An evidence-based call for tailored interventions to support women with HIV who use substances.

PURPOSE OF REVIEW: Women with HIV (WWH) face worse HIV care continuum outcomes than men with HIV due to factors such as delayed diagnosis, limited access to care, and increased risk for comorbidities, all of which are exacerbated by social determinants of health and substance use. We reviewed currently available research on substance use and intersecting issues among WWH, with a concentration on how multilevel factors influence women's health. We end with a call to expand research and develop tailored interventions for WWH who use substances.

RECENT FINDINGS: HIV care continuum outcomes among WWH did not meaningfully improve between 2015 and 2019. Among multiple factors, research suggests that social determinants of health and substance use are key contributors. Substance use, particularly stimulant use, consistently predicts poor HIV outcomes. Very few interventions have been developed to support WWH who use substances. However, existing evidence suggests that interventions designed specifically for women, and which integrate HIV, substance use treatment, and harm reduction services, would help improve outcomes.

SUMMARY: There is a critical need to develop and test integrated care interventions that address the needs of WWH who use substances. Successful interventions could improve individual health and support Ending the HIV Epidemic goals.