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Mental Health/Substance Use – When to Refer

When to Refer


There are few specific details on when to refer patients with HIV who have substance dependencies. Instead, the WHO recommend that treatment of PLWHIV who are injecting drug users (IDUs) follow a multidisciplinary approach.1

HIV treatment programmes should be linked to harm reduction services to facilitate enrolment and retention of IDUs, and to ensure that those in treatment can readily access risk reduction advice, counselling and relevant commodities (clean needles, syringes, condoms, etc).1


The four types of linked services that are recommended to work together for the care of these patients are:

  • general medical care and/or clinical infectious disease care
  • harm reduction
  • drug dependence treatment
  • psychosocial support.

Combined treatment and harm-reduction measures are described in the Treatment section.


  1. World Health Organization. HIV/AIDS Treatment and Care. Clinical Protocols for the WHO European Region, 2007. Accessed 25 October 2011.