Optimizing HIV Prevention Among High-Risk Opioid-Dependent Persons

University Of Connecticut Storrs, Storrs-Mansfield CT

Investigators

Linked publications & trials

Abstract

Abstract. The renewal of this K24 will enable me to optimize HIV prevention among opioid- dependent persons through three broad and interrelated aims that include: (1) Mentoring a broad range of patient-oriented researchers via UConn’s Institute for Collaboration on Health, Intervention, and Policy (InCHIP) and the Yale AIDS Program, (2) Expanding and deepening my patient-oriented research (POR) via new collaborations established during the original K24 award period, and (3) Engaging in structured training in cognitive neuroscience to complement my POR skillset via Yale’s NIH-funded Neuroimaging Sciences Training Program in Substance Abuse. The opioid epidemic in the U.S. has taken an unfathomable toll, and has halted much of our HIV prevention progress, with over 10% of new HIV infections now being attributed to people who inject drugs (PWID). Furthermore, 2.1 million Americans are now struggling with an opioid use disorder (OUD) and overdose deaths due to opioids have spiked to over 70,000 per year, representing a 400% increase in 15 years. In response, the CDC has intensified efforts to reduce the number of new HIV infections by optimally targeting PWID via: 1) reduced HIV risk behaviors, 2) increased adherence and retention in treatment; and 3) promotion of health behaviors that benefit public health. Although HIV risk reduction and adherence behaviors can be modified, this will require us to optimize evidence-based approaches by taking into account key features of the target population and intervention settings. Our recent work uncovered disturbing levels of cognitive dysfunction (~67%) among patients on medication for opioid use disorder (MOUD) in combination with very high levels of HIV risk behaviors. I was able to leverage my original K24-funded patient-oriented research (POR) to pilot test HIV prevention strategies to accommodate such patients, and mentored budding trainees in the process. In this K24 renewal, my expanding team would be ideally positioned to better conceptualize and refine strategies of the future to optimize adherence to PrEP and other biomedical prevention (e.g., opioid replacement therapies [ORT], syringe services programs [SSP], and overdose prevention [ODP]) alongside HIV risk reduction.