Start Date
9-10-2025 12:00 PM
End Date
9-10-2025 1:30 PM
Description
Abstract
Title: Effectiveness of Integrated Mental Health and Substance Use Services in HIV Prevention for High-Risk Populations: A Systematic Review
Hardik Pipalia 1,
1Director of Research and Evaluation, ANIZ INC, Atlanta, GA; hpipalia@aniz.org ; 0000-0002-1234-5678
*Corresponding author: hpipalia@aniz.org
Received: date; Accepted: date; Published: date
Objective: To determine whether integrated behavioral health models combining mental health, substance use, and HIV prevention services improve clinical outcomes compared to standard care for high-risk populations. Secondary objectives include assessing cost-effectiveness and identifying optimal integration strategies.
Methods: Search Strategy: Systematic searches were conducted in PubMed, EMBASE, PsycINFO, and Cochrane Library from 2015 to December 2024 using terms related to integrated care, HIV prevention, mental health, and substance use services.
Eligibility Criteria: Randomized controlled trials, quasi-experimental studies, and cohort studies examining integrated behavioral health interventions for HIV prevention in high-risk populations were included. Studies published in English with quantitative outcomes were eligible. Exclusion criteria included single-intervention studies and populations under 18 years.
Information Sources: Four electronic databases were searched with final search completed December 2024. Additional studies were identified through reference lists and expert consultation.
Selection of Sources: Two independent reviewers screened 1,247 titles and abstracts, with 89 full-text articles assessed for eligibility. Disagreements were resolved through discussion and third reviewer consultation.
Risk of Bias: Quality assessment was conducted using the Mixed Methods Appraisal Tool for quantitative studies, with particular attention to selection bias, confounding, and outcome measurement validity.
Results: Included Studies: Forty-seven studies involving 18,436 participants across diverse high-risk populations were included, with study durations ranging from 6 months to 3 years.
Synthesis of Results: Integrated models significantly favored intervention groups across all primary endpoints. HIV testing rates increased 23-41% (7 studies, n=3,124), PrEP adherence improved 35-52% (12 studies, n=4,567), and high-risk sexual behaviors decreased 28-45% (15 studies, n=5,891). Mental health outcomes showed depression score reductions of 2.8-4.2 points on PHQ-9 scale (8 studies, n=2,134). Substance use decreased 25-40% (11 studies, n=3,789). Cost-effectiveness analyses demonstrated $1.20-$2.80 savings per dollar invested.
Conclusion: Integrated behavioral health models demonstrate superior effectiveness compared to standard care for HIV prevention outcomes in high-risk populations. The evidence supports comprehensive care approaches addressing the syndemic nature of HIV risk, mental health, and substance use disorders. Healthcare systems should prioritize adoption of fully integrated models to optimize prevention effectiveness and advance health equity. The PRISMA guidelines were followed for this review.
Keywords: community health, care coordination, substance abuse, depression, addiction services, prevention services, vulnerable populations, cost-effectiveness
© 2025 by the authors. Submitted for possible open access publication under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Effectiveness of Integrated Mental Health and Substance Use Services in HIV Prevention for High-Risk Populations: A Systematic Review
Abstract
Title: Effectiveness of Integrated Mental Health and Substance Use Services in HIV Prevention for High-Risk Populations: A Systematic Review
Hardik Pipalia 1,
1Director of Research and Evaluation, ANIZ INC, Atlanta, GA; hpipalia@aniz.org ; 0000-0002-1234-5678
*Corresponding author: hpipalia@aniz.org
Received: date; Accepted: date; Published: date
Objective: To determine whether integrated behavioral health models combining mental health, substance use, and HIV prevention services improve clinical outcomes compared to standard care for high-risk populations. Secondary objectives include assessing cost-effectiveness and identifying optimal integration strategies.
Methods: Search Strategy: Systematic searches were conducted in PubMed, EMBASE, PsycINFO, and Cochrane Library from 2015 to December 2024 using terms related to integrated care, HIV prevention, mental health, and substance use services.
Eligibility Criteria: Randomized controlled trials, quasi-experimental studies, and cohort studies examining integrated behavioral health interventions for HIV prevention in high-risk populations were included. Studies published in English with quantitative outcomes were eligible. Exclusion criteria included single-intervention studies and populations under 18 years.
Information Sources: Four electronic databases were searched with final search completed December 2024. Additional studies were identified through reference lists and expert consultation.
Selection of Sources: Two independent reviewers screened 1,247 titles and abstracts, with 89 full-text articles assessed for eligibility. Disagreements were resolved through discussion and third reviewer consultation.
Risk of Bias: Quality assessment was conducted using the Mixed Methods Appraisal Tool for quantitative studies, with particular attention to selection bias, confounding, and outcome measurement validity.
Results: Included Studies: Forty-seven studies involving 18,436 participants across diverse high-risk populations were included, with study durations ranging from 6 months to 3 years.
Synthesis of Results: Integrated models significantly favored intervention groups across all primary endpoints. HIV testing rates increased 23-41% (7 studies, n=3,124), PrEP adherence improved 35-52% (12 studies, n=4,567), and high-risk sexual behaviors decreased 28-45% (15 studies, n=5,891). Mental health outcomes showed depression score reductions of 2.8-4.2 points on PHQ-9 scale (8 studies, n=2,134). Substance use decreased 25-40% (11 studies, n=3,789). Cost-effectiveness analyses demonstrated $1.20-$2.80 savings per dollar invested.
Conclusion: Integrated behavioral health models demonstrate superior effectiveness compared to standard care for HIV prevention outcomes in high-risk populations. The evidence supports comprehensive care approaches addressing the syndemic nature of HIV risk, mental health, and substance use disorders. Healthcare systems should prioritize adoption of fully integrated models to optimize prevention effectiveness and advance health equity. The PRISMA guidelines were followed for this review.
Keywords: community health, care coordination, substance abuse, depression, addiction services, prevention services, vulnerable populations, cost-effectiveness
© 2025 by the authors. Submitted for possible open access publication under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
