The Past, Present, and Future of PrEP implementation Among People Who Use Drugs

doi:10.1007/s11904-021-00556-z

Review

. 2021 Aug;18(4):328-338.

doi: 10.1007/s11904-021-00556-z. Epub 2021 Apr 27.

The Past, Present, and Future of PrEP implementation Among People Who Use Drugs

Katie B Biello^{1

2

3

4}, Matthew J Mimiaga^{5

6

7

8}, Pablo K Valente^{9

10}, Nimish Saxena⁵, Angela R Bazzi^{11

12}

Affiliations

¹ Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA. katie_biello@brown.edu.
² Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA. katie_biello@brown.edu.
³ Center for Health Promotion and Health Equity, Brown University, Providence, RI, USA. katie_biello@brown.edu.
⁴ The Fenway Institute, Fenway Health, Boston, MA, USA. katie_biello@brown.edu.
⁵ The Fenway Institute, Fenway Health, Boston, MA, USA.
⁶ Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.
⁷ Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
⁸ Center for LGBTQ Advocacy, Research, and Health, University of California Los Angeles, Los Angeles, CA, USA.
⁹ Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA.
¹⁰ Center for Health Promotion and Health Equity, Brown University, Providence, RI, USA.
¹¹ Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA.
¹² Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, USA.

PMID: 33907971
PMCID: PMC8286349
DOI: 10.1007/s11904-021-00556-z

Review

The Past, Present, and Future of PrEP implementation Among People Who Use Drugs

Katie B Biello et al. Curr HIV/AIDS Rep. 2021 Aug.

. 2021 Aug;18(4):328-338.

doi: 10.1007/s11904-021-00556-z. Epub 2021 Apr 27.

Authors

Katie B Biello^{1

2

3

4}, Matthew J Mimiaga^{5

6

7

8}, Pablo K Valente^{9

10}, Nimish Saxena⁵, Angela R Bazzi^{11

12}

Affiliations

¹ Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA. katie_biello@brown.edu.
² Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA. katie_biello@brown.edu.
³ Center for Health Promotion and Health Equity, Brown University, Providence, RI, USA. katie_biello@brown.edu.
⁴ The Fenway Institute, Fenway Health, Boston, MA, USA. katie_biello@brown.edu.
⁵ The Fenway Institute, Fenway Health, Boston, MA, USA.
⁶ Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.
⁷ Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
⁸ Center for LGBTQ Advocacy, Research, and Health, University of California Los Angeles, Los Angeles, CA, USA.
⁹ Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA.
¹⁰ Center for Health Promotion and Health Equity, Brown University, Providence, RI, USA.
¹¹ Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA.
¹² Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, USA.

PMID: 33907971
PMCID: PMC8286349
DOI: 10.1007/s11904-021-00556-z

Abstract

Purpose of review: Recent HIV outbreaks among people who use drugs (PWUD) necessitate additional HIV prevention tools. Pre-exposure prophylaxis (PrEP) is highly efficacious yet uptake among PWUD remains exceedingly low. To address multilevel, complex barriers to PrEP use among PWUD, a range of intervention strategies are needed.

Recent findings: The literature on interventions to optimize PrEP use among PWUD is nascent, comprising small pilots and demonstration projects in early phases of intervention development. Initial studies suggest that structural, healthcare, interpersonal, and individual-level interventions can improve PrEP use for PWUD, and a number of efficacy trials are underway. Future studies are needed to optimize the use of new PrEP modalities (e.g., injectable PrEP), simultaneously target multilevel challenges to PrEP use, and evaluate the integration of PrEP into other service settings and substance use treatment modalities.

Keywords: HIV; Injection drug use; Opioids; PrEP; Stimulants; Substance use.

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Readiness to implement contingency management to promote PrEP initiation and adherence among people who inject drugs: results from a multi-site implementation survey.
Pickering E, Viera A, Sung ML, Davidson D, Bailey G, Buchelli M, Jenkins M, Kolakowski J, Maier L, Edelman EJ, Rash CJ. Pickering E, et al. Addict Sci Clin Pract. 2024 Dec 23;19(1):97. doi: 10.1186/s13722-024-00503-4. Addict Sci Clin Pract. 2024. PMID: 39710733 Free PMC article.
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Cluesman SR, Gwadz M, Cleland CM. Cluesman SR, et al. AIDS Behav. 2025 May;29(5):1428-1448. doi: 10.1007/s10461-025-04613-1. Epub 2025 Jan 17. AIDS Behav. 2025. PMID: 39821058
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References

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1. Conrad C, Bradley HM, Broz D, Buddha S, Chapman EL, Galang RR, et al. Community outbreak of HIV infection linked to injection drug use of oxymorphone–Indiana, 2015. MMWR Morb Mortal Wkly Rep. 2015;64(16):443–4. - PMC - PubMed
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[1] Cicero TJ, Ellis MS, Surratt HL, Kurtz SP. The changing face of heroin use in the United States: a retrospective analysis of the past 50 years. JAMA Psychiatry. 2014;71(7):821–6. 10.1001/jamapsychiatry.2014.366. - DOI - PubMed

[2] Cicero TJ, Ellis MS, Surratt HL, Kurtz SP. The changing face of heroin use in the United States: a retrospective analysis of the past 50 years. JAMA Psychiatry. 2014;71(7):821–6. 10.1001/jamapsychiatry.2014.366. - DOI - PubMed

[3] Cicero TJ, Kuehn BM. Driven by prescription drug abuse, heroin use increases among suburban and rural whites. JAMA. 2014;312(2):118–9. 10.1001/jama.2014.7404. - DOI - PubMed

[4] Cicero TJ, Kuehn BM. Driven by prescription drug abuse, heroin use increases among suburban and rural whites. JAMA. 2014;312(2):118–9. 10.1001/jama.2014.7404. - DOI - PubMed

[5] Compton WM, Jones CM, Baldwin GT. Relationship between nonmedical prescription-opioid use and heroin use. N Engl J Med. 2016;374(2):154–63. 10.1056/NEJMra1508490. - DOI - PMC - PubMed

[6] Compton WM, Jones CM, Baldwin GT. Relationship between nonmedical prescription-opioid use and heroin use. N Engl J Med. 2016;374(2):154–63. 10.1056/NEJMra1508490. - DOI - PMC - PubMed

[7] Conrad C, Bradley HM, Broz D, Buddha S, Chapman EL, Galang RR, et al. Community outbreak of HIV infection linked to injection drug use of oxymorphone–Indiana, 2015. MMWR Morb Mortal Wkly Rep. 2015;64(16):443–4. - PMC - PubMed

[8] Conrad C, Bradley HM, Broz D, Buddha S, Chapman EL, Galang RR, et al. Community outbreak of HIV infection linked to injection drug use of oxymorphone–Indiana, 2015. MMWR Morb Mortal Wkly Rep. 2015;64(16):443–4. - PMC - PubMed

[9] Lankenau SE, Teti M, Silva K, Jackson Bloom J, Harocopos A, Treese M. Initiation into prescription opioid misuse amongst young injection drug users. Int J Drug Policy. 2012;23(1):37–44. 10.1016/j.drugpo.2011.05.014. - DOI - PMC - PubMed

[10] Lankenau SE, Teti M, Silva K, Jackson Bloom J, Harocopos A, Treese M. Initiation into prescription opioid misuse amongst young injection drug users. Int J Drug Policy. 2012;23(1):37–44. 10.1016/j.drugpo.2011.05.014. - DOI - PMC - PubMed

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The Past, Present, and Future of PrEP implementation Among People Who Use Drugs

Affiliations

The Past, Present, and Future of PrEP implementation Among People Who Use Drugs

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