August 2026  |   ATTCnetwork.org

Trey Weir

By Trey Weir on behalf of the ATTC Syndemic Solutions POWER Team

Human immunodeficiency virus (HIV) and substance use disorders (SUD) represent a significant public health syndemic. A syndemic occurs when two or more health conditions interact and reinforce one another, causing a synergistic negative effect (HHS, 2024). This syndemic is especially prevalent for men who have sex with men (MSM), a population who experience disproportionate rates of HIV and elevated prevalence of substance use (Bourne et al, 2017, HHS, 2026). According to federal health data, 89% of all new HIV diagnoses are transmitted via sexual contact, with the most common route being unprotected vaginal or anal sex (HHS, 2025). When substances are involved before or during sexual activity, the risk of HIV transmission increases.

Module 8: Selecting A Change Strategy

Choosing a change strategy can feel a little overwhelming. Your change team may have generated several good ideas, but which one should you actually try first?

That’s where the change strategy selection process comes in.

At this stage, the change leader brings the team together to talk through the ideas
generated during the nominal group technique exercise, with particular focus on the strategy the team voted to address first. The goal isn’t simply to pick an idea—it’s to think realistically about what it will take to implement the change and what kind of difference it could make.

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