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HIV Cross-Training Resources New

Cross-Training Initiative

• What is the Substance Abuse and Infectious Disease Cross-Training Initiative?
• Workshop Information
• Map of previous training locations in HTML or PDF(Requires Adobe Acrobat Reader)
• Guidelines for Developing Formal Requests for Cross-Training (HTML or PDF)
  (Requires Adobe Acrobat Reader)
• Legal Action Center and the Substance Abuse and Infectious Disease Cross-Training
• Why is Cross-Training Needed?
• What Technical Assistance is Available?
• Will Cross-Training Work for You?

What is the Substance Abuse and Infectious Disease Cross-Training Initiative?
Substance Abuse and Infectious Disease: Cross-Training for Collaborative Systems of Prevention, Treatment, and Care is an initiative that provides training and technical assistance to State and local public health, mental health, criminal justice, and substance abuse health care delivery systems so that they can collaborate more effectively to serve individuals with concurrent substance abuse problems and/or infectious diseases such as HIV/AIDS, other sexually transmitted diseases (STDs) (e.g., gonorrhea or chlamydia), viral hepatitis, and tuberculosis (TB). The goal is to create synergy among providers that will result in improved care for individuals who have or are at risk for concurrent conditions.

Professionals in the various health care delivery systems need to understand about the connections between infectious diseases and substance abuse in order to recognize and assess these often concurrent conditions. To help encourage and strengthen a collaborative environment, including the network of resources available to clients and patients at risk as well as the local training system, this workshop brings together training participants representing the following:

• Substance abuse prevention and treatment programs
• Public health and sexually transmitted disease clinics
• Tuberculosis prevention and treatment programs
• HIV/AIDS service organizations
• Mental health agencies
• Criminal justice systems
• Trainers from prevention, treatment, and other health systems
• Consumers in recovery, affected and infected by these diseases

Cross-training allows the acquisition of knowledge and enhancement of skills by persons who provide services to individuals at high risk for concurrent disorders such as infectious diseases and substance abuse. The intent is not to enable service providers to perform the work of others, but, to foster an improved collaborative environment to provide a continuum of care conducive to the needs of clients. Workshop participants engage in a variety of interactive learning activities with colleagues across specialties during this workshop. These Cross-Training activities can help service providers understand more about substance abuse or infectious disease, increase their appreciation of their own unique role in facilitating access to health care for at-risk individuals, and develop skills in brief screening, risk assessment, and behavior change.

To ensure this process is truly multidisciplinary, a "blended" 3 to 5-member training team, representing disciplines and agencies in the locality where training is being provided, conducts the workshop. Training is also reinforced through follow-up activities.

In order to ensure the continuation of collaboration across systems and building service capacity, the Cross-Training Initiative also includes a local planning committee representing the various disciplines and specialty areas. The Cross-Training Project Team works with this committee to facilitate collaboration among systems through:

• Local adaptation and replication of the Cross-Training curriculum
• Representation and diversity within all systems in the collaborative efforts
• Increased capacity for collaborative care systems
• Sustained service integration
• Resource allocation
• Systemic assessment and evaluation
• Assessment, referrals, and counseling

Why is Cross-Training Needed?
Cross-Training is needed to address the challenges of today's health care environment. The AIDS epidemic and blood-borne illnesses such as hepatitis B and C have led to a growing recognition of the importance of preventing and treating injection drug use. Designing and delivering effective interventions for injection drug users (IDUs) who have or are at high risk of HIV/AIDS and other infectious diseases requires that service providers and others better understand the lives and issues faced by IDUs and work to overcome personal and societal biases that may keep such individuals from getting needed care.

Many professionals in the public health, mental health, criminal justice, and substance abuse health care delivery systems have been inadequately prepared, either through training or experience, to fully address the complex needs of substance-abusing patients infected with HIV/AIDS, STDs, tuberculosis, or viral hepatitis. Cross-Training brings together professionals in public health, substance abuse, mental health, and criminal justice health care delivery systems to increase their understanding of both substance abuse and infectious diseases so that they can strengthen the network of resources available to their clients and patients.

Cross-Training is unique in bringing public health, substance abuse, mental health, and criminal justice systems together in a shared learning environment to be trained by a team that includes experts from the different service areas and disciplines. Through the Cross-Training process, critical knowledge and skills are transferred, and a climate is created for building important linkages in the community. In addition to enhancing knowledge and skills required by multiple disciplines, the Cross-Training process allows participants to explore the attitudes, sensitivities, and the interrelated health and confidentiality issues faced by clients and service providers that could pose barriers to integration of care.

Cross-Training creates synergy among providers, so that they can learn with and from each other, share best practices, and attempt to overcome personal beliefs and perspectives about patients' behavior, as well as religious or moralistic thinking that serves as a barrier to the provision of needed services. Participants develop an appreciation of each others' views, as well as an understanding of the funding, policy, and eligibility requirements that influence the scope of services that can be provided to patients. The workshops change attitudes and alter the ways that many participants work with clients, creating collaborations and service agreements.

Ultimately, it is hoped that concomitant screening for substance abuse, HIV/AIDS, STDs, viral hepatitis, and TB will facilitate access to health care for at-risk individuals by promoting early identification of these problems. In addition, the appropriateness and specificity of treatment placement can be improved when a dually diagnosed client is accurately screened. The risk of illness and spread of disease to the community will thereby be reduced.

For more information contact marvena.simmonds@samhsa.hhs.gov.

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