Table 1.

Recommendations for integrating care of HIV and SUD

Healthcare provider level

All clinicians should be trained to screen, diagnose, and treat SUDs and integrate with HIV testing and provision of PrEP/antiretrovirals based on testing results

Train CHWs to screen for SUDs and perform rapid HIV testing

Healthcare systems level

Increase access to telehealth providers, CHWs, peer-support staff, and mobile health clinics for PWUD and PWH

Create stigma-free environments in all healthcare programs (brick-and-mortar and mobile)

Pharmacies should keep appropriate stock of medications for SUDs, HIV, and PrEP

Hospitals and clinics should develop screening procedures for SUD and HIV with integrated treatment and assertive discharge planning to ensure retention on SUD and HIV prevention and treatment

Criminal justice settings should offer routine screening and treatment and prevention for SUDs and HIV including MOUD, naloxone, and PrEP with assertive reentry linkage upon release to have uninterrupted medication prescription

Policy level

Pass state legislation to permit mobile pharmacies that can meet people where they are

DEA must remove restriction on mobile pharmacy dispensation of buprenorphine

Pass state legislation to eliminate 1 for 1 syringe exchange

Introduce and strengthen harm reduction programming and MOUD in prisons and jails

Expand Medicaid in all states to improve health insurance access

Increase federal and state funding for harm reduction, SSPs, and overdose prevention sites

Increase federal and state funding for evidence-based SUD treatment programs and MOUD

CHW, community health workers; DEA, Drug Enforcement Administration; HIV, human immunodeficiency virus; MOUD, medication for treatment of opioid use disorder; PrEP, pre-exposure prophylaxis; PWH, people with HIV; PWUD, people who use drugs; SSP, syringe services program; SUD, substance use disorder