Increasing Immediate Engagement and Retention in HIV Treatment with Substance Users (R01- Clinical Trials Required)

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oEnsuring all PLWH have rapid access to care, especially in resource-limited settings, remains a key challenge to the success of HIV care/treatment efforts. Same day or other rapid treatment initiation may be available, but patients may be concerned that other needs will make treatment difficult or they may face delays related to the enrollment process for treatment support mechanisms (e.g., ADAP, Ryan White, Medicaid). Similarly, long-term retention in HIV care and sustained achievement of viral suppression can be challenging even when ARV is introduced at or close to HIV diagnosis. Existing practices such as Strengths-Based Case Management and Patient Navigation often demonstrate a lack of efficacy among people with SUD. Persons with SUD and HIV often present clinical complexities and engagement with multiple services may be necessary; where reducing and eliminating barriers (i.e. structural or individual) to immediate linkage to care is critical to minimizing time between diagnosis and treatment and can lead to achieving Ending the Epidemic goals. Even with rapid ARV uptake, this population may need additional supports to remain continuously engaged in care. There is a need to develop and test evidence-based interventions at the systemic, organizational, and/or provider levels that can reduce the time between diagnosis and treatment while also retaining persons with SUD in HIV and SUD care.

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