2. No conflicts of interest
DISCLAIMER…
No conflicts of interest

3. Share your thoughts on this presentation with #IAS2019
National Institution on Drug Abuse: HIV Substance Abuse Social & Behavioral Sciences Research
Redonna K. Chandler, Ph.D.
@NIDAnews
Share your thoughts on this presentation with #IAS2019

4. National Institute on Drug Abuse Advancing Addiction Science
Treatment and Care
Prevention
Consequences
Neural mechanisms
Behavioral Treatment
Medications Development
Implementation
Genetics
Environment
Development
Neurobiology
Interventions
Policy
HIV/AIDS
Fetal Exposure

5. Estimated HIV Prevalence Among People Who Inject Drugs by Country
Estimated HCV Among People Who Inject Drugs by Country
IDU=injecting drug use. No eligible report=evidence of IDU located, but no study of HCV antibody prevalence among people who inject drugs that met our eligibility criteria was located. Lancet Glob Health Dec; 5(12): e1192–e1207. Published online 2017 Oct 23. doi:  /S X(17)
IDU=injecting drug use. No eligible report=evidence of IDU located, but no study of HIV prevalence among people who inject drugs that met our eligibility criteria was located. Lancet Glob Health Dec; 5(12): e1192–e1207. Published online 2017 Oct 23. doi:  /S X(17)

6. Addiction Can Be Treated
Medications for Opioid Use Disorders (MOUD or MAT, OST)
Impact of MOUD on HIV Transmission
Log Dose
Opioid Effect
Full Agonist
(Methadone: Daily)
Partial Agonist
(Buprenorphine: 3x/week, ER 1 month)
Antagonist
(Naltrexone: ER 1 month)
DECREASES:
Opioid use
Opioid overdose deaths
Criminal activity
HIV and HCV transmission
INCREASES
Social functioning
Retention in HIV treatment
Improves HIV Outcomes
MOUD reduced HIV infections by 54%
MacArthur GJ et al. BMJ 2012

7. Medications for OUD are Highly Underutilized and Retention is Poor
MOUD Coverage among PWID
OUD Cascade of Care, USA
Larney S et al., Lancet Global Health 2017
Williams et al. Health Affairs Blog, 2017

8. Global Coverage Of Needle And Syringe Programs Among People Who Inject Drugs
Lack Of Harm Reduction
Interventions In US

9. Social, Economic, Health and Policy Determinants of Drug Use and HIV
Research to study environmental influences across the entire continuum of substance use, addiction, and HIV (including environment x biological interplay)
Identify the socioenvironmental factors that act as moderators or catalysts e.g. homelessness, poverty, unemployment, and design strategies address them at individual and population level
Diagnose and treat co-occurring mental health issues
Identify and understand the changing policy environment and how it interacts with trajectories: marijuana, tobacco regulation, health reform, criminalization
Modeling to predict community-level risk for OUD and HIV

10. Leverage Technology to Transform Substance Use and HIV Research
Leverage technology to transform substance use and HIV research and care
Role of technology in acquisition/use/communication about substance use, HIV risk, PrEP, HIV Care
Use new and improved technology to effectively intervene
Research utilizing myriad data available from multiple technology driven sources

11. Implementation Science: Move From Effectiveness to Implementation Research
Systematic (replicable, measurable) strategies for promoting adoption of evidence-based practices, with fidelity, in routine clinical settings
Subjecting that process to the scientific method
Hypothesis-driven, experimental designs
Grounded in conceptual model of implementation process
Approaching dissemination and implementation as deliberate actions (interventions)
Optimize adoption/sustainability of evidence-based substance abuse and HIV prevention & treatment interventions
Evaluate de-adoption strategies to eliminate use of ineffective prevention/treatment practices

12. NIDA Research Initiatives
NIDA Innovation Awards:
NIDA Avant-Garde Award Program for HIV/AIDS and Drug Use Research:
Avenir Award Program for Research on Substance Abuse and HIV/AIDS:
PrEP for HIV Prevention among Substance Using Populations:
Advancing Exceptional Research on HIV/AIDS and Substance Abuse:

13. Thank You