Substance Use Screening in HIV Care Settings: a Review and Critique of the Literature

  • Anthony E. HitchEmail author
  • Nicole K. Gause
  • Jennifer L. Brown
Behavioral Bio-Medical Interface (JL Brown and RJ DiClemente, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Behavioral-Bio-Medical Interface


Purpose of Review

People living with human immunodeficiency virus/AIDS (PLWHA) experience high prevalence of substance use disorders (SUD). HIV care settings represent a unique opportunity to identify possible SUD, to provide SUD interventions, and to improve linkage to SUD treatment. The aims of this paper are to (a) review and critique the extant literature examining substance use screening approaches among PLWHA in HIV care settings and (b) provide recommendations for future clinical practice.

Recent Findings

Twenty-one peer-reviewed articles that examined substance screening approaches employed in HIV and other primary care settings were included in the review. There was limited literature reporting on the implementation and evaluation of substance use screening practices within HIV care settings, and methodological rigor varied across studies. Further, the use of validated substance use screening measures or incorporation of other substance use screening approaches (e.g., use of urine drug testing) within routine HIV care practice is limited. Strategies to implement routine substance use screening within HIV care and incorporate additional substance use assessment, brief interventions, and referral to specialty substance use treatment are discussed.


Use of self-report substance use screening measures using web- or computer-delivered approaches that can be integrated within electronic health record systems is particularly promising. HIV care practices should consider potential models to optimally screen and treat SUD. Co-location of HIV and SUD treatment services may be optimal; when co-located services are not possible, strategies to consistently provide brief intervention approaches and referrals to specialty SUD treatment are needed.


Substance use HIV/AIDS Screening Screening, brief intervention, and referral to treatment (SBIRT) Primary care 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Anthony E. Hitch
    • 1
    Email author
  • Nicole K. Gause
    • 1
  • Jennifer L. Brown
    • 2
  1. 1.Department of PsychologyUniversity of CincinnatiCincinnatiUSA
  2. 2.Addiction Sciences Division, Department of Psychiatry & Behavioral NeuroscienceUniversity of Cincinnati College of MedicineCincinnatiUSA

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