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Advancing Addiction Science: HIV, Substance Abuse, and Behavioral Research

Explore the latest research on the connection between HIV, substance abuse, and behavioral sciences. Discover the impact of medication-assisted treatment (MAT) on HIV transmission and the underutilization of medications for opioid use disorders. Learn about harm reduction interventions, socioenvironmental factors, and leveraging technology for substance use and HIV research. Dive into implementation science and NIDA's research initiatives in this field.

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Advancing Addiction Science: HIV, Substance Abuse, and Behavioral Research

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  1. DISCLAIMER… No conflicts of interest

  2. National Institution on Drug Abuse: HIV Substance Abuse Social & Behavioral Sciences Research Redonna K. Chandler, Ph.D. @NIDAnews Share your thoughts on this presentation with #IAS2019

  3. National Institute on Drug AbuseAdvancing Addiction Science Prevention Genetics Environment Development Neurobiology Interventions Policy Treatment and Care Neural mechanisms Behavioral Treatment Medications Development Implementation Consequences HIV/AIDS Fetal Exposure

  4. Estimated HCV Among People Who Inject Drugs by Country Estimated HIV Prevalence Among People Who Inject Drugs by Country IDU=injecting drug use. No eligible report=evidence of IDU located, but no study of HIV prevalence among people who inject drugs that met our eligibility criteria was located. Lancet Glob Health. 2017 Dec; 5(12): e1192–e1207. Published online 2017 Oct 23. doi: 10.1016/S2214-109X(17)30375-3 IDU=injecting drug use. No eligible report=evidence of IDU located, but no study of HCV antibody prevalence among people who inject drugs that met our eligibility criteria was located. Lancet Glob Health. 2017 Dec; 5(12): e1192–e1207. Published online 2017 Oct 23. doi: 10.1016/S2214-109X(17)30375-3

  5. Addiction Can Be Treated Impact of MOUD on HIV Transmission Medications for Opioid Use Disorders (MOUD or MAT, OST) Opioid Effect Full Agonist (Methadone: Daily) Partial Agonist (Buprenorphine: 3x/week, ER 1 month) Antagonist (Naltrexone: ER 1 month) Log Dose • DECREASES: • Opioid use • Opioid overdose deaths • Criminal activity • HIV and HCV transmission • INCREASES • Social functioning • Retention in HIV treatment • Improves HIV Outcomes MOUD reduced HIV infections by 54% MacArthur GJ et al. BMJ 2012

  6. Medications for OUD are Highly Underutilized and Retention is Poor OUD Cascade of Care, USA MOUD Coverage among PWID Williams et al. Health Affairs Blog, 2017 Larney S et al., Lancet Global Health 2017

  7. Global Coverage Of NeedleAnd Syringe Programs Among People Who Inject Drugs Lack Of Harm Reduction Interventions In US

  8. Social, Economic, Health and Policy Determinants of Drug Use and HIV Research to study environmental influences across the entire continuum of substance use, addiction, and HIV (including environment x biological interplay) • Identify the socioenvironmental factors that act as moderators or catalysts e.g. homelessness, poverty, unemployment, and design strategies address them at individual and population level • Diagnose and treat co-occurring mental health issues • Identify and understand the changing policy environment and how it interacts with trajectories: marijuana, tobacco regulation, health reform, criminalization • Modeling to predict community-level risk for OUD and HIV

  9. Leverage Technology to Transform Substance Use and HIV Research Leverage technology to transform substance use and HIV research and care • Role of technology in acquisition/use/communication about substance use, HIV risk, PrEP, HIV Care • Use new and improved technology to effectively intervene • Research utilizing myriad data available from multiple technology driven sources

  10. Implementation Science: Move From Effectiveness to Implementation Research • Systematic (replicable, measurable) strategiesfor promoting adoption of evidence-based practices, with fidelity, in routine clinical settings • Subjecting that process to the scientific method • Hypothesis-driven, experimental designs • Grounded in conceptual model of implementation process • Approaching dissemination and implementation as deliberate actions (interventions) • Optimize adoption/sustainability of evidence-based substance abuse and HIV prevention & treatment interventions • Evaluate de-adoption strategies to eliminate use of ineffective prevention/treatment practices

  11. NIDA Research Initiatives • NIDA Innovation Awards: • NIDA Avant-Garde Award Program for HIV/AIDS and Drug Use Research: https://grants.nih.gov/grants/guide/rfa-files/rfa-da-18-019.html • Avenir Award Program for Research on Substance Abuse and HIV/AIDS: https://grants.nih.gov/grants/guide/rfa-files/RFA-DA-18-004.html • PrEP for HIV Prevention among Substance Using Populations: https://grants.nih.gov/grants/guide/rfa-files/RFA-DA-20-013.html • Advancing Exceptional Research on HIV/AIDS and Substance Abuse: https://grants.nih.gov/grants/guide/rfa-files/RFA-DA-18-022.html

  12. Thank You

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