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Interventions for Integrating Behavioral Health into HIV Settings for US Adults: A Narrative Review of Systematic Reviews and Meta-analyses, 2010–2020

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Abstract

Mental health and substance use disorders can negatively affect physical health, illness management, care access, and quality of life. These behavioral health conditions are prevalent and undertreated among people with HIV and may worsen outcomes along the entire HIV Care Continuum. This narrative review of tested interventions for integrating care for HIV and behavioral health disorders summarizes and contextualizes findings from systematic reviews and meta-analyses conducted in the past decade. We sought to identify gaps in research that hinder implementing evidence-based integrated care approaches. Using terms from the Substance Abuse and Mental Health Services Administration-Health Resources & Services Administration standard framework for integrated health care, we searched PubMed and PsycInfo to identify peer-reviewed systematic reviews or meta-analyses of intervention studies to integrate behavioral health and HIV published between 2010 and 2020. Among 23 studies identified, only reviews and meta-analyses that described interventions from the United States designed to integrate BH services into HIV settings for adults were retained, leaving six studies for narrative review by the study team. Demonstrated benefits from the relatively small literature on integrated care interventions include improved patient- and service-level outcomes, particularly for in-person case management and outreach interventions. Needed are systems-level integration interventions with assessments of long-term outcomes on behavioral health symptoms, HIV viral suppression, HIV transmission rates, and mortality. HIV, primary care, and other providers must include behavioral health as a part of overall healthcare and must play a central role in behavioral health care delivery. Research is needed to guide their way.

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Acknowledgements

This work was supported by a center grant and an Ending the HIV Epidemic supplement to that grant from the National Institute of Mental Health (P30-MH43520), Principal Investigator: Robert H. Remien, PhD. The authors thank Marian LaForest, MPH, an informationist at Columbia University Irving Medical Center, August C. Long Health Sciences Library, 701 West 168th Street, New York, NY 10032 USA, for developing and conducting the literature search.

Funding

This work was supported by a center grant and Ending the HIV Epidemic supplement to that grant from NIMH (P30-MH43520), Principal Investigator: Robert H. Remien, PhD. McKinnon, Boccher-Lattimore, and Cournos had the idea for this review article; McKinnon, Lentz, Boccher-Lattimore, Cournos, Pather, Sukumaran, Remien, and Mellins drafted and/or critically revised the work.

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Authors and Affiliations

  1. HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute and Department of Psychiatry, Columbia University, 1051 Riverside Drive, Unit 112, New York, 10032, USA

    Karen McKinnon, Cody Lentz, Daria Boccher-Lattimore, Francine Cournos, Ariana Pather, Stephen Sukumaran, Robert H. Remien & Claude A. Mellins

  2. Northeast/Caribbean AIDS Education and Training Center, Department of Psychiatry, Columbia University, 601 West 168 Street, New York, 10032, USA

    Karen McKinnon, Daria Boccher-Lattimore & Francine Cournos

  3. Mailman School of Public Health, Department of Epidemiology, Columbia University, 722 West 168th St, New York, 10032, USA

    Francine Cournos

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  1. Karen McKinnon
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Correspondence to Karen McKinnon.

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This narrative review of systematic reviews and meta-analyses published in the peer-reviewed literature between 2010 and 2020 did not involve the participation of human subjects; as such, no ethical approval was required.

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McKinnon, K., Lentz, C., Boccher-Lattimore, D. et al. Interventions for Integrating Behavioral Health into HIV Settings for US Adults: A Narrative Review of Systematic Reviews and Meta-analyses, 2010–2020. AIDS Behav (2024). https://doi.org/10.1007/s10461-024-04324-z

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