Background: Florida had the third greatest number of new HIV diagnoses in the United States in 2020. This cross-sectional study aimed to assess HIV education and perceptions among diverse populations in South Florida to enhance public health community outreach efforts. Specifically, it investigated how HIV knowledge and perceptions vary based on race, primary language, and country of origin.
View Article and Find Full Text PDFAmong Black women living with HIV (BWLWH) the current study aimed to quantitatively assess changes in religious coping and social support over time via linear growth modeling (LGM). BWLWH (N = 276) provided longitudinal survey data on demographics, religious coping, and social support across fourteen study visits (between 2019 and 2024) at three-month intervals in the Southeastern United States. Religious coping and social support mean scores fluctuated over time and were relatively high at the onset of the COVID-19 pandemic.
View Article and Find Full Text PDFBackground And Aims: The overdose epidemic accounts for more than 89 000 deaths across the United States annually. Despite the availability of medications and therapies to treat substance use disorders (SUD), most people remain untreated. Stigma towards treating patients with SUD has been identified as a potential barrier to SUD treatment.
View Article and Find Full Text PDFDrug Alcohol Depend
September 2025
Medications for opioid use disorder (MOUD) can reduce opioid use and overdose deaths. This study examined whether the Communities That HEAL (CTH) intervention increased MOUD initiation, retention, and linkage. The HEALing Communities Study was a multi-site, 2-arm, parallel, community-level, cluster-randomized, unblinded, wait-list controlled trial conducted in 67 communities (n = 34 intervention, n = 33 control).
View Article and Find Full Text PDFVeterans differ in sociodemographic composition and experience higher frequencies of disability than non-Veterans of the same age. Yet the epidemiology of the long-term care needs of Veterans, specifically activities of daily living (ADLs) and instrumental activities of daily living (IADLs), remains an important gap in the literature. The objectives of this study were to (1) characterize Veterans across levels of hierarchy of ADL and IADL support needs; (2) compare Veterans across the degree of need for help, from those who can still "self-manage" to those with an "unmet need"; and (3) identify the types and prevalence of ADL and IADL need combination patterns.
View Article and Find Full Text PDFIntroduction: The HEALing Communities Study (HCS) tested a community-based intervention in 67 communities across Kentucky, Massachusetts, New York, and Ohio to reduce opioid overdose deaths. This paper introduces the HCS measures for monitoring the intervention uptake, reports crude rates for benchmarking, and highlights the importance of interpreting jurisdictional trends in the context of state policies.
Methods: We present technical specifications for the HCS measures and the common data model.
Int J Drug Policy
August 2025
Background: As part of the New York HEALing Communities Study, we modeled the opioid epidemic in New York State (NYS) to help coalition members understand short- and long-term capacity-building needs and trade-offs in choosing the optimal mix of harm reduction, treatment, and prevention strategies.
Methods: We built and validated a system dynamics simulation model of the interdependent effects of exposure to opioids, opioid supply and overdose risk, community awareness of overdose risk, naloxone supply and use, and treatment for opioid use disorder (OUD). We simulated overdose and fatality rates, OUD prevalence, and related measures from 2012 to 2032 for the NYS population aged ≥12 and tested policy scenarios for reducing future overdose deaths.
Open Forum Infect Dis
April 2025
Background: People with HIV (PWH) who use cocaine are less likely to achieve virologic suppression (<200 copies/mL) because of poor engagement in care. We tested the efficacy of an integrated substance use treatment and outpatient HIV care intervention on improving viral suppression in nonsuppressed PWH who use cocaine.
Methods: Project RETAIN recruited 360 cocaine-using PWH who were not virologically suppressed in Miami, FL, and Atlanta, GA.
Introduction: Along with a surge of opioid overdose deaths in the United States, the rates of nonfatal opioid overdose (NFOO) emergency department (ED) visits and hospitalizations have been sharply increasing.
Methods: In the HEALing Communities Study (HCS), we conducted a pre-specified secondary analyses to evaluate the effectiveness of the Community that HEALS (CTH) intervention on reducing the count of NFOO ED visits and hospitalizations in a multi-site cluster randomized multi-site, two-arm, parallel, community-level, open, wait list-controlled trial study, Sixty-seven communities in Kentucky, Massachusetts, New York, and Ohio were randomized to the intervention (N = 34) or waitlist control condition (N = 33) stratified by state and balanced by urban/rural classification, fatal opioid overdose rate and population size of communities. We compared the rate of NFOO per 100,000 adults aged ≥18 years between intervention and control communities from July 1, 2021, to June 30, 2022.
Int J Cardiol Cardiovasc Risk Prev
June 2025
Introduction: Black women are at greater risk of hypertensive disorders of pregnancy (HDP). Racial residential segregation (RRS) drives racial health disparities. This study investigates the association between RRS and the onset of HDP among Black parous women in the U.
View Article and Find Full Text PDFPre-exposure prophylaxis (PrEP), an effective biomedical prevention intervention, is not sufficiently reaching populations experiencing high HIV incidence. Behavioral health (BH) treatment addressing mental health and substance use similarly requires increased reach to HIV-affected populations. HIV testing is an opportunity to refer individuals to PrEP and BH treatment.
View Article and Find Full Text PDFDrug Alcohol Depend
February 2025
Introduction: Prevalence estimates of opioid use disorder (OUD) at local levels are critical for public health planning and surveillance, yet largely unavailable across the US especially at the local county level.
Methods: We used a Bayesian evidence synthesis approach to estimate the prevalence of OUD for 57 counties across New York State for 2017-2019 and compare rates of OUD across counties as well as assess the extent of undiagnosed OUD. We developed a generative model to assess conditional probabilistic relations between different subgroups of the OUD population defined by diagnosis, treatment, and overdose fatality.
AIDS Patient Care STDS
February 2025
Pre-exposure prophylaxis (PrEP) is an effective HIV prevention tool available in several modalities (e.g., daily oral, injectable, implants, rectal douching).
View Article and Find Full Text PDFAIDS Behav
April 2025
In Southern U.S. states with high HIV incidence and low HIV Pre-Exposure Prophylaxis (PrEP) uptake, enhanced efforts to increase interest in and willingness to use PrEP are needed.
View Article and Find Full Text PDFSeveral large-scale, pragmatic clinical trials on opioid use disorder (OUD) have been completed in the National Drug Abuse Treatment Clinical Trials Network (CTN). However, the resulting data have not been harmonized between the studies to compare the patient characteristics. This paper provides lessons learned from a large-scale harmonization process that are critical for all biomedical researchers collecting new data and those tasked with combining datasets.
View Article and Find Full Text PDFJ Subst Use Addict Treat
February 2025
Introduction: Little is known about how pharmacists' attitudes and stigma toward naloxone and Medication for opioid use disorder (MOUD) influence effective linkage to treatment. We examine the psychometrics of a new Pharmacist Opioid Use Disorder Perceptions Questionnaire (P-OUDP-Q), a multidimensional measure to examine pharmacists' stigma and perceptions related to MOUD in the New York State (NYS) site of the HEALing Communities Study.
Methods: The study recruited a sample of 324 pharmacists from 16 counties in NYS between January and June 2022.
Importance: The HEALing Communities Study (HCS) evaluated the effectiveness of the Communities That HEAL (CTH) intervention in preventing fatal overdoses amidst the US opioid epidemic.
Objective: To evaluate the impact of the CTH intervention on total drug overdose deaths and overdose deaths involving combinations of opioids with psychostimulants or benzodiazepines.
Design, Setting, And Participants: This randomized clinical trial was a parallel-arm, multisite, community-randomized, open, and waitlisted controlled comparison trial of communities in 4 US states between 2020 and 2023.
Importance: Local-level data are needed to understand whether the relaxation of X-waiver training requirements for prescribing buprenorphine in April 2021 translated to increased buprenorphine treatment.
Objective: To assess whether relaxation of X-waiver training requirements was associated with changes in the number of clinicians waivered to and who prescribe buprenorphine for opioid use disorder and the number of patients receiving treatment.
Design, Setting, And Participants: This serial cross-sectional study uses an interrupted time series analysis of 2020-2022 data from the HEALing Communities Study (HCS), a cluster-randomized, wait-list-controlled trial.
To determine whether endorsement patterns of psychosocial symptoms revealed distinct subgroups, or latent classes, of people living with HIV who use substances (PLWH-SU), and to assess whether these classes demonstrated differential health outcomes over time. This study uses data from 801 PLWH-SU initially enrolled across 11 US hospitals during 2012-2014 and followed up in 2017. Latent class analysis included 28 psychosocial items.
View Article and Find Full Text PDFIntroduction: Improving the delivery of existing evidence-based interventions to prevent and diagnose HIV is key to Ending the HIV Epidemic in the United States. Structural barriers in the access and delivery of related health services require municipal or state-level policy changes; however, suboptimal implementation can be addressed directly through interventions designed to improve the reach, effectiveness, adoption or maintenance of available interventions. Our objective was to estimate the cost-effectiveness and potential epidemiological impact of six real-world implementation interventions designed to address these barriers and increase the scale of delivery of interventions for HIV testing and pre-exposure prophylaxis (PrEP) in three US metropolitan areas.
View Article and Find Full Text PDFN Engl J Med
September 2024
People with HIV (PWH) frequently suffer from Opioid (OP) Use Disorder (OUD). In an investigation of the impact of OUD on underlying immune dysfunction in PWH, we previously reported that OP use exacerbates inflammation in virally controlled PWH followed in the Infectious Diseases Elimination Act (IDEA) Syringe Services Program (SSP). Unexpectedly, Flu vaccination-induced antibody responses in groups with OUD were superior to PWH without OUD.
View Article and Find Full Text PDFBMC Health Serv Res
April 2024
Background: The accessibility of pharmacies has been associated with overall health and wellbeing. Past studies have suggested that low income and racial minority communities are underserved by pharmacies. However, the literature is inconsistent in finding links between area-level income or racial and ethnic composition and access to pharmacies.
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