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Substance Use and HIV

 

Please note: Many additional resources related specifically to injection drug use – in particular, focusing on people who inject drugs – are found on the People Who Inject Drugs and HIV page of the NEAETC Online Resource Library.

Fact Sheets, Guidelines, and Reports

HIV and Substance Use (HIVinfo) – This fact sheet examines the connection between HIV and drug and alcohol use, ways that substance use can increase the risk of HIV infection, and the harmful effects that substance use can have on people with HIV. Also available in Spanish.

HIV and Substance Use (CDC) – This fact sheet has basic information on HIV risk associated with some commonly used substances, including alcohol, opioids, methamphetamine, crack cocaine, and inhalants. It also links to resources on a number of related topics, including injection drug use and different modes of HIV transmission.  

Alcohol and Drug Use (HIV.gov) – This fact sheet examines the ways alcohol, drug use, and HIV can affect health, and how to find alcohol and drug treatment or support programs.

Alcohol and HIV Risk (HIV.gov) – This fact sheet in FAQ format describes how alcohol use increases the risk of becoming infected with or transmitting HIV, steps people can take to reduce alcohol consumption and HIV risk, and where to get help.

Substance Use and HIV Risk (HIV.gov) – This fact sheet in frequently-asked-questions (FAQ) format describes how drug use increases the risk of becoming infected with or transmitting HIV, prevention options for people who inject drugs, syringe services programs, and ways to stay healthy.

2022 National Drug Control Strategy (White House Office of National Drug Control Policy) – This recently adopted strategy is designed “to bend the curve on overdose deaths in the immediate term and reduce drug use and its damaging consequences over the longer term.” The strategy includes seven general goals and twenty specific objectives for reducing the demand for and availability of illicit drugs, as well as the consequences of illicit drug use.

Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV: Considerations for Antiretroviral Use in Special Patient Populations – Substance Use Disorders and HIV (Clinicalinfo.hiv.gov) – This document includes sections with background information on substance use disorders among people with HIV; substance use and sexual risk taking; screening for substance use disorders; co-occurring mental illness; selecting, initiating, and maintaining antiretroviral therapy (ART) in people with ongoing substance use; commonly used substances and their impact on HIV and ART; and medications for the treatment of substance use disorders.

Drugs, Alcohol, and HIV (U.S. Department of Veterans Affairs) – This fact sheet provides an overview of the interrelationships of drugs, alcohol, and HIV. It examines how drugs and alcohol affect the immune system; interactions between drugs, alcohol, and HIV medications; safer sex; and HIV risks and prevention for people who inject drugs.

Prevention and Treatment of HIV Among People Living with Substance Use and/or Mental Disorders (Substance Abuse and Mental Health Services Administration) – This evidence-based resource guide provides an overview of current approaches and challenges to preventing and treating HIV for people with mental illness and/or substance use disorder (SUD). The guide includes five main sections: an issue brief highlighting key concerns; a review of research to date on the effectiveness of programs and strategies to prevent HIV among people with co-occurring mental illness and/or SUD and to link them to HIV care; guidance for selecting and implementing evidence-based practices; examples of effective programs and strategies; and resources for evaluation and quality improvement.

Harm Reduction Hacks: A Syringe Services Program (SSP) Provider Basic Operations Handbook (National Alliance of State and Territorial AIDS Directors) – This document includes informal guidance for SSPs, including tips on leadership, organizational design and planning, community relations, advocacy, legal and fiscal structure, fundraising, workforce development, and other topics.

 

Compiled Resources: Substance Use and HIV

Resources from CDC for Consumers

 

Resources from CDC for Providers and Public Health Partners

 

Resources from Substance Abuse and Mental Health Services Administration

 

Selected Resources from AIDS Education and Training Centers (AETCs)

National HIV Curriculum: Substance Use Disorders (AETC, University of Washington, and other partners, updated 2021) – This is the seventh lesson in the Curriculum’s Basic HIV Primary Care module. It has detailed information on many topics, including:

  • Background
  • Screening for Substance Use Disorders
  • Epidemiology of Substance Use in United States
  • Impact of Substance Use Disorders on HIV Metrics
  • Alcohol Use Disorder
  • Cannabis Use Disorder
  • Hallucinogen Use Disorder
  • Opioid Use Disorder
  • Stimulant Use Disorder
  • Tobacco Use Disorder
  • Summary Points

 

18th Annual Conference on HIV/AIDS and Aging (New England AETC, September 2022) – This webinar covers many issues related to HIV and aging, including  long-term survival, primary prevention, PEP, PrEP, transgender health, oral health, mental health, and substance use.

Implementing Substance Use Disorder (SUD) Services in HIV Care Settings Toolkit (AETC National Coordinating Resource Center and others, August 2022) – This toolkit of linked resources was created to help multidisciplinary healthcare team members improve SUD-related health outcomes for people with HIV with SUD in all stages of recovery.

Addressing Opioid Use Disorder in Asian Americans, Native Hawaiians, and Pacific Islanders with HIV (Pacific AETC, July 2022) – This presentation provides an overview of HIV and SUD/opioid use disorder in these population groups, and outlines key strategies in the management of opioid use disorder in people with HIV.

Models of Case Management for Substance Use Disorders in HIV Care Settings (Pacific AETC, July 2022) – This webinar reviews the topic of case management for patients with SUD and/or mental health conditions in HIV care settings. Four models of effective case management that can be tailored to HIV care settings are presented.

Mental Health and HIV Webinar Series Part 4: Trauma and Stressor-Related Disorders (New England AETC, June 2022) – This webinar provides information about the pervasiveness of trauma among people with HIV and the principles of care necessary to avoid doing harm. The diagnosis and treatment of specific trauma disorders, including PTSD, are also discussed.

Mental Health and HIV Webinar Series Part 1: Addressing Depression in People with HIV (New England AETC, May 2022) – This webinar describes the importance of addressing depression in people with HIV, and evidence-based approaches for diagnosing and treating depressive illnesses. There is also a discussion about how treating depression impacts both mental health and HIV outcomes.

PrEP for PWID: Challenges and Opportunities (Mountain West AETC, May 2022) – This training reviews challenges (lack of awareness, interest, and risk perception), and opportunities (improving uptake, sustainability, and adherence) for PrEP among people with injection drug use disorder.

SSPs in Public Health – Mobile Innovations to Reach Rural Communities (New England AETC, April 2022) – This webinar examines existing data and public health challenges in HIV/HCV prevention and SSP access in rural areas and reviews innovative models for bringing services to most at-risk communities.

Strategies and Lessons Learned from Data Utilization to Improve Patient Care (New England AETC, April 2022) – This webinar describes how data utilization techniques can be applied to UDS quality metrics, quality improvement projects, and provides strategies to use the data to improve patient care in a homeless population with a high prevalence of SUD.

Chemsex: Essentials for Treating the Addictive Fusion of Drugs and Sex (New England AETC, April 2022) – This seminar reviews the clinical presentation and treatment of co-occurring drug use (particularly amphetamines) and sexual behavior. Biopsychosocial risk factors are reviewed, along with the specific impact of various drugs on sexual functioning.

Fentanyl: A Hidden Epidemic (Mountain West AETC, April 2022) – The training summarizes drug overdose mortality trends in HHS Region 10, describes core infrastructure states are using to respond to the overdose epidemic, and identifies approaches to improve overdose responses.

Myth-Busting HCV Treatment: Responsive HCV Screening, Treatment and Care (New England AETC, March 2022) – This part of the “Myth-Busting HCV Treatment” series focuses on identifying culturally responsive components of HCV treatment that successfully engage incarcerated populations for HCV screening, treatment, and care.

Unhealthy Alcohol Use Among Persons with HIV: A Modifiable Barrier to Optimal Management of HIV and its Comorbidities (Mountain West AETC, March 2022) – These training slides describe unhealthy alcohol use, identify approaches to screening for unhealthy alcohol use in HIV clinical settings, and review alcohol treatment strategies that providers can integrate into HIV clinical care.

“Microdosing” Buprenorphine Inductions (Mountain West AETC, February 2022) – These training slides offer a refresher on buprenorphine pharmacology and review challenges with standard induction for different populations. The idea behind and evidence for microdosing inductions are also shared.

Stigma, HIV, and SUD (New England AETC, February 2022) – This podcast covers: 1) what stigma is, and how it impacts health outcomes in the context of HIV, SUD, and other chronic diseases; 2) research findings on associations between stigma prevention and treatment outcomes within the contexts of HIV and SUD; and 3) intervention tools to reduce stigma and enhance resilience to stigma.

More than Health Care – Improving Public Health Response through Partnership: A Unique Collaboration to Combat the Opioid Crisis in Lowell, MA (New England AETC, January 2022) – This webinar recording features a research collaborative drawing on public health and emergency medical services data and spatial epidemiological analyses to map opioid-related incidents.

Myth-Busting HCV Treatment: Demystifying HCV Treatment in At-Risk Populations (New England AETC, January 2022) – This part of the “Myth-Busting HCV Treatment” series explores how advances in HCV treatment have affected the clinical management of people who inject drugs and persons with SUD. It also examines various monitoring strategies that can be used during HCV treatment and follow-up for hard-to-reach populations.

Myth-Busting HCV Treatment: Interdisciplinary HCV Screening, Treatment and Follow-up (New England AETC, December 2021) – This part of the “Myth-Busting HCV Treatment” series focuses on the role of an interdisciplinary team in completing the essential components of HCV treatment assessment, service delivery for marginalized populations, and outreach to individuals experiencing SUD.

Substance Use and Mortality: How the COVID-19 Pandemic is Affecting People with HIV & Communities of Color (Northeast/Caribbean AETC, January 2022) – These training slides review pre-COVID-19 rates of SUD and overdose deaths, as well as pre-COVID-19 rates of HIV prevalence and prevention efforts, in order to understand the impact of the COVID-19 pandemic on the HIV and SUD epidemics among communities of color.

Fentanyl and Other High Potency Synthetic Opioids (Mountain West AETC, December 2021) – These training slides cover the properties of fentanyl and the history of the spread of illicitly manufactured synthetic opioids. National epidemiology and regional variations, fentanyl testing, overdose prevention, and opioid use disorder treatment are also covered.

Opioids and HIV: Effects of the COVID-19 Pandemic (Northeast/Caribbean AETC, December 2021) – These training slides review the state of opioid use disorders and HIV prior to the COVID-19 pandemic, the impact COVID-19 has had on people with HIV and opioid use disorders, and ways to meet the needs of this vulnerable population.

Methamphetamine and HIV (Northeast/Caribbean AETC, December 2021) – These training slides provide an overview of methamphetamines and HIV, including the history of amphetamines; substance use trends in the U.S.; meth use in the U.S. New York City, and in the gay and HIV communities; long-term effects of meth use; medical complications; treatment options; and more.

Harm Reduction in the Continuum of Care for Substance Use Disorders (Northeast/Caribbean AETC, December 2021) – These training slides review the importance and utility of providing harm reduction services for people with substance use disorders and identify various types of harm reduction services available and how to determine which service will be the most beneficial to one’s clients.

Being Triply Diagnosed While Black During the COVID-19 Pandemic (Northeast/Caribbean AETC, November 2021) – These training slides examine mental illness through a cultural lens to review the impact of COVID-19 on the Black community while facing the challenges of mental illness, substance use disorder, and HIV infection. Various treatment options are also addressed.

Myth-Busting HCV Treatment: Integrated Models of HCV Care Delivery (New England AETC, November 2021) – This part of the “Myth-Busting HCV Treatment” series describes the process of care and patient outcomes in a practice serving young injection drug users (YIDU) with integrated HCV treatment services and OUD services.

Methadone Patient Journey Demystified Video Series (New England AETC, October 2021) – This four-part video series follows a patient’s journey into methadone treatment to demystify the process for healthcare providers treating people with substance dependence. It is part of a larger curriculum from the Connecticut Regional Partner. You must create an account on the Connecticut AETC website to get access to these free resources.

Connect to Cure – A Care Innovation Project (New England AETC, October 2021) – This seminar describes a multidisciplinary team’s experience providing innovative care for people at risk of drug and sex-related harms.

Recovery Support Services Along the Continuum of Substance Use and HIV Treatment (Pacific AETC, September 2021) – This online course is designed to help participants understand the Recovery Support Services available for people with HIV and co-occurring SUD. It offers information and interactive activities to help integrate effective recovery support services at different stages along a continuum of care to improve patient retention and engagement.

Substance Use Disorder Curriculum (Southeast AETC and others, September 2021) – This curriculum covers the following topics: addiction as a brain disease, motivational interviewing and substance use disorder, challenging behaviors of addiction, and trauma-informed care and substance use disorder.

Treating Hepatitis C Among People who Use Drugs (Mountain West AETC, July 2021) – These training slides review the epidemiology of HCV among people who use drugs, review treatment as prevention, dispel myths about HCV treatment among people who use drugs, and discuss special considerations about HCV treatment for this population.

Methamphetamine 2021: Focus on HIV (New England AETC, July 2021) – This webinar covers the role of methamphetamine use in the transmission of HIV, as well as strategies for improving outcomes and reducing harm with individuals who use methamphetamine.

Supervised Consumption Sites (New England AETC, July 2021) – This lecture on supervised injection sites discusses the successes of safe consumption site programs and the benefits of establishing a program in the U.S. amidst an overdose epidemic.

 

The contents listed on this page are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, the New England AIDS Education and Training Center.