Opportunities and Challenges

Substance abuse and mental illness are associated with risky behaviors that may lead to STDs, including HIV.¹⁹ Injection drug use remains a primary vector of co-infection with hepatitis.²⁰ Persons with HIV/AIDS and injection drug users are among of the largest populations needing substance abuse treatment and HIV/AIDS prevention and treatment services.²¹ HIV infection among females in the United States is associated primarily with unprotected heterosexual contacts.²¹ Pediatric AIDS is a particularly virulent problem among the children of persons involved in drug-related lifestyles.²²

Designated States or U.S. jurisdictions with high AIDS rates are required to set aside a percentage of their Substance Abuse Prevention and Treatment Block Grant funds to provide HIV early intervention services (pretest counseling, testing, posttest counseling, and therapeutic measures to prevent and treat deterioration of immune system and other medical conditions). In 2004, SAMHSA began the Rapid HIV Testing Initiative, which provides free rapid oral fluid HIV 1 and 2 test kits to qualified programs in support of early intervention services. Key elements in preventing the spread of HIV/AIDS and hepatitis must include improved access to mental health and substance abuse treatment for injection drug users, as well as risk reduction prevention programs that promote awareness of the consequences of substance abuse and its association with increased sexual risk-taking and STDs.

As noted earlier, rates of adolescents' disapproval toward drug and alcohol use have shown improvement, and disapproval is inversely related to use. Prevention programs can capitalize accordingly and create initiatives that reinforce risk-reducing behaviors.

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