Penn Center for AIDS Research: Feasibility and Acceptability of Extended-Release Buprenorphine and Peer Services Among Adults with HIV and OUD Exiting Jail

University Of Pennsylvania, Philadelphia PA

Investigators

Linked publications & trials

Abstract

SUMMARY Intersections among HIV, opioid use disorder, and incarceration are a national public health crisis requiring innovative, multimodal intervention strategies that are responsive to geographically specific trends. Philadelphia, Pennsylvania has been especially affected by this public health crisis. In 2021, Philadelphia experienced a 9% increase in the number of people newly diagnosed with HIV and experienced its highest number of deaths due to unintentional overdose, with 1,276 people dying that year, largely due to opioids (82%). These trends, together with the ongoing HIV outbreak in Philadelphia among people who inject drugs and the risk of overdose that is more than 37 times greater in the first two weeks of adults’ community return from Philadelphia jails than the risk in the general population, underscore the urgency of the proposed research. In this research, we will develop a new integrated intervention to respond to this HIV outbreak, improve HIV care engagement and outcomes, and reduce HIV and opioid use risk behaviors among a highly vulnerable population: people with HIV and opioid use disorder who are preparing for community return from the Philadelphia Department of Prisons. This study will draw upon the Consolidated Framework for Implementation Research (CFIR) to pursue the following aims: 1) Assess feasibility, acceptability, facilitators and barriers to providing XR-buprenorphine with 15 people living with HIV and experiencing opioid use disorder who are preparing for community return from the Philadelphia Department of Prisons; 2) With findings from Aim 1, develop a peer navigator intervention to be integrated with XR- buprenorphine to reduce barriers and strengthen facilitators to accessing XR-buprenorphine, HIV case management and treatment, and community-based substance use treatment; and 3) Assess feasibility, acceptability, facilitators and barriers to providing integrated XR-buprenorphine and peer navigator services with 15 people living with HIV and experiencing opioid use disorder who are preparing for community return from the Philadelphia Department of Prisons. From the outset, this study carries immediate potential to save lives. Achievement of its aims will advance scientific understanding and clinical implementation of an innovative, integrative intervention to improve HIV and substance use outcomes for people exiting jail and facing complex intersecting risks.