Managing service change in post HIV drugs services--a case study from Inner London.

Area of Science:

• Public Health
• Addiction Medicine
• Health Management

Background:

• The emergence of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) created ideological conflicts for drug treatment organizations.
• Incorporating HIV prevention strategies into existing drug misuse services proved to be a complex and problematic undertaking.

Purpose of the Study:

• To analyze the response of drug misuse services in one Inner London district health authority (Bloomsbury) to the HIV/AIDS epidemic between 1985 and 1989.
• To identify key factors and organizational competencies crucial for managing change in integrated drug and HIV services.

Main Methods:

• A case study approach was employed to examine the drug misuse services of a specific Inner London district health authority.
• The study period covered 1985-1989, a critical phase of the HIV/AIDS epidemic.

Main Results:

• Despite evident innovation and enthusiasm, specialized challenges hindered an effective and cohesive strategic response to HIV/AIDS.
• Several key factors influencing the management of change within drug and HIV services were identified.

Conclusions:

• Effective strategic response to the HIV/AIDS epidemic within drug services requires addressing specific organizational and managerial challenges.
• Key competencies for clinicians, managers, and funders in managing integrated drug and HIV services are suggested for improved outcomes.