# Characterizing medication-assisted opioid use treatment and HIV care delivery for community re-entrants with HIV and opioid use disorder in South Africa

> **NIH NIH R21** · JOHNS HOPKINS UNIVERSITY · 2020 · $212,540

## Abstract

PROJECT SUMMARY
The availability of antiretroviral therapy (ART) has markedly reduced HIV-related mortality and
morbidity in Africa. Yet HIV remains the leading cause of death among adult men and women in
South Africa due fails to initiated ART or remain in care. Between 2 and 3% of HIV-infected men
in South Africa pass through the corrections system annually. During incarceration uptake of
ART is excellent; unfortunately, during community re-entry most individuals who were on ART
are lost from care. Qualitative and quantitative research conducted by this research group in
South Africa indicates that this population encounters multiple barriers to care engagement.
These barriers include lack of patient-centered care, family abandonment and limited social
capital, enacted stigma, economic insecurity, and substance use. More than 55% of community
re-entrants report illicit opioid use; this appears to the leading cause of loss from care. An
evidence-based approach to help management this issue is long-term medication-assisted
treatment (MAT) of substance use. In South Africa, methadone and buprenorphine/naloxone are
available but have never been used specifically for re-entrants. This project seeks to
characterize the needs of dual diagnosed re-entrants, their journey, and key components of
implementing a MAT program for this population. We propose to recruit a cohort of 40 dual-
diagnosed inmates, offer opioid use services and HIV linkage to care and follow them for 6
months post release. Post-release follow-up will include longitudinal in-depth interviews to
generate a rich understanding of the dynamic process or community re-entry for dual-diagnosed
inmates. This includes their relationships with opioid use and with opioid use management
services. We will also interview key stakeholders to develop a clear understanding of
implementation needs and convene workshops to reflect on findings with stakeholders,
including dual diagnosed ex-inmates, to develop a feasible and acceptable working model for
substance use management in this population. The current proposal will allow for the adaptation
of an existing community MAT and harm reduction program to fit the needs of re-entrants. This
project has the potential to develop considerable new knowledge on an population that has
received little attention – dual diagnosed individuals in South Africa and community re-entrants
in general.

## Key facts

- **NIH application ID:** 10071356
- **Project number:** 1R21TW011689-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** CHRISTOPHER J HOFFMANN
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $212,540
- **Award type:** 1
- **Project period:** 2020-09-09 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10071356

## Citation

> US National Institutes of Health, RePORTER application 10071356, Characterizing medication-assisted opioid use treatment and HIV care delivery for community re-entrants with HIV and opioid use disorder in South Africa (1R21TW011689-01). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10071356. Licensed CC0.

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