The twin epidemics of substance use and HIV: a state-level response using a train-the-trainer model.

Use of alcohol and drugs is highly correlated with acquiring the human immunodeficiency virus (HIV), the precursor to developing an AIDS-related condition. Today the USA faces not one but two epidemics, the twin epidemics of substance use and HIV infection. A needs assessment in the state of Ohio of the 300 state-supported drug treatment facilities confirmed a need for HIV-related education and training of the 120 health care personnel, physicians and nurses. Unique train-the-trainer programming was planned and undertaken, including in the same training programme physician and nurse participants dealing both with substance use and HIV/AIDS issues. Significant differences were found in perceived levels of knowledge, and/or attitudes, before and after programme sessions, regarding substance use, HIV/AIDS, and related training issues. To reach all of Ohio's 120 drug treatment facility physicians and nurses required a 2.75 person-hour per trainee expenditure of professional resources.