By Thomas Kohout
A staff of researchers from the George Washington College (GW) has been chosen as considered one of 5 teams that can take part within the HIV Prevention Trials Community (HPTN) INTEGRA examine (HTPN 094), which can decide whether or not utilizing cellular well being items to ship built-in well being companies can enhance HIV and substance use outcomes amongst folks with opioid use dysfunction who inject medicine.
The examine is sponsored by the Nationwide Institute of Allergy and Infectious Ailments with funding from the Nationwide Institute on Drug Abuse, each a part of the Nationwide Institutes of Well being
Main the GW analysis staff is principal investigator Irene Kuo, affiliate analysis professor of epidemiology within the Milken Institute College of Public Well being, and co-investigator Marc Siegel, affiliate professor of medication on the College of Medication and Well being Sciences and chief of the NIH-funded GW HPTN Medical Analysis Website
“The examine focuses on providing built-in take care of substance use, HIV care or prevention and remedy for sexually transmitted infections, in addition to referrals for care of viral hepatitis, particularly hepatitis C,” Dr. Kuo stated. On the finish of a 26-week interval, Dr. Kuo added, researchers hope to see elevated uptake of substance abuse remedy and medicine for HIV prevention and care amongst examine volunteers.
Total, the INTEGRA examine will enroll roughly 860 volunteers, between the ages of 18 and 60, in Houston; Philadelphia; the Bronx, New York; Los Angeles; and Washington, D.C. The volunteers should be individuals who inject medicine and don’t at the moment obtain medical remedy for opioid use dysfunction.
Irene Kuo (l) affiliate analysis professor of epidemiology within the Milken Institute College of Public Well being, and Marc Siegel, affiliate professor of medication on the College of Medication and Well being Sciences.
The GW staff is trying to enroll a 172-person cohort from a number of places within the metropolis. Examine individuals will likely be randomly assigned to both the intervention group or an energetic management group. Intervention individuals will obtain built-in well being companies from the cellular well being unit that features HIV and hepatitis testing, prevention and remedy companies, in addition to help from educated peer navigators to entry well being care and keep in remedy for opioid use. These within the management group will likely be assigned to a peer navigator who will refer the participant to established companies locally.
“The speculation is that folks with opioid use dysfunction have many limitations to care,” stated Dr. Siegel. Individuals who inject medicine, he added, “are inclined to produce other underlying medical circumstances—HIV, sexually transmitted infections, diabetes, hypertension, psychological well being problems—so once they get into an opioid remedy program, these different well being care wants aren’t addressed.”
“By bringing care out to the place individuals are really situated, it won’t solely permit us to offer entry to remedy for opiate use dysfunction, however it would additionally permit us to handle their different medical wants on the similar time, notably HIV,” Dr. Siegel continued. “And if they don’t seem to be HIV constructive, we will present them with pre-exposure prophylaxis, in order that they don’t purchase HIV.”
Dr. Kuo added that the supply of pre-HIV publicity prophylaxis is “one of the vital fascinating facets of the examine. The CDC has issued suggestions for physicians to offer pre-exposure prophylaxis to individuals who inject medicine, particularly those that share needles or have intercourse with HIV-positive companions or with companions wherein their HIV standing is unknown. Nonetheless, it is a advice that not often is acted on, in keeping with Dr. Kuo.
If the examine volunteers take a look at unfavorable for hepatitis A and B, the staff will refer the volunteers to be vaccinated as a result of each ailments are at elevated prevalence amongst folks with opiate use dysfunction. In the event that they take a look at constructive for hepatitis C, which is prevalent amongst individuals who inject medicine, the medical workers will refer them for remedy.
This examine additionally seems to be to advance habit science by figuring out the simplest option to combine HIV care and prevention, opioid use dysfunction remedy and different well being care in a approach that can overcome the limitations that forestall these most in want from accessing companies. Contributors enrolled within the examine will likely be adopted for one 12 months. The outcomes from general examine are anticipated in 2025.