-related diagnoses and coexisting HIV, hepatitis B, or hepatitis C from 2015 to 2025. Using the TriNetX USA Minimal Date Shift Network, we constructed annual cohorts and assessed encounter-day buprenorphine prescribing, with and without chronic pain diagnoses. Prescribing rose from 6% in 2015 to 17% in 2020, then plateaued at 16–19% through 2025, with marked attenuation after 2020. Despite expanded prescriber eligibility, most were not prescribed buprenorphine at clinical contact, suggesting regulatory reform alone is insufficient and that integrated, systemic approaches are needed.