Harm Reduction in HIV Primary Care for PLWH Who Use Drugs
Trial statusRecruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18+
SponsorUniversity of Pittsburgh
About this trial
People living with HIV (PLWH) who use drugs experience significant health disparities including lower rates of retention in HIV care and higher rates of unsuppressed viral load, resulting in secondary infections and increased mortality. The proposed study will used mixed methods to explore (a) the relationship between healthcare providers' attitudes towards working with PLWH who use drugs and providers' acceptance and practice of structural and relational harm reduction; (b) the degree to which relational harm reduction moderates the effect of intersectional stigma experienced in healthcare settings on patients' perceptions of their relationship with providers; (c) the degree to which structural HR moderates the relationship between the patient-provider relationship and clinical outcomes, and (d) whether patient-perceived HR approaches to care are directly associated with HIV clinical outcomes. The study will also use these findings to inform the development and pre-testing of an intervention to operationalize harm reduction in HIV clinical settings, using stakeholder-engaged and human-centered design approaches, presenting a novel path to reducing HIV health inequities for PLWH who use drugs.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Providers' Inclusion Criteria
Working at one of our 3 study sites (UPMC HIV/AIDS Program, Positive Health Clinic, or 1917 Clinic) or one of their partner sites offering substance use treatment (Internal Medicine Recovery Engagement Program, Center for Inclusion Health, or UAB's Outpatient-Based Opioid Treatment Clinic) for at least one year
Providing service or care to PLWH or people who use drugs at high risk for HIV acquisition
Working in one of the following positions: front desk/patient engagement, social worker, nurse, medical assistant, advanced practice provider, or physician
Disqualifiers
None
Trial population
1. Providers of services to people living with or at high risk for HIV. Providers include all members of the healthcare team; i.e., reception, nurses, clinical providers, social workers, and pharmacists. Providers must have worked in one of our study settings for at lease one year. 2. Patients living with HIV who have receive care at one of our study sites with lifetime or current use of illicit drugs (excluding marijuana), or of prescription drugs for non-medical reasons.
Trial design
Design model
Other
Time perspective
Cross-sectional
Treatments tested in this trial
Harm Reduction
BehavioralHarm reduction aims to reduce negative effects of risky health behaviors without necessarily terminating the behaviors completely.Though often thought of as structural approaches (e.g., policy or syringe services), Harm reduction is also a relational approach to care focusing on non-punitive patient-provider interactions to promote autonomy. The degree to which harm reduction care is offered in study settings and is associated with clinical outcomes is the focus of this study.
Treatment groups
768 Participants
are divided into 2 treatment groupsGroup A: Providers0 interventions
Group B: Patients1 intervention
Trial outcomes
Primary outcomes
1
HIV Viral Load
Viral load will be assessed as a continuous and dichotomous variable (virally suppressed \<200 copies/ml)
Time frame
Retrospective, past 5 yearsSecondary outcomes
1
Retention in care - Missed Visits
Proportion of missed versus kept HIV primary care visits
Time frame
Retrospective, past 5 years2
Retention in care - Kept visits
At least 2 kept HIV primary care visits separated ≥90 days during a 12-month period
Time frame
Retrospective, past 5 years3
Hepatitis C Viral Load
HCV Viral suppression
Time frame
Retrospective, past 5 years4
HIV Adherence
Self-report of ART adherence - CASE Index
Time frame
Retrospective, past 5 yearsSponsors and contacts
Click on the lead sponsor to view all of their trials.
University of Pittsburgh
Lead sponsor
Allegheny Health Network
Collaborator
University of Alabama at Birmingham
Collaborator
National Institute on Drug Abuse (NIDA)
Collaborator
National Institutes of Health (NIH)
Collaborator
Source ClinicalTrials.gov