![[ Visit Client Website ]](images/banner.gif)
Background
Integration of HIV and substance use treatment services is a national priority in the United States because integration is an effective strategy for reducing HIV risk behaviors. However, practitioners lack the training needed to effectively integrate HIV prevention with substance using clients. We hypothesize that formal HIV training, and training in risk assessment, risk reduction and in recovery counseling are associated with integration of HIV prevention. This knowledge may inform policies aimed at integration of HIV and substance use treatment services for key target populations.
Methods
From 2013-15, practitioners (N=379) in 36 New York City (USA) social/public health services agencies provided cross-sectional data for an NIMH-funded study (5R01MH095676). Agency budgets: $500,000 to 5 million USD. One-third have ²25 staff; one-third have >100. Sample: More than half are case managers (29%) and outreach workers/navigators (24%); Education: Secondary or higher. Mean age: 41 (SD=12). Gender: 63% females. Race/ethnicity: Black (51%); Latino (38%); White (6%); Asian (5%). Outcome: "To what extent do you offer "X" [list of strategies] to your substance using clients?" (0-4 Likert Scale). Key Predictors: HIV training, and training in risk assessment, reduction and recovery counseling. Analysis: Frequencies were calculated for each strategy. Outcome variables were analyzed and F tests calculated for each predictor in separate logistic regressions.
Results
Half of participants report integration of risk assessment, HIV testing, but not condom use education (no: 51%). 22.4% do not integrate any HIV prevention strategy. 35.9% integrate all strategies. HIV-specific training is associated (p < .05) with providing HIV testing, and risk assessment/reduction and condom use education. Training in recovery counseling is associated with condom use education. Training in evidence-based counseling is associated with providing risk assessment, risk reduction, and condom use education.
Conclusions
Knowing the associations between specific types of training and HIV service integration helps address a major challenge to enhance efficiency, lower costs, and improve the effectiveness of behavioral health systems in the USA and abroad. Development and implementation of specific types of training in academia and through continuing education to health care practitioners working with substance using clients, are priority areas to target.