On World AIDS Day, SAMHSA reaffirms commitment to Ending HIV Epidemic with support from partners
Impact on your practice
This signals federal funding and grant opportunities for therapists and agencies in high-burden HIV areas, particularly around integrated testing and treatment linkage. Therapists in targeted geographic areas should monitor MAI grant cycles.
Key facts
SAMHSA leading Ending the HIV Epidemic: A Plan for America with partner agencies
70% of Minority AIDS Initiative (MAI) grant funding concentrated in 48 geographic areas with highest new HIV cases
MAI grantees required to conduct HIV testing on all clients at intake and provide linkage to care
Represents significant federal funding stream for integrated HIV/mental health/SUD services
Therapy Companion analysis
If your practice or agency is located in one of the 48 federally designated high-burden HIV areas, you should prioritize applying for or renewing Minority AIDS Initiative (MAI) funding before the next fiscal year cycle closes. MAI grantees receive concentrated federal resources and are required to implement universal HIV testing at intake and provide linkage-to-care services—a mandate that changes your clinical workflow. Your intake process must now include HIV screening protocols for all clients, not just those presenting with obvious risk factors. This represents both a funding opportunity and a compliance obligation: grantees must track positive results and referrals, meaning your documentation systems need to capture screening outcomes and warm handoffs to confirmatory testing and treatment. For practices with significant substance use disorder (SUD) or mental health populations, this requirement aligns naturally with your existing client base—SAMHSA specifically identifies SUD and mental health programs as critical screening entry points. However, practices not in the 48 targeted areas should still consider whether local health departments or state AIDS programs offer parallel HIV screening grants, as federal momentum behind universal testing in mental health and SUD settings is expanding. The Prevention Navigator program mentioned offers training and education funding, which can offset staff time costs for implementing screening protocols. Non-grantee practices should budget for staff training on HIV screening procedures, test administration (particularly oral fluid testing, which SAMHSA is endorsing), and warm referral protocols to ensure compliance with emerging standard-of-care expectations around HIV prevention in integrated care settings.
Background
The Ending the HIV Epidemic: A Plan for America initiative represents a coordinated federal commitment to reduce new HIV diagnoses by 90 percent by 2030, with SAMHSA playing a lead role in the behavioral health component. The strategic concentration of 70 percent of MAI grant funding in 48 high-incidence geographic areas reflects an evidence-based approach: HIV prevalence is heavily concentrated in urban centers and specific regions with correlated substance use and mental health epidemiology. SAMHSA's emphasis on universal testing in mental health and SUD treatment settings acknowledges a critical gap in the HIV prevention-to-treatment continuum—individuals with serious mental illness and substance use disorders have disproportionately high HIV rates, yet many never receive a formal diagnosis or linkage to antiretroviral therapy. This announcement signals that federal policy is moving toward requiring integrated HIV screening as a standard clinical function in behavioral health agencies, not an optional add-on. The mention of over 60,000 individuals already screened by existing grantees demonstrates both the scale of this initiative and the feasibility of implementation in typical practice settings.
What you should do
Determine if your practice location falls within one of the 48 SAMHSA-designated high-burden HIV areas; if yes, immediately review the current Minority AIDS Initiative (MAI) grant RFP, application deadlines, and funding amounts for FY 2024-2025 grant cycles. Contact your state or local health department and SAMHSA regional technical assistance center for guidance on application competitiveness.
Audit your current intake documentation and assessment protocols: do you systematically screen all clients for HIV status and risk factors? If not, develop a standardized HIV screening question set compliant with CDC guidelines (or MAI requirements if applicable) and integrate it into your electronic health record system before the next grant cycle or contract renewal.
If your practice is not pursuing MAI funding, review whether your state Medicaid program, local health department, or insurance payers have begun adding HIV screening as a covered screening benefit or care coordination requirement in mental health and SUD settings; budget for staff training on oral fluid testing, result communication, and warm referral protocols regardless of funding source.
Register for SAMHSA's Technology Transfer Centers technical assistance offerings if you are a grantee or considering one, as these provide real-time consultation on implementation of screening, tracking, and linkage requirements; this is a free resource that accelerates compliance and improves data quality.
Develop a referral protocol and written partnership agreement with your local HIV treatment center, infectious disease clinic, or PrEP provider to ensure clients who screen positive or are identified as high-risk receive warm handoffs and scheduled appointments, not just referral paperwork; document all linkage-to-care attempts in the clinical record.
Notable excerpts
SAMHSA's goal is to improve prevention, increase testing frequency, and increase referrals and support linkage to HIV treatment when necessary. SAMHSA has concentrated 70 percent of the Minority AIDS initiative grantees within the 48 identified areas with the highest number of new HIV cases.
These grantees of the MAI are required to request HIV testing on all individuals upon intake/enrollment and provide linkage to confirmatory testing and services upon positive results.
Because drug use may weaken the immune system and lead to risky behaviors such as needle sharing and unsafe sex, people who use drugs — including injection drugs — have a greater likelihood of contracting HIV, hepatitis, and other infectious diseases…SAMHSA understands that increasing capacity and service delivery to those with substance use disorder will result in increased screening, detection, and then linkage to those with HIV/AIDS in this high risk population.
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