{"id":192718,"date":"2022-11-30T07:01:06","date_gmt":"2022-11-30T12:01:06","guid":{"rendered":"https:\/\/today.uconn.edu\/?p=192718"},"modified":"2022-11-30T14:16:19","modified_gmt":"2022-11-30T19:16:19","slug":"new-trial-targets-reducing-risk-behaviors-increasing-prep-adherence-for-people-who-use-drugs","status":"publish","type":"post","link":"https:\/\/today.uconn.edu\/2022\/11\/new-trial-targets-reducing-risk-behaviors-increasing-prep-adherence-for-people-who-use-drugs\/","title":{"rendered":"New Trial Targets Reducing Risk Behaviors, Increasing PrEP Adherence for People who Use Drugs"},"content":{"rendered":"

Michael Copenhaver, a professor in the Department of Allied Health Sciences<\/a> (College of Agriculture, Health and Natural Resources<\/a>) is working on a $2.8 million grant from the National Institute of Drug Abuse to improve intervention outcomes for people who use drugs and are at high risk for HIV infection.<\/p>\n

Since 1999, the number of opioid overdose deaths in the U.S. has increased six-fold, killing 450,000 people in the past 20 years. With this trend, the number of HIV infections among people who inject drugs have also increased.<\/p>\n

Copenhaver has been working with the population of people who inject drugs for decades. At one point, he noticed that as many as two-thirds of these patients had some level of cognitive impairment. This led Copenhaver and his collaborators to ask if there was a way to tailor their interventions to make them more effective for this population.<\/p>\n

In this new trial, they will use adaptation strategies developed for other cognitively impaired patient populations, like people with traumatic brain injuries, Alzheimer\u2019s disease, and older adults. The intervention will target the reduction of risky sex- and drug-related behaviors (like having unprotected sex or sharing needles), and adherence to pre-exposure prophylaxis (PrEP). PrEP, when taken daily, provides protection from contracting HIV.<\/p>\n

\u201cWhat we\u2019re doing is trying to see if those successful tools from other patient populations can be applied to ours,\u201d Copenhaver says.<\/p>\n

Copenhaver and his team will test accommodation strategies for four different cognitive domains: attention, using strategies like increasing the frequency and decreasing the length of sessions; executive function, helping patients anticipate and role play risky situations; memory, using text message reminders between sessions about upcoming appointments and summarizing key content; and information processing, by presenting content more slowly and with mixed presentation methods of visual, verbal, and hands-on learning.<\/p>\n

\u201cThese are little tools that, when combined, we think will help them to benefit more rather than just assuming they\u2019re getting every single thing that we\u2019re presenting in these groups,\u201d Copenhaver says.<\/p>\n

Copenhaver will use an innovative methodological approach known as a multiphase optimization strategy (MOST), with consultation from Linda Collins, an NYU professor of global public health. This means participants will all receive basic group informational sessions, which Copenhaver has previously tested and found to be effective. But then, the researchers will try combinations of accommodation strategies, for a total of 16 experimental unique conditions.<\/p>\n

\u201cAt the end of it, you\u2019re able to say not only whether these accommodation strategies work, but which combination of strategies works the best for helping patients reduce HIV risk and adhere to medications,\u201d Copenhaver says.<\/p>\n

David Vanness (Pennsylvania State University) will help the team determine not only which combinations work best, but which would be the most cost effective for a clinic to implement.<\/p>\n

Before the trial begins, the researchers will ask participants about their sex- and drug-related risk behaviors.<\/p>\n

\u201cIt\u2019s a whole network, a high-risk network of interactions they\u2019re involved in a lot of times,\u201d Copenhaver says. \u201cAnd that\u2019s why it\u2019s so important if we can get them to take pre-exposure prophylaxis, because that can stop [them from] contracting HIV and transmitting it. It can be a really important turn in the field for slowing down the spread of HIV.\u201d<\/p>\n

They will also assess if participants know how to use a condom and clean needles properly.<\/p>\n

After the four-week intervention period, the researchers will follow-up with participants after three, six, and nine months. During these follow-ups, they will ask if their engagement in risky behaviors has changed and check their PrEP adherence through interviews, blood tests, and pharmacy refill records.<\/p>\n

The team will recruit 256 participants from an opioid treatment clinic in New Haven. Importantly, the group will only recruit patients with cognitive impairment who are new to opioid replacement therapy.\u201cThe reason we\u2019re so interested in this segment of the population is because they happen to be much more risky overall, because they\u2019re less stable and they\u2019re still engaged in a lot of very high-risk behavior out there,\u201d Copenhaver says. \u201cAnd if we can capture that segment of the patient population, we\u2019ll be contributing much more to slowing down the spread of HIV than people who are already engaged and stable in treatment.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

This study will work with people who use drugs and have cognitive impairment, helping them reduce risky sex- and drug- related behaviors and increase adherence to PrEP<\/p>\n","protected":false},"author":147,"featured_media":192722,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_crdt_document":"","wds_primary_category":0,"wds_primary_series":0,"wds_primary_attribution":0,"footnotes":""},"categories":[2296,2224,2231,2269,2194,2076,2235],"tags":[],"magazine-issues":[],"coauthors":[2277],"class_list":["post-192718","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-allied-health-sciences","category-cahnr","category-health-well-being","category-inchip","category-new-haven-county","category-research","category-today-homepage"],"pp_statuses_selecting_workflow":false,"pp_workflow_action":"current","pp_status_selection":"publish","acf":[],"publishpress_future_action":{"enabled":false,"date":"2026-05-04 05:36:52","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts\/192718","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/users\/147"}],"replies":[{"embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/comments?post=192718"}],"version-history":[{"count":6,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts\/192718\/revisions"}],"predecessor-version":[{"id":192760,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts\/192718\/revisions\/192760"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/media\/192722"}],"wp:attachment":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/media?parent=192718"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/categories?post=192718"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/tags?post=192718"},{"taxonomy":"magazine-issue","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/magazine-issues?post=192718"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/coauthors?post=192718"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}