Addiction, Drug Use, HIV Infections, Intravenous Drug Usage, Opioid Use, Substance Use Disorders
Conditions
Keywords
Injection Drug Use, HIV Prevention, Social Networks
Brief summary
The goal of this clinical trial is to evaluate the effectiveness of a social network intervention to recruit people who inject drugs and their networks for HIV testing and linkage to HIV prevention and treatment services in Maryland. Study aims are to determine the effectiveness of a social network driven intervention to increase: * HIV testing (primary); * PrEP knowledge; * Uptake of HIV services and pre-exposure prophylaxis (PrEP); * Uptake of medication for opioid use disorder (MOUD) initiation. Eligible participants who access syringe service programs (SSPs) serving two counties in Maryland and their risk network members (NMs) will be recruited using an established network inventory and coupon recruitment method. When an index successfully recruits NMs, the index-NM cluster will be randomized to either a peer-educator intervention arm or an equal-attention control arm. Index participants randomized to the peer-educator intervention arm will complete a training program adapted with stakeholder input to context that emphasizes effective communication, frequent HIV testing, and awareness of evidence-based HIV prevention and treatment services. An important innovation to the network intervention will be training indexes to use and distribute HIV self-test kits and naloxone to their NMs. Index participants randomized to the equal-attention control arm will receive training sessions focused on the opioid overdose epidemic and will not include any training to serve as a peer educator. All participants (indexes and NMs) will complete study assessments at baseline and at 3 and 9 months. We will compare the peer-educator intervention group and the equal-attention control group on rates of HIV testing, knowledge of PrEP options and resources, and rates of initiation of HIV treatment, PrEP, and MOUD treatment since the previous assessment (past 3 or 6 months).
Interventions
BEHAVIORALPeer-educator-based network
The intervention is a social network-based method of dispersing HIV knowledge, HIV self-testing (HIVST) kits, and naloxone in social networks of people who inject drugs (PWID). It targets index participants (peers) to receive training on HIVST, peer education, and linkage to syringe service programs (SSPs) for HIV services.
Sponsors
National Institute on Drug Abuse (NIDA)
Maryland Department of Health and Mental Hygiene
Johns Hopkins University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Inclusion criteria for index participants: * Aged 18 or older * Self-reported injection drug use in the prior month * Accessed services at the SSP in the prior 3 months * Willing to undergo training and attend weekly booster group sessions * Able to recruit at least 1 drug use Network Member (NM) into study * Willing to talk with peers about PWID topics such as HIV prevention and care * Not previously enrolled in the study as index or NM * English-speaking Inclusion criteria for network member participants: * Aged 18 or older * Self-reported injection drug use in the prior month * Have a valid coupon or able to recall the 3-digit ID number * Not previously enrolled in the study as index or NM * English-speaking
Exclusion criteria
• Individuals lacking the capacity to consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of HIV testing for Network Members | 3 months, 9-months | Proportion of Network Members (both study arms) who report that they conducted HIV testing since the previous study assessment (i.e., in the prior 3 or 6 months). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of HIV testing for Index Members | 3- and 9-month follow-up | Proportion of Index Members (both study arms) who report testing since the previous study assessment (i.e., in the prior 3 or 6 months). |
| Proportion of HIV negative participants who have used PrEP | 3- and 9-month follow-up | Proportion of HIV-negative participants who have used PrEP (yes/no) since the previous study assessment (i.e., in the prior 3 or 6 months) among Network Members. |
| Proportion of HIV testing for Index and Network Members | 3- and 9-month follow-up | Proportion of Index and Network Members (both study arms) who report testing since the previous study assessment (i.e., in the prior 3 or 6 months). |
| Proportion of participants using anti-retroviral therapy (ART) | 3- and 9-month follow-up | Proportion of participants living with HIV who reported they are currently using anti-retroviral therapy (ART), (yes/no) at the 3- or 9-month follow-up among Network Members. |
| Proportion of participants who have used Medication for opioid use disorder (MOUD) uptake | 3- and 9-month follow-up | Proportion of participants who report that they have used MOUD (yes/no) since the previous study assessment (i.e., in the prior 3 or 6 months) among Network Members. |
| Change in Knowledge of PrEP options | 3- and 9-month follow-up | Knowledge of PrEP options and resources measured by questionnaire at 3 and 9 months among Network Members. |
Countries
United States
Contacts
Primary ContactOluwaseun Falade-Nwulia, MBBS, MPH
Backup ContactGregory Lucas, MD
Outcome results
None listed