Type of Activity: Services
Funding Mechanism: Grant
Total Available Funding: $ 61.6 million
Number of Awards: 140 grants
Award Amount: Grants that provide outreach and pretreatment services are funded for an amount to pass $400,000/year/grant. Grants that provide clinical substance abuse treatment are funded up to $450,000/year/grant.
Length of Project Period: 5 Years
Federal Partners: Department of Health and Human Services
Summary: The TCE/HIV program implements the Congressional directive for the National Minority AIDS Initiative to enhance the quality of services and expand the service capacity of substance abuse treatment programs with a history of providing services to high risk communities of color that are severely impacted by substance abuse and HIV/AIDS. Projects address both the shortage of substance abuse treatment and HIV/AIDS services including, HIV counseling and testing, health education, and access and referral to STD, hepatitis B and C and TB testing in minority communities. All grantees under the program are required to offer rapid HIV testing, and do on-site testing for grantees within the FY 2008 and 2009 Cohorts. In addition, funds community providers/community-based organizations that serve predominantly racial and ethnic minorities to increase treatment capacity including outreach and pretreatment services for individuals living with HIV/AIDS or at risk for HIV/AIDS related to their substance abuse. Funds are also used to continue a multi-site prospective evaluation that will allow programs to address behavioral risk factors and other related information that affect treatment outcome.
- Address the gaps in substance abuse treatment capacity and outreach services by increasing the accessibility and availability of substance abuse treatment and HIV/AIDS services.
- Encourage state-of-the-art practices in the area of substance abuse treatment and HIV/AIDS outreach, prevention and treatment for at-risk target populations.
- Develop effective methods and approaches that will be used to reach the specified target population(s) of high risk substance abusers, partners, and substance abusing people living with AIDS.
- Increase the number of individuals that are contacted, engaged, referred to treatment, and complete substance abuse treatment; and closely monitor their substance abuse treatment outcomes and reduction in risk behaviors.
- Reduce risky behaviors associated with contracting HIV and other infectious diseases.
- Test for HIV using rapid tests.
Background: In 2008, the Centers for Disease Control and Prevention (CDC) with the use of new technology estimated that approximately 56,300 new HIV infections occurred in the U.S. in 2006 — a figure that is 40% higher than CDC’s former estimate of 40,000 new infections per year. These new estimates indicate that there are about 1,106,400 adults and adolescents living with HIV infection in the United States (CDC’s MMWR, October, 2008). These new findings also indicated that African Americans and Hispanics/Latino populations continue to be disproportionately affected by HIV infection. Recent estimates showed that African Americans represented 46% and Hispanics/Latinos 18% of new HIV infections, respectively. In 2008, an estimated 18,341 blacks and 7,864 received an AIDS diagnosis (CDC, June 2008). Individuals with substance use disorders are also at increased risk for HIV/AIDS as a result of either sharing contaminated syringes or by exhibiting impaired judgment while under the influence of a legal or illegal drug with abuse potential (e.g., alcohol, cocaine, methamphetamine, marijuana, and/or other non-injection drugs) which may increase high risk sexual behavior associated with HIV infection or transmission. This public health concern is supported by the CDC 2006 estimated HIV prevalence in the United States, which found that people infected with HIV through injection drug use accounted for 12% of annual new HIV infections and 19% of all people living with HIV (204,600 persons; 131,500).
Location(s) of Projects: See above
Evaluation Activities: For the multi-site evaluation, design the overall evaluation, identify a coordinating center, prepare OMB clearance documents, develop a standardized survey instrument, design a data analysis plan, and develop reporting protocols, and a dissemination strategy. Multi-Site Evaluation was awarded in FY 08 for $3,000,000/year.
Future Prospects: Current activities are funded under a fixed line item in the SAMHSA budget. However, the recently released Presidential National HIV/AIDS Strategy (July, 2010) makes a series or recommendations for SAMHSA. Future funding and activities will be determined by the gaps in services documented through increased and improved local, State and National surveillance. An overall goal of the plan is to increase access to care and optimizing health outcomes for people living with HIV while reducing health disparities. The accompanying Vision Statement is also quite simple but will have short and long range implications on how SAMHSA operates. The Vision: The United States will become a place where new HIV infections are rare and when the do occur, every person, regardless of age, gender, race/ethnicity, sexual orientation, gender identify or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free for stigma and discrimination.
More Information: No grants were funded in FY 2010 through the SAMHSA TCE-HIV program. URL for grants funded for FY 2006 to FY 2009 can be found at the following links and contains the name of grantee, location, contact information and amount of award.
FY 2009 http://www.samhsa.gov/Grants/2009/awards/ti0806.aspx
FY 2008 http://www.samhsa.gov/Grants/2008/awards/ti08006.aspx
FY 2007 http://www.samhsa.gov/grants/2007/awards/ti07004.aspx
FY 2006 http://www.samhsa.gov/Grants/2006/TI_06_010.aspx
Team Leader, TCE-HIV Program
Division of Services Improvement, Center for Substance Abuse Treatment