Webinar Reflection: Integrated Care for Syndemics, Bringing SUD, HIV & HCV Treatment Together

On 4 December 2025, ISSUP had the pleasure of hosting an engaging and timely webinar presented by Dr Sarah Kattakuzhy, whose clinical and research expertise sits at the intersection of infectious diseases and substance use. The session attracted practitioners, researchers, policymakers, and community partners from around the world to explore what it truly means to deliver integrated syndemic care, and why this approach has become essential for improving outcomes across substance use disorders (SUD), HIV, and hepatitis C (HCV).

Dr Kattakuzhy began by grounding the discussion in a straightforward, accessible understanding of the term “syndemic”. Rather than viewing SUD, HIV, and HCV as separate challenges, she reminded us that these conditions often cluster together and intensify one another, shaped by the social and structural vulnerabilities people face. In her words, “you cannot fix one part of the syndemic without paying close attention to the others”. This framing set the stage for a session that blended data, clinical reasoning, and the human realities of people navigating interconnected health challenges.

What followed was a rich exploration of the evidence showing just how transformative integrated care can be. Whether delivered through co-located services, dual-provider models, telemedicine-supported care, mobile outreach units, or full provider integration, the research is remarkably consistent: treatment uptake increases, viral suppression improves, and rates of HCV cure rise when care is brought together rather than divided. Importantly, Medication for Opioid Use Disorder (MOUD) emerged as a cornerstone of this work, not only improving outcomes for opioid use disorder itself but also reducing HCV incidence and strengthening the HIV treatment cascade. These benefits were not theoretical but instead were demonstrated across diverse settings, from opioid treatment programmes to prisons, homeless outreach vans, and community-based clinics.

One of the most compelling aspects of the presentation was how clearly it illustrated that integrated care is not a one-size-fits-all blueprint. Instead, it is a flexible family of approaches that programmes can adapt based on context, workforce capacity, and system readiness. This adaptability is critical for countries and communities at different stages of service development, and the examples shared helped illuminate practical entry points; co-location, telemedicine facilitation, shared-care arrangements; without overwhelming teams with unrealistic expectations.

The heart of the webinar, however, lay in the case studies which brought to life the multidimensional improvements that integrated care can produce. Beyond clinical outcomes, they showed what happens when care becomes more person-centred: reduced risk-taking, improved stability, strengthened trust, and enhanced overall quality of life. These narratives reminded us that while data provides direction, human stories provide meaning, and that dignity and connection are as essential to recovery as any medication or algorithm.

Dr Kattakuzhy also shared how her own path into syndemic care emerged organically from her clinical work in hepatitis C. Witnessing, day after day, how deeply HCV overlapped with untreated opioid use disorder, she followed her curiosity, and her concern, into a field where infectious disease care and addiction medicine are deeply intertwined. This personal reflection reinforces the idea that impactful research and innovation often begin with a simple question and a genuine desire to understand the people we support more fully.

Several core themes emerged throughout the session: the necessity of integrated care; the strength and consistency of the evidence across global contexts; the importance of aligning treatment goals with the client’s own priorities; and the essential role of collaboration across infectious disease providers, addiction specialists, programmes targeting the harms related to substance use, policymakers, and community organisations. Taken together, these messages underscored that integrated care is not only effective, it is achievable, scalable, and humane.

Looking back on the discussion, it’s clear we have a significant opportunity ahead of us. With so much evidence, so many workable models, and so many examples of success, the next step is translating these insights into policy, workforce strategies, and locally grounded implementation efforts. For many health systems, especially those facing structural constraints or rising burdens of HIV, HCV, and SUD, integrated pathways represent not just a clinical improvement but a necessary evolution in how we respond to intertwined public health challenges.

ISSUP extends its sincere gratitude to Dr Sarah Kattakuzhy for her clarity, generosity, and thought-provoking presentation, and to all participants who contributed questions and insights. This conversation marks an important step forward in continuing to build joined-up, person-centred care systems that meet people where they are and support them toward better health.

Access the recording of the session here, and look out for an upcoming series of The ISSUP Exchange podcast, focussed on this topic area!