# Implementing computerized substance use and depression screening and evidence-based treatments in an HIV primary care population

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2020 · $529,032

## Abstract

ABSTRACT
Substance use disorders (SUDs) and depression are common among HIV-positive patients and lead to poor
HIV treatment outcomes and increased mortality. Yet these disorders often go unrecognized and untreated,
despite the availability of effective interventions. To enhance HIV care, this study examines the impact of self-
administered tablet-based screening for SUD risk and depression using validated measures, with results
integrated into the electronic health record and reviewed by behavioral health specialists (BHSs) embedded in
primary care HIV clinics. Based on screening results, BHSs will initiate motivational interviewing (MI)- and
cognitive behavioral therapy (CBT)-based clinical interventions. Using a hybrid study approach, we will
evaluate both implementation and effectiveness of screening and intervention. Specifically, we will employ a
stepped-wedge trial design, with a 12-month intervention phase implemented sequentially in the 3 largest HIV
primary care clinics serving 4600 HIV-positive patients in Kaiser Permanente Northern California (KPNC), with
a 12-month usual care period prior to implementation in each clinic functioning as an observational phase for
comparison. This design, a variation of a cross-over RCT, allows for intervention refinement at each clinic and
provides the opportunity to compare outcomes among patients before and after implementation. We will
evaluate patient-level (e.g., demographics, HIV, SUD and depression severity) and provider-level (e.g.,
provider attitudes) factors affecting implementation and effectiveness, and will analyze cost effectiveness. The
results of the study will provide insights regarding the implementation of evidence-based treatments for SUD
and depression, such as: 1) How self-administered computerized SUD and depression screening and
corresponding behavioral interventions can be effectively and efficiently implemented in HIV primary care
clinics and sustained over time; 2) What patient and clinic characteristics influence screening and intervention
rates; 3) To what extent implementation of screening and treatment impacts SUD and depression outcomes,
as well as HIV outcomes, including retention in care, viral suppression and Veterans Aging Cohort Study index
score, and 4) What are the barriers, facilitators and costs of implementation. The study setting is generalizable
to other HIV clinics and health systems and will provide key data regarding the effective delivery of treatment
options within primary care settings, and in coordination with SUD and psychiatry specialty care. Furthermore,
the study addresses NIH-identified high priority HIV research topics since effective treatment of SUDs and/or
depression would alleviate HIV treatment disparities for these individuals and reduce SUD- and depression-
related medical comorbidity and mortality.

## Key facts

- **NIH application ID:** 9986717
- **Project number:** 5R01DA043139-05
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Derek D Satre
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $529,032
- **Award type:** 5
- **Project period:** 2016-09-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9986717

## Citation

> US National Institutes of Health, RePORTER application 9986717, Implementing computerized substance use and depression screening and evidence-based treatments in an HIV primary care population (5R01DA043139-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9986717. Licensed CC0.

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