Yuva Sath (Youth Together): A peer-led intervention to support substance use treatment engagement and HIV prevention among young people who inject drugs

Massachusetts General Hospital, Boston MA

Investigators

Linked publications & trials

Abstract

The opioid epidemics in the United States (U.S.) and other settings significantly impact young people who inject drugs (YPWID; 18-29 years of age). YPWID engage poorly in opioid use disorder treatment and HIV prevention services, bearing a disproportionate burden of new HIV infections. Increasing engagement in treatment for opioid use disorder and uptake of HIV prevention services among YPWID is an urgent public health priority. India has the largest number of opioid users in the world. This project leverages the large YPWID population in India, and the existence of Integrated Care Centers in 8 cities in India that deliver medications for opioid use disorder (MOUD) and other HIV prevention services to develop “Yuva Sath” (Youth Together), a brief peer-led behavioral intervention to support MOUD engagement and uptake of HIV prevention services among YPWID who have initiated MOUD but are under-engaged in treatment. Yuva Sath is anticipated to be broadly translatable to several settings including in the U.S. as YPWID across these settings face similar multiple barriers for MOUD engagement that also limit uptake of HIV prevention services. YPWID under-engaged in MOUD have high risk behaviors, low HIV testing, and high HIV seroconversion. Peer-delivered interventions have high potential to increase accessibility to support for substance use treatment engagement and HIV prevention among YPWID, particularly in high-volume, low resource settings including in the U.S. Dr. Ganapathi is a pediatric infectious diseases physician who aspires to lead rigorous research to develop and implement youth-tailored behavioral interventions for YPWID. She will utilize this K23 Award to: 1) develop expertise in behavioral intervention development, 2) gain skills in advanced statistical methods and study design for intervention research, and 3) develop an understanding of the principles of implementation science. Utilizing empirical principles used in successful youth-tailored interventions, Yuva Sath will be developmentally tailored, leverage peer support, and employ convenient mobile phone delivery. Development of Yuva Sath will entail adapting “Life-Steps”, an empirically supported problem-solving intervention. Intervention development will be informed by: 1) analysis of existing quantitative data collected from a retrospective cohort of YPWID initiating MOUD across 8 Integrated Care Centers, and 2) collection of qualitative data to understand YPWID preferences for intervention content and delivery. Dr. Ganapathi will then conduct a pilot randomized controlled trial of Yuva Sath, compared to usual care, among YPWID at a single Integrated Care Center to inform a future fully powered effectiveness trial. Dr. Ganapathi will be mentored by a multidisciplinary team, with expertise in behavioral medicine, infectious diseases, and addiction medicine. By developing a novel behavioral intervention for YPWID, this work has potential to impact public health while facilitating her transition to independence.