Substance Abuse and HIVAIDS

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Substance Abuse and HIV/AIDS

• Dianne Weyer, RN, MS, CFNP
• and John Blevins, ThD
• Southeast AETC
• August 2005

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Diagnostic algorithm and supplementary materials

• Developed by Dianne Weyer and Jonathan Blevins
  from the Southeast AETC.
• Reviewed by members of the AETC Mental Health and
  HIV/AIDS Workgroup, including individuals from
  the Pacific AETC, Pennsylvania/MidAtlantic AETC,
  and NY/NJ AETC.

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Diagnostic algorithm

• Developed for a setting in which a person with
  HIV infection receives primary care, versus a
  substance abuse setting.
• Developed by a mental health expert and HIV
  primary care clinician.
• Formatted to enhance user-friendliness
• Supported by supplementary tools

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• The tool has been used in some clinical settings
  and is in the public domain. It has not been
  piloted in an HIV care setting.

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The tool supports HIV clinicians by offering

• A simple screening process to identify HIV
  patients who also have a substance abuse
  diagnosis.
• A user-friendly screening tool that can be
  administered in a time-limited environment and
  can be used in other clinical settings (e.g.,
  family practice, infectious disease, OB/GYN).
• Tools and resources to manage dually or
  triply-diagnosed patients in an HIV care setting.

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Tool objectives

• Help providers identify HIV-infected individuals
  whose substance use may compromise overall immune
  status or HIV care
• Guide HIV primary care clinicians to manage
  substance abuse, including behavior change methods

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Addressing provider needs

• Algorithm begins with a needs assessment Does
  the patient present with clues or evidence of
  substance abuse?
• Familiar screening tool (CAGE) and simple, but
  effective FRAMES interventions
• Questions that allow the patient to address
  substance abuse by him or herself
• Simple rating scales that clinician reference
  easily while using the tool.

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Supplementary materials

• DAST (Drug Abuse Screening Test)
• AUDIT (Alcohol Use Disorders Identification Test)
• SOCRATES (Stage of Change Readiness and Treatment
  Eagerness Scale)
• Stages of Change Influencing Factors Diagram
• Cocktails and Party Favors
• Phases of Preparation

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Challenges faced in development process

• Providing brief guidelines for easy reference
• Creating a tool that can be useful in a variety
  of settings for a variety of resources, while
  allowing for specific direction for individual
  providers

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Next Steps

• We encourage your feedback to support
  modifications of the tools
• Please pilot test in your clinical setting and
  share your experiences with us
• Questions nrc_at_aidsetc.org