Substance Abuse Treatment in Persons with HIV/AIDS: Challenges in Managing Triple Diagnosis
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Clinical management of HIV must account for the "triple diagnosis" of HIV, psychiatric diagnosis, and substance use disorders and requires integrated treatment services that focus beyond just mitigation of substance use and psychiatric and medical symptoms but also address other health behaviors. Because clinical management of HIV/AIDS has shifted significantly with the advent of highly active antiretroviral therapies (HAART) in the mid 1990s, a literature review focusing on literature published since 2000, and using relevant key words was conducted using a wide range of literature search databases. This literature review was complemented by studies to expand on specific treatment modalities for which there was a dearth of literature addressing HIV infected cohorts and to provide discussion of issues around substance abuse treatment as an HIV prevention tool. Existing models of substance abuse treatment including cognitive behavioral therapy and motivational interviewing have proven to be useful for enhancing adherence and reducing substance use in outpatient populations, while methadone maintenance and directly observed treatment have been useful with specific subgroups of users. Contextualization of services heightens the likelihood of successful outcomes and relapse prevention.
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Research supports CBT effectiveness for a wide range of people trying to quit smoking, including PTSD patients, people with HIV, individuals with mental illness, low socioeconomic smokers, adults with chronic pain, overweight and disadvantaged smokers, and youth.
“Research supports that CBT is effective for a wide range of individuals who are trying to quit smoking, including PTSD patients,63 people living with HIV,66 individuals with mental illness,67 low socioeconomic smokers,57 adults with chronic pain,68 overweight and disadvantaged smokers,61 and youth.65”
From Are smoking cessation treatments associated with suicidality risk? An overview (2016) · cites this paper as [66]
The 'Substance Abuse Treatment Techniques and Outcomes in the Triply Diagnosed' section (page unavailable) reports reductions in some substance-use outcomes with CBT in HIV-infected cohorts. It cautions that results vary and may not generalize across drugs; it does not report CBT effectiveness for quitting smoking among people living with HIV. (LLM, conf=0.84)
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- Authors
- Durvasula, R., & Miller, T. R.
- Affiliations
- California State University Los Angeles (US)
- Chapman University (US)
- Corresponding author
- Durvasula, Ramani
- Venue
- Behavioral Medicine
- Publisher
- Informa UK Limited
- Published
- 2014-04-03
- Volume
- 40
- Issue
- 2
- Pages
- 43-52
- ISSN
- 0896-4289 (ISSN-L)
- 1940-4026
- PMC
- PMC3999248
- OpenAlex
- W1969660039
- Cited by
- 151
- References
- 82
- Citations by year
- 2026: 2 · 2025: 18 · 2024: 8 · 2023: 15 · 2022: 11 · 2021: 18 · 2020: 17 · 2019: 19 · 2018: 17 · 2017: 13 · 2016: 10 · 2015: 3
- FWCI
- 3.16
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (SC1MH093181)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- HIV/AIDS, addiction treatment, psychiatric comorbidity, substance use disorders, highly active antiretroviral therapy, HIV prevention, cognitive behavioral therapy, motivational interviewing, methadone maintenance treatment, directly observed therapy, medication adherence, relapse prevention, outpatient care
- MeSH terms
- Acquired Immunodeficiency Syndrome, Mental Disorders, Combined Modality Therapy, Humans, Patient Acceptance of Health Care, Risk-Taking, Cognitive Behavioral Therapy, Substance-Related Disorders, Antiretroviral Therapy, Highly Active, Cultural Competency, Motivational Interviewing
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