Publications by authors named "Sandra A Springer"

Background: Buprenorphine is a Food and Drug Administration-approved medication for opioid use disorder. However, individuals with opioid use disorder often report information needs regarding buprenorphine treatment on social media platforms such as Reddit. The field lacks a systematic approach to organizing these data and characterizing treatment information needs that may be unique and unavailable elsewhere.

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Background: In an effort to address health risks for HIV among justice-involved individuals, linkage to community services for HIV and substance use disorder prevention and treatment is critical. Stakeholder feedback informing the development of interventions aimed at linking individuals to care is paramount to ensuring the success of the intervention. The current study examines focus group data collected as part of a 5-year NIDA-funded project and presents this data within an implementation science framework.

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People living with HIV (PLWHs) have higher risk of opioid use disorder (OUD). Whether medications for opioid use disorder (MOUDs) change immune responses in HIV infection is unknown. We examined the immune profiles in PLWHs before and 3 months after initiation of the μ opioid receptor agonist methadone, partial agonist buprenorphine, and antagonist naltrexone.

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Importance: Hospitalizations are increasing in the US due to infections related to opioid use disorder (OUD); however, few patients have treatment with medications for OUD (MOUD) initiated. Injectable long-acting buprenorphine (LAB) could help improve MOUD receipt and infection treatment completion.

Objective: To compare initiation of LAB combined with infectious disease (ID) management (ID-LAB) with treatment as usual (TAU) during inpatient medical hospitalization periods for improving receipt of MOUD at 12 weeks.

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Background: Mobile retail pharmacies were legalized in Connecticut in 2023 to provide primary care, human immunodeficiency virus (HIV) and hepatitis C virus (HCV) testing, preexposure prophylaxis (PrEP), immediate HIV antiretroviral therapy (ART), and medications for substance use disorders directly to people who use drugs (PWUD).

Methods: InMOTION mobile pharmacy and clinic (MPC) pilot findings describe services provided by pharmacists, clinicians, and community health workers.

Results: From 13 December 2023 through 5 November 2024, the MPC engaged with 414 participants, of whom 43% were female, 26% Black/African American, 32% uninsured, and 37% unhoused or unstably housed.

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Article Synopsis
  • - The text emphasizes that new antiretroviral drugs and formulations are continuously being developed for HIV prevention and treatment, highlighting the importance of updated strategies to manage the virus effectively.
  • - A panel of expert physician scientists has compiled updated recommendations for 2024 based on extensive literature reviews and data from scientific conferences, focusing on treatment protocols tailored to specific patient needs.
  • - Current recommendations advocate for antiretroviral therapy for all individuals with HIV, primarily using integrase strand transfer inhibitors, while also offering alternatives for those with unique circumstances, and suggesting both oral and injectable options for HIV prevention.
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Article Synopsis
  • Buprenorphine treatment for opioid use disorder is frequently hindered by clinicians worrying about causing sudden withdrawal symptoms in patients.
  • A systematic review by Gregory et al. found that precipitated withdrawal is rare, even in individuals using fentanyl.
  • The study emphasizes that treatment decisions should be based on evidence rather than fear of withdrawal.
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Hospitalizations are increasing among persons who use opioids, secondary to overdose and infections. Our study identified acute hospitalization as a reachable moment for engaging people who use drugs in increased screening and education about human immunodeficiency virus risk and prevention (preexposure prophylaxis).

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Over 1.2 million Americans aged 13 years and older have been diagnosed with human immunodeficiency virus (HIV). While HIV incidence has been declining since 2017, the risk of HIV acquisition and transmission persists among persons who use drugs via injection drug use and unprotected sexual intercourse associated with substance use.

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Introduction: Medications for opioid use disorder (MOUD) include opioid agonist therapies (OAT) (buprenorphine and methadone), and opioid antagonists (extended-release naltrexone). All forms of MOUD improve opioid use disorder (OUD) and HIV outcomes. However, the integration of services for HIV and OUD remains inadequate.

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People with substance use disorder (SUD) face barriers to prevention and treatment services, increasing risk for hospitalization and death. Injection drug use (IDU) can lead to an increased risk of overdose and infections. However, identifying people who inject drugs (PWID) within healthcare systems is challenging.

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Preexposure prophylaxis (PrEP) is underused in persons who use drugs and justice-involved persons. In an ongoing randomized controlled trial in 4 US locations comparing patient navigation versus mobile health unit on time to initiation of HIV medication or PrEP for justice-involved persons who use stimulants or opioids and who are at risk for or living with HIV, we assessed HIV risk factors, perceived HIV risk, and interest in PrEP. Participants without HIV (n = 195) were 77% men, 65% White, 23% Black, and 26% Hispanic; 73% reported a recent history of condomless sex, mainly with partners of unknown HIV status.

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Objective: The United States is in the fourth wave of the opioid epidemic marked by the increase in fentanyl and co-occurring stimulant use related overdose deaths. Measures are needed to quickly diagnose opioid and stimulant use disorders, yet current traditional diagnostic assessments pose barriers to providing rapid diagnoses.

Methods: This study aimed to (1) validate an updated version of the Rapid Opioid Dependence Screen (RODS) from DSM-IV criteria for opioid dependence to the now DSM-5 moderate-to-severe opioid use disorder, the Rapid Opioid Use Disorder Assessment (ROUDA); and (2) create and validate the Rapid Stimulant Use Disorder Assessment to DSM-5 stimulant use disorder (RSUDA) when compared to the substance use disorder module from the DSM-5 version of the Mini International Neuropsychiatric Interview.

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Purpose Of Review: Behaviors and practices associated with substance use contribute to lack of HIV virologic suppression and onward transmission. In the USA, many recent HIV outbreaks have been connected with substance use. Evidence-based strategies for integrating care of those at risk for and living with HIV and who use substances continue to evolve.

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Objectives: Persons with opioid use disorder (OUD) suffer disproportionately from morbidity and mortality related to serious addiction-related infections requiring hospitalization. Long-acting buprenorphine (LAB) is an underused medication for OUD that may facilitate linkage to care and treatment retention when administered before hospital discharge. Transition onto buprenorphine in the inpatient setting is often complicated by pain, active infection management, potential surgical interventions, and risk of opioid withdrawal in transition from full agonists to a partial agonist.

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Background: In the United States, a disproportionate number of persons with HIV (PWH) and opioid use disorder (OUD) are involved in the justice system. Medications for OUD (MOUD) can reduce convictions and incarceration time in persons with OUD. Extended-release naltrexone (XR-NTX) has been shown to reduce craving of opioids, recurrence of use, and overdose and help achieve or maintain HIV viral suppression in PWH with OUD involved with the justice system.

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While the COVID-19 pandemic disrupted healthcare delivery everywhere, persons with carceral system involvement and opioid use disorder (OUD) were disproportionately impacted and vulnerable to severe COVID-associated illness. Carceral settings and community treatment programs (CTPs) rapidly developed protocols to sustain healthcare delivery while reducing risk of COVID-19 transmission. This survey study assessed changes to OUD treatment, telemedicine use, and re-entry support services among carceral and CTPs participating in the National Institute on Drug Abuse (NIDA)-funded study, Long-Acting Buprenorphine vs.

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Background: Persons who inject drugs are at increased risk for acquiring hepatitis C virus (HCV). Medications for opioid use disorder (MOUD) are associated with reduced injection drug use (IDU) frequency among persons with opioid use disorder (OUD). However, whether HCV treatment uptake or changes in IDU frequency differ by HIV serostatus among persons receiving MOUD is incompletely understood.

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Importance: Recent advances in treatment and prevention of HIV warrant updated recommendations to guide optimal practice.

Objective: Based on a critical evaluation of new data, to provide clinicians with recommendations on use of antiretroviral drugs for the treatment and prevention of HIV, laboratory monitoring, care of people aging with HIV, substance use disorder and HIV, and new challenges in people with HIV, including COVID-19 and monkeypox virus infection.

Evidence Review: A panel of volunteer expert physician scientists were appointed to update the 2020 consensus recommendations.

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Introduction: Opioid use disorder (OUD) and injection drug use (IDU) place justice-involved individuals at increased risk for acquiring or transmitting HIV or hepatitis C virus (HCV). Methadone and buprenorphine have been associated with reduced opioid IDU; however, the effect of extended-release naltrexone (XR-NTX) on this behavior is incompletely studied.

Methods: This study examined injection opioid use and shared injection equipment behavior from a completed double-blind placebo-controlled trial of XR-NTX among 88 justice-involved participants with HIV and OUD.

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Synopsis of recent research by authors named "Sandra A Springer"

  • - Springer’s research emphasizes the need for comprehensive strategies in HIV prevention and treatment that simultaneously address the issue of substance use, highlighting the interconnectedness of these public health challenges.
  • - The latest article published in "Lancet HIV" reinforces the point that effective HIV intervention plans must consider the impact of substance use behaviors on transmission rates and treatment adherence.
  • - By advocating for an integrated approach, Springer aims to influence policy and clinical practices in order to better serve at-risk populations and improve overall health outcomes in the context of HIV.