NIH-Funded Trial: Integrated Services Delivered by Mobile Medical Units Cut Deaths by 71% Among People Who Inject Drugs
Results from a clinical trial funded by the National Institutes of Health (NIH), announced on November 4, show that delivering integrated HIV and substance use disorder (SUD) services using peer navigation in mobile medical units reduced all-cause deaths by 71% compared to participants who received peer navigation to community-based services alone. The trial was conducted in five major U.S. cities: Houston, Los Angeles, New York City, Philadelphia, and Washington, D.C. Scientists found no difference in the use of daily oral preexposure prophylaxis (PrEP) and medication for opioid use disorder (MOUD) between the groups, although the secondary outcome of reduced mortality was significant. The results were published in JAMA Psychiatry.
The trial, known as HIV Prevention Trials Network Study 094 (HPTN 094), enrolled 409 adults without HIV who injected drugs, had opioid use disorder, were not taking MOUD at enrollment, and were willing to consider MOUD. One group received 26 weeks of peer navigation plus integrated PrEP, MOUD, and limited clinical and supportive services delivered on a mobile unit; the other received 26 weeks of peer navigation linking them to non-mobile community services. Although there was no difference in MOUD use between study arms, 14% of people used MOUD at 26 and 52 weeks, a clinically meaningful level considering none were on MOUD at study start.
"Injection drug use is an important contributor to HIV in the U.S. that also increases risk for other serious infectious diseases," said Nora D. Volkow, M.D., director of NIH's National Institute on Drug Abuse (NIDA), which funded the study. "Although we have effective interventions for this population, there are significant barriers to their accessibility and use. Nonetheless, these findings suggest that delivering low threshold services through mobile units could save lives."
"People who inject drugs often face fragmented systems, unstable housing, stigma, and other barriers that make sustained care difficult," said Nabila El-Bassel, Ph.D., of Columbia University, a study co-chair. Researchers noted that the relatively low use of oral PrEP underscores major challenges for PrEP acceptance among people who inject drugs and points to the importance of evaluating long-acting PrEP formulations in this population. NIH noted that replication of the mortality finding is needed.
(Source: National Institutes of Health)
Source: National Institutes of Health
Published by GSM · USA (original Chinese edition)
Photo: 图：移动医疗诊所启用（资料图）。Senator Stabenow 摄，CC BY 2.0，经 Wikimedia Commons。 / Photo: Launching a new mobile medical clinic (file photo). Photo by Senator Stabenow, CC BY 2.0, via Wikimedia Commons.
