Colorado's Ryan White SBIRT Collaborative Project: Screening and brief intervention for substance use in HIV/AIDS case management and healthcare settings

This presentation discusses screening, brief intervention, and referral to treatment for substance use (SBIRT) within HIV/AIDS treatment and care and lessons learned from Colorado's Ryan White SBIRT Collaborative Project. Evidence demonstrates that screening and brief intervention in healthcare settings is effective in changing behavior and preventing adverse outcomes attributable to substances. Studies show people living with HIV are more likely to experience substance abuse problems than the general population, and early detection and intervention offsets the negative ramifications, including poor treatment adherence. Despite the linkage between substance use and HIV, screening and brief intervention protocols have not been readily adopted in the continuum of HIV/AIDS services. In order to introduce SBIRT procedures tailored for HIV/AIDS care in Colorado, we collaborated efforts between SAMHSA's SBIRT initiative and HRSA's Ryan White program. Of 1,954 patients screened, 36% received a brief intervention for risky alcohol, tobacco, or drug use and 19% were referred to specialized treatment. Data suggests people living with HIV are more likely to misuse substances and to experience negative consequences due to their use. Preliminary findings indicate that SBIRT can be successfully implemented into HIV treatment and care to address substance use. This presentation explores the obstacles that hinder the efficacy of SBIRT, and identifies the administrative and policy considerations that are necessary for effective implementation. Recommendations are made for standardizing SBIRT in HIV care: applying a systematic approach to screening; training providers to conduct brief interventions; establishing a referral system; and, integrating SBIRT services with adherence and retention efforts.