New trial tests the value of mobile medicine


Health centers in 5 US cities are participating in a study launched by the HIV Prevention Trials Network to determine whether mobile health units can improve treatment and prevention of HIV and substance abuse in people with HIV-related disorders. opioid use.

The aim of these units, which provide integrated health services, is to prevent overdoses and deaths and to provide antiretroviral therapy or pre-exposure HIV prophylaxis in people who inject opioids. People are tested for other sexually transmitted infections (STIs) and are given drugs for the treatment and prevention of HIV / STIs. The program includes testing and referrals for other health care needs, including routine immunizations and other primary care and harm reduction services. After the first 26 weeks of the trial intervention, participants will be transferred to other community services to meet their health care needs.

The trial will recruit approximately 860 people who inject drugs but do not receive medication for an opioid use disorder. They will be randomly assigned to receive the full range of mobile medical services or to a control arm for 26 weeks. Control arm participants will only receive peer health navigation that connects them to services available in physical locations in the community. The investigators will compare the results between the 2 arms of the study.

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The Centers for Disease Control and Prevention (CDC) reports that in 2019, there were 70,630 drug overdose deaths in the United States. Synthetic opioids are the main contributor to overdose deaths, leading to 49,860 overdose deaths in 2019 (70.6% of all drug overdose deaths). People who inject drugs are at risk of both overdosing and transmitting and acquiring HIV. They often face multiple barriers to care, including access to treatment.

The University of Texas at Houston Health Sciences Center is one of the participating centers. Trial investigator James Langabeer, PhD, professor of biomedical informatics, emergency medicine and public health at the center, said the effort was aimed at meeting people with disorders related to the use of opioids where they are found and with non-judgmental health services. “There is a well-documented gap in the treatment of certain vulnerable populations, particularly those who inject drugs and who may be at increased risk of contracting HIV,” said Dr. Langabeer. “Using a mobile van to quickly deliver care to geographic hot spots in the city could help reduce wait times for people in need of treatment. “

Eligible participants include people aged 18 to 60 with an opioid use disorder who inject drugs, are at risk of contracting HIV, or are living with HIV and who wish to start treatment. for opioid use disorders. “In Houston and elsewhere, the epidemic of opioid use disorders has exploded. We are seeing a disturbing trend of increasing overdoses and deaths attributed to not finding and treating people in need quickly. We see this as a potential strategy to fight the epidemic, ”said Dr Langabeer.

The trial is also being conducted at centers in Los Angeles, New York, Philadelphia and Washington, DC. It is sponsored by the National Institute of Allergy and Infectious Diseases, with funding from the National Institute of Drug Abuse.


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