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Changes in integrated HIV care in substance use treatment facilities (2015 -2020)

Data Sources National Survey of Substance Abuse Treatment Services

Authors Suparna Das, Kasimu Muhetaer, Herman A. Alvarado

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Recommended Citation: Das, S., Muhetaer, K., & Alvarado, H. A. (2022, May 2). Changes in integrated HIV care in substance use treatment facilities (2015-2020) (The CBHSQ Spotlight). Rockville, MD: Substance Abuse and Mental Health Services Administration.

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The White House, in collaboration with federal partners and with input from the HIV community across the United States, released the National HIV/AIDS Strategy (2022-2025) (NHAS). The fourth goal of NHAS emphasizes the need for integrated care of substance use services as a strategy to end the HIV epidemic. People who use/misuse substances are at increased risk of contracting HIV 1.  Early intervention should cover services that include routine offering and encouragement of HIV/STI (sexually transmitted infections) counseling, testing, and the provision of prophylactic and anti-viral prescriptions 2.  Research shows that HIV testing and early intervention are important for reducing the spread of HIV and for improving outcomes of people living with HIV (“PLHIV”) 3,4. The aim of this analysis was to develop a baseline of substance use treatment services provided by facilities. The National Survey of Substance Abuse Treatment Services (N-SSATS) was used for this analysis for the years 2015-2020. The N-SSATS is an annual census of facilities providing treatment services for substance use disorders5. Three variables were selected and collected through N-SSATS: early intervention,  HIV testing and STI testing.

changes in STI testing, HIV testing, and early intervention in SU facilities
Figure 1. Change in percent of HIV testing, STI testing and early intervention services in substance use treatment facilities in US. (percent error bars)

Figure 1 shows that whereas provision of early intervention remained relatively even over the years, there was a change in HIV testing (22 percent) and STI testing (14 percent) from 2015 to 26 percent and 21 percent, respectively, by 2020.  Increased early intervention, HIV testing, and STI testing, particularly through the availability of pre-exposure prophylaxis (PrEP), may have significantly contributed to the improvement of health outcomes of PLHIV who use or misuse substances. SAMHSA supports harm reduction efforts such as PrEP and syringe support services through various programs, grants, and evidence-based planning strategies for PLHIV. These efforts significantly support the NHAS strategy and assist in overcoming individual and health system barriers to implement effective integration of substance-use prevention and treatment.

End Notes

1. Elkbuli A, Polcz V, Dowd B, McKenney M, Prado G. HIV prevention intervention for substance users: a review of the literature. Subst Abuse Treat Prev Policy. 2019;14(1):1.           

2. SAMHSA. Fact Sheet. Substance Abuse Prevention and Treatment Block Grant. Early Intervention Services for HIV. Rockville, MD 2000.

3. Volkow ND, Monater J. Enhanced HIV Testing, Treatment, and Support for HIV-Infected Substance Users. JAMA. 2010;303(14).

4. Guinness L, Vickerman P, Quayyum Z, et al. The cost-effectiveness of consistent and early intervention of harm reduction for injecting drug users in Bangladesh. Addiction. 2010;105(2):319-328.

5. SAMHSA. National Survey of Substance Abuse Treatment Services (N-SSATS): 2020. Data on Substance Abuse Treatment Facilities. In: CBHSQ, ed. Rockville, MD 2021.