World AIDS Day provides a yearly call to action for us to work collaboratively to end the HIV epidemic in the United States and worldwide. This year marks the 35th anniversary of World AIDS Day, a milestone that gives us the opportunity to commemorate those we have lost to AIDS-related illnesses; to honor the more than 40 million people around the world, and more than 1.2 million Americans who are living with HIV; and to raise awareness of the importance of HIV testing, prevention, care, and treatment. This year’s World AIDS Day theme, Remember and Commit, also gives us the opportunity to emphasize the urgency of our collective commitment to end the HIV epidemic. We have made significant progress in our effort to end the HIV epidemic in the United States, but challenges remain. In many communities, accessing comprehensive HIV prevention and treatment are impacted by limited awareness, access, and HIV-related stigma, which continue to hinder efforts to implement and accelerate the dissemination of effective tools to prevent and treat HIV.
SAMHSA’s mission is to lead public health and service delivery efforts that promote mental health, prevent substance misuse, and provide treatments and supports to foster recovery while ensuring equitable access and better outcomes. SAMHSA’s grant recipients work to address the syndemic of HIV, viral hepatitis, substance use, and mental illness. The Centers for Disease Control and Prevention (CDC) recommends that everyone ages 13-64 get tested for HIV at least once as part of their routine health care and know their status. For people with certain risk factors, including many people with or at risk for behavioral health conditions, CDC recommends getting tested at least once a year. Additionally, per recently-updated medical guidelines (PDF | 370 KB), all sexually-active adults and adolescents should be informed about pre-exposure prophylaxis (PrEP) as an option to protect against HIV.
In 2023, SAMHSA awarded over $34 million in grants to meet the behavioral health needs of people who either are at risk for contracting or are living with HIV/AIDS. These grant programs include:
- $21.9 million for the Minority AIDS Initiative: Substances Use Disorder Treatment for Racial/Ethnic Minority Populations at High Risk for HIV/AIDS. This program increases engagement in care for racial and ethnic medically underserved individuals with substance use disorders (SUDs) and/or co-occurring SUDs and mental health conditions (COD) who are at risk for or living with HIV. For example, one grantee serves their community with SUD treatment, HIV and hepatitis C testing as well screening for any mental illness that may warrant a referral for additional services. The grantee also provides recovery support services by creating a safe environment focused on family and employment to assist grant beneficiaries with sustaining and maintaining long term recovery. According to the grant recipient, “without SAMHSA funding it would have been a huge challenge for this community to receive these services.”
- $10.5 million for the Minority AIDS Initiative: Substance Use and Human Immunodeficiency Virus Prevention Navigator Program for Racial/Ethnic Minorities. This program provides substance use and HIV prevention services to those at high risk for SUDS and HIV, including racial and ethnic minority populations. The program places emphasis on supporting persons who identify as Lesbian, Gay, Bisexual, Transgender, Queer/Questioning and Intersex who are not in stable housing and/or reside in communities with high rates of HIV, viral hepatitis (including Hepatitis A, B, and C), and/or sexually transmitted infections. For example, one grantee noticed hesitancy among the Black men who have sex with men (MSM) towards initiating Pre-Exposure Prophylaxis (PrEP) or Post-Exposure Prophylaxis (PEP). The grantee completed an environmental assessment which showed the hesitation stemmed from lack of knowledge about PrEP/PEP, including where and how to access it. To address this barrier, the grantee conducted a media campaign on radio and TV with Black MSM spokespeople to educate the public on PrEP and PEP.
- $1.9 million for the Minority HIV/AIDS Fund: Integrated Behavioral Health and HIV Care for Unsheltered Populations Pilot Project. This pilot program aims to provide comprehensive healthcare for medically underserved people, including racial and ethnic populations experiencing unsheltered homelessness, focusing on supporting the integration of behavioral health and HIV treatment and prevention services through the delivery of portable clinical care delivered on the street or in other areas convenient to unsheltered populations. Additionally, through this pilot program, which consist of two grant recipients based in California and one grant recipient based in Arizona, SAMHSA anticipates gaining some valuable knowledge, including best practices for addressing Substance Use Disorders, HIV/Hepatitis and mental health for unsheltered populations which will be shared with the public.
SAMHSA continues to prioritize decreasing HIV/AIDS transmission among people who have mental illnesses and/or SUDs and linking Americans who have HIV and co-occurring mental illness and/or substance use disorder to appropriate care and treatment. In 2020, SAMHSA published Prevention and Treatment of HIV Among People Living with Substance Use and/or Mental Disorders, which reviews effective programs and practices to prevent HIV and increase adherence to and retention in care. SAMHSA MAI-funded programming is in alignment with the National HIV/AIDS Strategy (NHAS) (PDF | 1.8 MB), reflect SAMHSA’s commitments laid out in our contribution to the NHAS Federal Implementation Plan (PDF | 707 KB), and are in alignment with the goals of the Ending the HIV Epidemic in the U.S. (EHE) initiative, of which SAMHSA is a proud contributing agency. SAMHSA works with grantees, federal agencies, health care providers and others to implement these goals.
SAMHSA also is committed to centering equity within our HIV response by ensuring improved access to appropriate HIV testing and linkage to appropriate HIV treatment and prevention services, including in nontraditional, community-based settings. Many of those with HIV are unaware they are infected. HIV self-testing plays a critical role in reaching people who either don’t have access to or prefer not to get tested in traditional clinical settings. To get access to an HIV self-test, go to CDC’s Together TakeMeHome. Finally, if you, or someone you know, is seeking help for substance use or mental illness, SAMHSA’s Behavioral Health Treatment Services Locator can help you connect with treatment programs in your area.
On World AIDS Day 2023, SAMHSA would like to thank staff, grantees, federal partners, health care providers, and the substance use and mental health community in working toward our shared goal of ending the HIV epidemic in the United States. Thank you for the work you do to save lives and improve the health of the people of America.