Learn about SAMHSA-funded grants and other efforts that provide behavioral health support to those with HIV, AIDS, and viral hepatitis.
SAMHSA addresses the issues of HIV, AIDS, and viral hepatitis by providing grant opportunities to support:
- Coordinated mental health and addiction treatment services
- HIV testing with pre- and post-test counseling
- Referrals for treatment
- Testing for other infectious diseases
Collaborative efforts of community organizations, hospitals, academic institutions, and religious organizations are essential to effectively serve the multifaceted needs of the HIV, AIDS, and viral hepatitis population.
A current, successful effort is the only national program that addresses the intersection of HIV and substance use treatment services: the Targeted Capacity Expansion (TCE) Program: Substance Abuse Treatment for Racial/Ethnic Minority Populations at High Risk for HIV/AIDS (TCE-HIV). This program supports substance use treatment and HIV- and AIDS-related services in minority communities with the help of faith-based organizations in states with the highest HIV prevalence rates (at or above 270 per 100,000). The TCE-HIV program funds grantees that focus substance use treatment and HIV services on different racial and ethnic groups, high-risk populations including men who have sex with men (MSM), young MSM, and minority women including lesbians and transgender individuals. Past grantees have reported increases in a number of positive client behaviors at six months of participation, including decreased substance use, positive employment and housing statuses, and decreased contact with the criminal justice system. The same 2010 data also reported decreases in the use of injection drugs, unprotected sex, symptoms related to depression and anxiety, and suicide attempts.
SAMHSA offers a wide variety substance use disorder treatment programs with HIV components. Past initiatives have involved the treatment of pregnant and post-partum women, as well as incarcerated individuals and people involved in the criminal justice system. For example, the Addiction Technology Transfer Center (ATTC) Network offers programs with a focus on lesbian, gay, bisexual, and transgender populations.
The Minority Serving Institutions (MSI) Partnerships with Community-Based Organizations (CBO) grant program supports substance use prevention education and testing to equip and empower minority serving institutions located in American communities at the highest risk of substance abuse and HIV and hepatitis C infections. The program supports evidence-based methodologies to increase access to comprehensive, integrated substance use and HIV and hepatitis C prevention services. The program aims to prevent and/or reduce substance use as a risk factor for the transmission of HIV/AIDS and viral hepatitis among African American, Hispanic/Latino, Asian American/Pacific Islander, and American Indian/Alaska Native young adult populations (ages 18 to 24) on Minority Serving Institution campuses.
SAMHSA’s efforts to help address HIV and AIDS extend outside the United States and include assisting other countries with serious substance abuse and HIV infection rates. For example, the Cooperative Agreement for Workforce Development in Vietnam: HIV-Addiction Technology Transfer Center (ATTC) is a TCE program that focuses on the intersection of substance use treatment and HIV. The mission of this program is to support the prevention, care, and treatment of HIV/AIDS associated with substance use as a member of the President’s Emergency Program for AIDS Relief (PEPFAR) Vietnam team. SAMHSA’s work with Vietnam is based on an initial interagency agreement with the Department of Health and Human Services’ Office of Global Affairs, the agency responsible for managing the PEPFAR program worldwide. The Vietnam program provides technical assistance, direct training, coordination, and limited financial assistance to promote the availability of high quality, effective prevention, care, and treatment of substance use disorders associated with the spread of HIV/AIDS. These approaches are employed directly and collaboratively with relevant Vietnamese, United States, and other governmental agencies, as well as international entities and non-governmental organizations.
Minority AIDS Initiative
The Minority AIDS Initiative Targeted Capacity Expansion: Integrated Behavioral Health/Primary Care Network (MAI-TCE Program) provides prevention, treatment, and recovery support services, and HIV testing for people with, and at risk for, mental and/or substance use disorders and those living with, or at high risk, for HIV infection. Targeted to the cities with the highest HIV impact, the MAI-TCE developed and expanded integrated behavioral health and primary care networks, including HIV and medical services, in 11 metropolitan statistical areas and metropolitan divisions in the United States.
The Minority AIDS Initiative (MAI) Program Using New Media to Prevent Substance Abuse & HIV/AIDS for Populations at High Risk funds novel interventions to use new media to promote targeted substance use and HIV prevention messages to high-risk racial and ethnic minority populations. The program aims to decrease prejudice and discrimination by giving those at risk of contracting HIV the opportunity to share their stories online, allowing for interaction with others in their communities, and encouraging healthy behaviors. In addition, volunteer peer mentors and coaches train and encourage racial and ethnic populations to engage in healthy lifestyles, and get tested or treated for HIV and viral hepatitis.
In FY 2014, SAMHSA launched the Minority AIDS Initiative Continuum of Care Pilot. The purpose of this jointly funded program is to integrate care (behavioral health treatment, prevention, and HIV medical care services) for racial or ethnic minority populations at high risk for behavioral health disorders and at high risk for or living with HIV. The grant will fund programs that provide coordinated and integrated services through the co-location of behavioral health treatment and HIV medical care. This program is primarily intended for substance use treatment programs and community mental health programs that can fully integrate HIV prevention and medical care services. An important part of this program includes the use of set-aside funds for viral hepatitis prevention, vaccination, testing, and linkage to clinical care.
Testing and Treatment
Research suggests that simply knowing one’s HIV status can reduce risky behavior and thus help to reduce HIV transmission. SAMHSA works with a number of partners to increase access to rapid testing for HIV. Rapid testing can provide results in minutes, compared with traditional HIV test results that can take a week or more to obtain. The faster availability of results enables behavioral health professionals to quickly provide referrals to treatment when needed. A 2011 SAMHSA Advisory describes rapid HIV testing and reviews the benefits of its use in substance use treatment facilities.
Substance abuse treatment facilities are ideal places to provide HIV testing and treatment services because studies have shown that participation in drug treatment can effectively reduce the risk of HIV transmission. In 2009, 55% of all substance use treatment facilities provided HIV and AIDS counseling, education, or support. Twenty-eight percent provided on-site HIV testing and 9% had special programs specifically for people with HIV and AIDS. SAMHSA continues to encourage behavioral health programs to provide onsite testing for both HIV and viral hepatitis.
A 2010 report (PDF | 977 KB) by the National Survey of Substance Abuse Treatment Services noted that facilities that provide opioid treatment programs were more likely than other treatment facilities to offer special programs for people with HIV and AIDS, as well as provide counseling and early intervention. Sixty-three percent of these facilities provided testing, and 83% provided education, counseling, and support.