The HPTN 094 Peer Navigation Model: Integration of Substance Use Treatment and HIV Prevention and Care for People Who Inject Drugs.

IF 3.1 3区医学 Q1 SUBSTANCE ABUSE

Journal of Addiction Medicine Pub Date : 2026-08-04 DOI:10.1097/ADM.0000000000001759

Nabila El-Bassel, Steven Shoptaw, Brett Hanscom, Timothy Skalland, Albert Hasson, Cecile Denis, David Goodman-Meza, Irene Kuo, Jordan E Lake, Rashaunna Redd, Amy M Richards, Rahul Paul Choudhury, Melissa Cummings, Jayla Harris-Wisecarver, Jessica Fogel, Paul Richardson, Redonna Chandler, Laramie R Smith, David Metzger, Philip Andrew

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引用次数: 0

Abstract

Objectives: To describe HPTN 094 study's peer navigation (PN) intervention, implemented in 5 urban US cities among people who inject drugs (PWID) at risk for or living with HIV, including guiding theories, core components, navigator training, available services, implementation challenges, and implications for future PN intervention research dissemination.

Methods: This 2-arm, randomized, open-label study assessed outcomes for PWID receiving integrated care services delivered in a mobile health unit that provided medication for opioid use disorder (MOUD), HIV prevention/treatment, and other health care in addition to PN to community services compared with PN to community services alone. Participants were PWID with opioid use disorder (OUD) not receiving MOUD and were either at risk for HIV or living with HIV. The PN model was grounded in 5 complementary theories addressing individual, interpersonal, social, systemic, and structural determinants of care. Variables used to measure PN intervention utility were number of sessions attended, session length, session topics, and in-person versus remote navigation sessions.

Results: Across study sites, participants without HIV (PWOH; n = 409) completed 3390 PN sessions and participants with HIV (PWH; n = 38) completed 365 PN sessions; the median number of sessions per participant was 6 in both groups. Most sessions were conducted in person and commonly addressed MOUD, HIV prevention or HIV care, and other medical or social service needs. These findings support the feasibility of delivering a flexible, theory-informed PN model for urban PWID and help characterize how peer navigation was used to address substance use, HIV, and broader service needs within HPTN 094.

Conclusions: The PN model is acceptable with urban PWID and potentially for people with other public health concerns in underserved communities. The findings have implications for future research examining the effectiveness and dissemination of the PN intervention.

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HPTN 094同伴导航模型：药物使用治疗和艾滋病毒预防与注射吸毒者护理的整合。

目的：描述HPTN 094研究的同伴导航（PN）干预，在美国5个城市的注射吸毒者（PWID）中实施，包括指导理论、核心组成部分、导航员培训、可用服务、实施挑战以及对未来PN干预研究传播的影响。方法：这项双组、随机、开放标签的研究评估了PWID接受移动卫生单位提供的综合护理服务的结果，该服务提供阿片类药物使用障碍（mod）药物、艾滋病毒预防/治疗以及除PN外的其他卫生保健社区服务，与单独PN社区服务相比。参与者是患有阿片类药物使用障碍（OUD）的PWID，未接受mod治疗，并且有感染艾滋病毒的风险或患有艾滋病毒。PN模型建立在5个互补理论的基础上，这些理论涉及护理的个人、人际、社会、系统和结构决定因素。用于测量PN干预效用的变量包括参加的会话次数、会话长度、会话主题以及面对面与远程导航会话。结果：在所有研究地点，未感染艾滋病毒的参与者（PWH, n = 409）完成了3390次PN治疗，感染艾滋病毒的参与者（PWH, n = 38）完成了365次PN治疗；在两组中，每个参与者的疗程中位数都是6次。大多数会议都是面对面进行的，通常涉及艾滋病毒预防或艾滋病毒护理以及其他医疗或社会服务需求。这些发现支持了为城市PWID提供一个灵活的、有理论依据的PN模型的可行性，并有助于描述如何在HPTN 094中使用同伴导航来解决药物使用、艾滋病毒和更广泛的服务需求。结论：PN模式对于城市PWID是可以接受的，对于服务不足社区中有其他公共卫生问题的人也是可以接受的。这些发现对未来研究PN干预的有效性和传播具有启示意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Addiction Medicine 医学-药物滥用

CiteScore

6.10

自引率

9.10%

发文量

260

审稿时长

>12 weeks

期刊介绍： The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.