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Integrating HIV and substance use services: a systematic review
Victoria Haldane1, Francisco Cervero-Liceras1, Fiona Lh Chuah1
1Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Journal of the International AIDS Society
|July 11, 2017
Summary
Integrating HIV and substance use services improves patient outcomes. This systematic review found that combined care models enhance treatment effectiveness and patient well-being, highlighting the need for further research into holistic approaches.
Area of Science:
- Public Health
- Infectious Diseases
- Addiction Medicine
Background:
- Substance use is a significant risk factor for HIV infection, disproportionately affecting vulnerable populations.
- Co-occurring HIV and substance use disorders present complex care challenges.
- Opportunities exist for integrating HIV and substance use services to improve patient management.
Purpose of the Study:
- To systematically review the evidence on the integration of care for people living with HIV (PLWH) and substance use problems.
- To identify and categorize different models of service integration.
- To assess the impact of integrated services on patient and service outcomes.
Main Methods:
- Systematic literature search of multiple databases from inception to October 2015.
- Inclusion of studies evaluating service integration for substance use and HIV.
- Independent screening and risk of bias assessment by two reviewers.
Main Results:
- 51 studies met inclusion criteria, examining integration models by facility type, level, and degree of integration.
- Integrated activities in four randomized controlled trials demonstrated improved patient outcomes.
- Integration offers benefits from screening to comprehensive treatment, including improved referral pathways.
Conclusions:
- Greater integration of HIV and substance use services yields significant benefits for patient and service outcomes.
- Further research is needed to understand innovative and holistic care models at the intersection of these services.
- Evidence suggests potential for integrating services across various facility types, including mobile health.
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