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Substance use and the HIV care continuum

Guest Edited by:
P. Todd Korthuis, MD, MPH, Oregon Health & Science University, USA
Jennifer Edelman, MD, MS, Yale School of Medicine, USA

The HIV care continuum – also referred to as the HIV treatment cascade – identifies five stages of HIV medical care: 1) HIV diagnosis, 2) linkage to HIV care, 3) engagement and retention in HIV care, 4) treatment with antiretroviral therapy (ART), and 5) achievement of HIV viral suppression – all of which are essential in order to effectively treat and prevent the spread of HIV. Recent data from the U.S. estimate that 86% of people living with HIV are diagnosed, 40% are engaged in care, 37% receive ART, and only 30% achieve HIV viral suppression. People who use drugs and alcohol are particularly likely to experience gaps in each stage of the HIV care continuum, preventing them from realizing improvements in HIV survival. Screening for and treating substance use disorders may close these gaps in care and help achieve the UNAIDS 90-90-90 goal of achieving 90% diagnosis, 90% ART treatment, and 90% HIV viral suppression by 2020.

This thematic series in Addiction Science & Clinical Practice highlights articles that address the impact of drug and/or alcohol use on the HIV care cascade and specifically the role of substance use disorder screening and treatment as a means of meeting the 90-90-90 goal.

The Editors of the series declare no competing interests.

  1. People who use drugs are an important priority for HIV programs. However, data related to their utilization of HIV services are limited. This paper reports patterns of HIV testing, drug use, and risk and servi...

    Authors: Gitau Mburu, Chanrith Ngin, Sovannary Tuot, Pheak Chhoun, Khuondyla Pal and Siyan Yi
    Citation: Addiction Science & Clinical Practice 2017 12:27
  2. Engaging people who drink alcohol or inject drugs in HIV care can be challenging, particularly in Eastern Europe. Healthcare facilities in Russia are organized by specialty; therefore linking patients from add...

    Authors: Bulat Idrisov, Karsten Lunze, Debbie M. Cheng, Elena Blokhina, Natalia Gnatienko, Emily Quinn, Carly Bridden, Alexander Y. Walley, Kendall J. Bryant, Dmitry Lioznov, Evgeny Krupitsky and Jeffrey H. Samet
    Citation: Addiction Science & Clinical Practice 2017 12:30
  3. Improving the extent to which evidence-based practices (EBPs)—treatments that have been empirically shown to be efficacious or effective—are integrated within routine practice is a well-documented challenge ac...

    Authors: Bryan R. Garner, Mark Zehner, Mathew R. Roosa, Steve Martino, Heather J. Gotham, Elizabeth L. Ball, Patricia Stilen, Kathryn Speck, Denna Vandersloot, Traci R. Rieckmann, Michael Chaple, Erika G. Martin, David Kaiser and James H. Ford II
    Citation: Addiction Science & Clinical Practice 2017 12:32
  4. In 2010, the first comprehensive National HIV/AIDS Strategy for the United States was released and included three goals: (1) reducing the number of people who become infected with HIV, (2) increasing access to...

    Authors: Bryan R. Garner, Heather J. Gotham, Stephen J. Tueller, Elizabeth L. Ball, David Kaiser, Patricia Stilen, Kathryn Speck, Denna Vandersloot, Traci R. Rieckmann, Michael Chaple, Erika G. Martin and Steve Martino
    Citation: Addiction Science & Clinical Practice 2017 12:31

    The Correction to this article has been published in Addiction Science & Clinical Practice 2018 13:9

  5. Though timely initiation of antiretroviral therapy (ART) is a vital component of effective HIV prevention, care and treatment, people who inject drugs are less likely to receive ART than their non-drug using c...

    Authors: Alexis Cooke, Haneefa Saleem, Dorothy Mushi, Jessie Mbwambo, Saria Hassan and Barrot H. Lambdin
    Citation: Addiction Science & Clinical Practice 2017 12:23
  6. Contemporary studies about HIV care continuum (HCC) outcomes within substance using populations primarily focus on individual risk factors rather than provider- or systems-level influences. Over 25% of people...

    Authors: Lauretta E. Grau, Abbie Griffiths-Kundishora, Robert Heimer, Marguerite Hutcheson, Amy Nunn, Caitlin Towey and Thomas J. Stopka
    Citation: Addiction Science & Clinical Practice 2017 12:24
  7. Alcohol consumption has been associated with poor antiretroviral therapy (ART) adherence but less is known about its relationship to HIV viral suppression, or whether certain drinking patterns have a stronger ...

    Authors: R. L. Cook, Z. Zhou, N. E. Kelso-Chichetto, J. Janelle, J. P. Morano, C. Somboonwit, W. Carter, G. E. Ibanez, N. Ennis, C. L. Cook, R. A. Cohen, B. Brumback and K. Bryant
    Citation: Addiction Science & Clinical Practice 2017 12:22
  8. HIV prevalence remains high in Cambodia among female entertainment and sex workers (FESW), and amphetamine-type stimulant (ATS) use significantly increases risk of infection. A successful continuum of care (Co...

    Authors: Sokunny Muth, Aynar Len, Jennifer L. Evans, Maly Phou, Sophal Chhit, Yuthea Neak, Song Ngak, Ellen S. Stein, Adam W. Carrico, Lisa Maher and Kimberly Page
    Citation: Addiction Science & Clinical Practice 2017 12:20
  9. Persons living with HIV and unhealthy substance use are often less engaged in HIV care, have higher morbidity and mortality and are at increased risk of transmitting HIV to uninfected partners. We developed a ...

    Authors: Claire Simeone, Brad Shapiro and Paula J. Lum
    Citation: Addiction Science & Clinical Practice 2017 12:19
  10. Interventions are needed to improve viral suppression rates among persons with HIV and substance use. A 3-arm randomized multi-site study (Metsch et al. in JAMA 316:156–70, 2016) was conducted to evaluate the ef...

    Authors: Maxine Stitzer, Tim Matheson, Colin Cunningham, James L. Sorensen, Daniel J. Feaster, Lauren Gooden, Alexis S. Hammond, Heather Fitzsimons and Lisa R. Metsch
    Citation: Addiction Science & Clinical Practice 2017 12:16
  11. People who smoke crack cocaine and people who inject drugs are at-risk for criminal justice involvement as well as HIV and HCV infection. Compared to criminal justice involvement, substance use treatment (SUT)...

    Authors: Barrot H. Lambdin, Alex H. Kral, Megan Comfort, Andrea M. Lopez and Jennifer Lorvick
    Citation: Addiction Science & Clinical Practice 2017 12:13
  12. Women in South Africa who use alcohol and other drugs face multiple barriers to HIV care. These barriers make it difficult for women to progress through each step in the HIV treatment cascade from diagnosis to...

    Authors: Wendee M. Wechsberg, Charles van der Horst, Jacqueline Ndirangu, Irene A. Doherty, Tracy Kline, Felicia A. Browne, Jennifer M. Belus, Robin Nance and William A. Zule
    Citation: Addiction Science & Clinical Practice 2017 12:12
  13. Persons living with HIV and substance use disorders face barriers to sustained engagement in medical care, leading to suboptimal antiretroviral treatment outcomes. Innovative mobile technology tools such as cu...

    Authors: Ryan P. Westergaard, Andrew Genz, Kristen Panico, Pamela J. Surkan, Jeanne Keruly, Heidi E. Hutton, Larry W. Chang and Gregory D. Kirk
    Citation: Addiction Science & Clinical Practice 2017 12:11
  14. People living with HIV (PLWH) with a substance use disorder (SUD) tend to receive inadequate medical care in part because of a siloed healthcare system in which HIV and substance use services are delivered sep...

    Authors: Kasey Claborn, Sara Becker, Susan Ramsey, Josiah Rich and Peter D. Friedmann
    Citation: Addiction Science & Clinical Practice 2017 12:8

The article processing charge for a select number of articles in this series was funded by the National Institute on Drug Abuse (NIDA), the National Drug Abuse Treatment Clinical Trials Network and the NIDA/SAMHSA Blending Initiative. This has been individually acknowledged within the articles. All articles in this series have undergone the journal’s full standard peer-review process.