This tool focuses on the role of stigma at the intersection of HIV and OUD systems, and introduces opportunities for intervention at the systems level. The information provided in this tool can support ongoing discussions, strategic planning, needs assessment, policy development, and training as states collaborate across HIV and OUD systems of care. The tool introduces a framework that states can follow in their local planning or training efforts by providing background and facilitating conversations about how stigma affects people with HIV and OUD as they seek care and have to navigate multiple systems. It outlines a framework for identifying opportunities to interrupt stigma by targeting its causes at multiple levels, beginning with systems. This approach differs from many stigma resources that focus on training for frontline staff and providers and emphasize individual-level interventions. Rather, this framework is intended to help states identify opportunities to institutionalize policies and practices that promote access to care across HIV and OUD services and prevent discrimination. Systems-level interventions accelerate implementation of organizational interventions, which promote implementation of interpersonal and individual interventions.
Keywords: opioids, HIV, stigma