Ryan White CARE Act Title II survey: services for HIV-positive substance users.

A national survey was conducted among Ryan White CARE Act-funded providers to determine what types of services are specifically provided for HIV-positive substance users through Title II within the context of the overall delivery system for substance abuse treatment services. There was an 87% return rate on questionnaires representing 47 states. Only 18 of the 47 states reported funding some form of substance abuse services. The results show (1) the types of substance abuse services funded under Title II, (2) what special populations are served by those programs, (3) additional funding sources utilized by those programs, (4) the common systemic barriers to care, (5) the greatest programmatic barriers to care, and (6) gaps in knowledge about unmet needs for HIV-positive substance users. Some states have been quite innovative in targeting resources to support HIV-positive substance users while others report less activity. Although design and implementation of innovative programs for HIVpositive substance users rests with service providers, state agencies responsible for Title II planning are in the best position to identify system strengths and weaknesses.