Federal: Other MH Policy

Date: December 01, 2020 Categories: Substance Use, HIV/AIDS By: Kristin Roha, M.S., M.P.H., Senior Advisor, Center for Substance Abuse Treatment and Dr. Neeraj Gandotra, M.D., Chief Medical Officer Established in 1988, World AIDS Day allows the people of the world to show support for people living with and affected by HIV, and to commemorate people who have lost their lives to AIDS. In 2020, the COVID-19 pandemic has provided an urgent reminder that pandemics can devastate communities, lives, and livelihoods. The theme for World AIDS Day 2020 is “Ending the HIV/AIDS Epidemic: Resilience and Impact.” We at SAMHSA have seen how the COVID-19 crisis has exacerbated the challenges faced by people living with HIV, substance use disorder, and mental disorder. SAMHSA is proud to stand with our federal partners, our grantees, and the people of the world in observing World AIDS Day 2020. SAMHSA’s mission is to reduce the impact of substance abuse and mental illness on America’s communities. People with mental or substance use disorders are at an increased risk of HIV in the form of high-risk drug use behaviors, particularly injection drug use, and high-risk sexual practices that frequently occur during intoxication and in the situation of untreated mental illness. Increasing capacity and service delivery to those with substance use disorder will result in increased screening, detection, and then linkage to those with HIV/AIDS in this high-risk population; treating substance use disorder and mental disorder is a form of HIV prevention. Substance use treatment centers, like SAMHSA’s grantees and partner organizations and community mental health centers, serve on the front lines of the HIV epidemic as important pathways to HIV testing, treatment for people who test positive, and prevention services to ensure people who are HIV-negative stay negative. As one of several collaborating HHS agencies participating in the federal initiative Ending the Epidemic: A Plan for America, SAMHSA’s principal goals are to: reduce new HIV infections, improve HIV-related health outcomes, and reduce HIV-related health disparities for racial and ethnic minority communities. The pathway to meeting these goals is through: - Increasing testing frequency, - Increasing referrals to treatment for HIV positive individuals and pre-exposure prophylaxis (PrEP) for HIV-negative individuals, and - Supporting linkage to HIV treatment for enrollees who test HIV-positive. In 2020, our mission was complicated by COVID-19, as SAMHSA’s grantees have navigated the intersection between the COVID-19, opioid, and HIV/AIDS pandemics. But SAMHSA’s grantees and partner organizations have risen to the challenge, and developed innovative ways to deliver substance use disorder, mental disorder, and HIV testing and referrals in a largely virtual space. Thanks to updated guidelines from the CDC, SAMHSA grantees have been able to leverage alternative testing strategies, such as HIV self-testing, which allows individuals to perform their HIV tests in their own homes. In FY2020, SAMHSA grantees screened nearly 19,000 individuals for HIV, including 577 newly identified HIV-positive people, and linked 564 of those people to lifelong treatment. Our eventual goal is to ensure that every beneficiary of SAMHSA programming receives an HIV test, post-test counseling, and linkage to treatment or prevention services. To assist our grantees and partner organizations in their efforts to combat the HIV epidemic, SAMHSA has produced resources and funded grants that aim to address the intersection between substance abuse, mental disorder, and HIV/AIDS. In 2018, Dr. Elinore McCance-Katz reached out to colleagues to urge the substance use treatment communities to focus on the synergistic epidemics of substance use disorder HIV, and viral hepatitis. In 2019, Dr. McCance-Katz reached out to colleagues again to endorse greater utilization of oral fluid testing among all programs as an effective tool for HIV screening. Again in 2019, SAMHSA also produced a social media resource, the New HIV Prevention Platform. SAMHSA’s Substance Abuse and HIV Prevention Navigator Program for Racial/Ethnic Minorities provides training and education around the risks of substance misuse, education on HIV/AIDS, and needed linkages to service provision for individuals with HIV. SAMHSA’s Technology Transfer Centers provide technical assistance in real time to grantees navigating the COVID-19, opioid, and HIV epidemics. Published in November 2020, SAMHSA’s Prevention and Treatment of HIV among People Living with Substance Use and/or Mental Disorders aims to inform health care and administrators, policy makers, and community members about strategies to prevent and treat HIV among individuals who have mental illness and/or substance use disorders. On World AIDS Day 2020, SAMHSA would like to thank our staff, grantees, federal partners, and the substance use disorder and mental health community as a whole in working toward our shared goal of ending the HIV epidemic. SAMHSA understands the difficulties inherent in delivering care during the COVID-19 epidemic, and we thank you for your diligence and your flexibility during this time of great uncertainty. Thank you for the work you do to save lives and improve the health of the people of America.