Coordinating Systems of Care for HIV and Opioid Use Disorder: A Systematic Review of Enablers and Barriers to Integrated Service Access, and Systems and Tools Required for Implementation

Abstract

Individuals who have HIV who also use drugs experience increased age-matched morbidity and mortality in comparison with those with HIV who do not use drugs. A systematic review was conducted to describe models of integrated HIV and opioid use disorder (OUD) services, enablers of and barriers to integrated service access, and the coordinated systems and tools at the state and service delivery levels required for implementation. Database searches yielded 235 candidate articles, of which 22 studies met the inclusion criteria. Analysis found that integrated programs operated with minimal coordinated policy and systems guidance at the state level. Service delivery systems and tools used for integration, including use of integrated protocols, risk assessment tools, case management tools, and referral systems, were similar across integration models. Concerted efforts to coordinate state-level systems and develop supportive policies, guidelines, and standardized tools may facilitate integration at the service delivery level.

Strengthening systems of care for people with or at risk for HIV, HCV and opioid use disorder: a call for enhanced data collection

“…MOUD has demonstrated the improvement of the HIV and HCV treatment and prevention cascades [ 15 , 16 ] in addition to the 60 years of evidence for being the best treatment for OUD [ 17 ]. Despite the evidence for MOUD, its scale-up has been hindered in part due to structural impediments including the disconnect between service provision and funding for OUD, HIV and HCV [ 18 ].…”