Prevention and Treatment of HIV Among People Living with Substance Use and/or Mental Disorders

Course overview

This course is based upon material from the Substance Abuse and Mental Health Services Administration and is available as an open access article. People with mental illness and/or SUD are disproportionally affected by HIV. They may participate in behaviors that increase risk for contracting and transmitting HIV, such as sharing injection drug equipment or engaging in sexual behaviors that increase HIV risk. This guide addresses the co-occurrence of HIV and mental illness and/or SUD. It reviews effective programs and practices to prevent HIV and, for those with HIV, to increase linkage and retention in care in order to improve health outcomes. The goal of this course is to review the literature on preventing and treating HIV for people with mental illness and/or SUD, distill the research into recommendations for practice, and provide examples of how practitioners use these practices in their programs. An overview of current approaches and challenges to preventing and treating HIV in these special populations is followed by a review of current evidence of effectiveness of programs and strategies to prevent HIV among people with co-morbidities in mental health, as well as ways to link them to HIV care. Practices to increase uptake of and improve adherence to Pre-Exposure Prophylaxis (PrEP), Syringe Services Programs, Contingency Management, Cognitive Behavioral Therapy, and Patient Navigation are reviewed. Next, practical information to consider when selecting and implementing programs and practices to improve health outcomes is considered. The course concludes with examples of successful programs and a review of resources for evaluation and quality improvement. This course on HIV in those with substance use or mental disorders is designed for social workers, professional counselors, psychologists, nurses, and substance abuse counselors, who do clinical work. This course is appropriate for beginning, intermediate and advanced level practitioners who wish to develop or increase their knowledge of HIV prevention and treatment in special populations. It may also be useful for licensed clinicians who require clinical continuing education courses for license renewal. Authors: Substance Abuse and Mental Health Services Administration, US Department of Health and Human Services Learning Objectives: This course will provide the practitioner with detailed information regarding HIV prevention and treatment among people living with substance use and/or mental disorders. Specifically, a professional will: Recognize current approaches and challenges to preventing and treating HIV for people with mental illness and/or SUD Summarize evidence on effectiveness of programs and strategies to prevent HIV among people with co-occurring mental illness and/or SUD Distinguish challenges and strategies to consider when selecting and implementing programs and practices to improve heath outcomes for people with mental illness and/or SUD with or at risk for HIV Citation: Substance Abuse and Mental Health Services Administration (SAMHSA). Prevention and Treatment of HIV Among People Living with Substance Use and/or Mental Disorders. Publication No. PEP20-06-03-001 Rockville, MD: National Mental Health and Substance Use Policy Laboratory. Substance Abuse and Mental Health Services Administration, 2020.