Integrating HIV and Substance Use Services: A Systematic Review

August 2017 - Combination Prevention

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Haldane, V., Cervero-Liceras, F., Chuah, F.L.H., et al. Journal of the International AIDS Society, 20:21585, doi:10.7448/IAS.20.1.21585.

This systematic review examined global evidence from programs that integrated HIV care and substance use. Each of the 51 eligible studies were classified as one of  three integration models:

  • Model 1 comprised HIV facilities that integrated substance use services. The model was further broken down into three types of HIV services: services that integrated substance use assessments, those integrating substance use treatment, and those integrating substance use treatment and other services.
  • Model 2 comprised substance use facilities that integrated HIV services, with subcategories of substance use services that integrated HIV screening and counseling, HIV treatment, and treatment of HIV and other illnesses.
  • Model 3 included integration at facility types, such as other clinical settings, mobile clinics, or harm reduction sites.

The benefits of integration included increased ability to identify HIV and/or substance use and support treatment adherence; decreased likelihood of drug interactions; and reduced costs for clients. Challenges to integration included high service delivery costs, a higher provider training burden, and difficulties with implementing integration. Staff at substance use facilities expressed lack of confidence in administering HIV tests and delivering positive results to clients. The findings also showed linkages to other community services also present challenges. The authors concluded that though more research is necessary, integrating HIV and substance abuse services confers benefits to patient and service outcomes.

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