Integrated Care Models: HIV and Substance Use

Area of Science:

• Public Health
• Infectious Diseases
• Addiction Medicine

Background:

• Substance use is linked to poor HIV virologic suppression and transmission.
• Recent HIV outbreaks in the USA are associated with substance use.
• Integrating care for HIV and substance use disorders is crucial.

Purpose of the Study:

• To review and evaluate integrated care initiatives for patients at risk for or living with HIV and a substance use disorder.
• To assess evidence-based strategies for managing co-occurring HIV and substance use disorders.
• To provide an overview of current approaches to integrated care.

Main Methods:

• Literature review of scientific and medical publications up to March 2023.
• Evaluation of existing integrated care models and initiatives.
• Synthesis of evidence on effective care delivery strategies.

Main Results:

• Integrated care improves health outcomes, including HIV viral suppression, for co-occurring conditions.
• Brick-and-mortar facilities require strong leadership, trained staff, and adequate resources for successful integration.
• Community-based delivery (mobile clinics, telehealth) and technology (apps) enhance service accessibility.
• Harm reduction programs and carceral settings are important targets for integrated services.

Conclusions:

• Integrated care models are effective for improving health outcomes in patients with HIV and substance use disorders.
• Expanding integrated services to diverse settings, including community and carceral environments, is recommended.
• Investment in integrated care and supportive legislation are essential for increasing access to services.