A clinical trial is underway in five U.S. cities to determine whether delivering integrated health services through mobile clinics can improve HIV and substance use outcomes among people with opioid use disorder who inject drugs, according to a news release from the National Institutes of Health (NIH), which is funding the study.
If effective, mobile clinics could serve as an innovative strategy for expanding access to care and providing uninterrupted treatment in this underserved population that addresses the linked public health crises of addiction and HIV.
According to the Centers for Disease Control and Prevention, approximately 1 in 10 new HIV diagnoses in the United States are attributed — in whole or in part — to injection drug use. Further, high rates of injection drug use in communities have been linked to HIV outbreaks. While injection drug use is not limited to injecting opioids — a drug class that includes heroin and fentanyl — these drugs have a high rate of use among key populations in this new study. The NIH expects that nearly all study participants will be injecting opioids at the time of enrollment.
The study aims to address these challenges by providing holistic health services delivered in accessible mobile clinics. These integrated services include safe and effective medication for opioid use disorder and overdose reversal, syringe services where available, HIV testing, ART for HIV treatment, PrEP for HIV prevention, testing for hepatitis and sexually transmitted infections (STIs) and primary care services.
Mobile clinics will be placed in residential areas determined to be accessible for those affected by HIV and who inject opioids. In contrast, many community-based agencies are located throughout downtown and commercial areas that may be difficult for people with limited transportation options to access.
For 26 weeks, participants in both study arms will receive access to trained peer navigators to help coordinate and facilitate care visits, in which they will be offered routine health services based on needs identified during the initial assessment. At weeks 26 and 52, investigators will evaluate the use of medications for opioid use disorder, rates of viral suppression among participants with HIV, use of PrEP among HIV-negative participants, use of opioids and other substances based on participant self-report and urine screenings, drug overdose events, and new diagnoses of HIV, SARS-CoV-2 (the virus that causes COVID-19), hepatitis C, and bacterial STIs, among other health measures in both groups.
