# When pandemics collide: The intersection of the opioid crisis, COVID-19 and HIV pandemics among people who inject drugs in the United States

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2020 · $665,811

## Abstract

Project Summary/Abstract
Despite the more than decades long downward trend in HIV incidence among people who inject drugs (PWID),
there is cause for alarm due to the COVID-19 pandemic and the instability the response will likely cause,
particularly among vulnerable populations. COVID-19 will disrupt access to the very interventions that led to
declining HIV incidence among PWID, including harm reduction services and antiretroviral therapy (ART). As a
result, COVID-19 threatens to undo efforts to end the HIV epidemic in the US. Several recent HIV outbreaks in
the US that resulted from increasing use and exposure to synthetic opioids highlights how the COVID-19
pandemic is being layered onto an existing public health emergency in the US that is disproportionately
affecting PWID populations. It is unknown how the intersection of the opioid crisis and COVID-19 pandemic will
interact to impact the health of PWID in the short term and whether it will create conditions sufficient to
destabilize PWID populations enough to support the resurgence of HIV. Research is therefore urgently needed
to examine the immediate impact and downstream consequences of COVID-19 on PWID. The objective of this
proposal is therefore to determine the potential of HIV resurgence among PWID due to the impact of the
COVID-19 pandemic on individual and network factors. Our central hypothesis is that COVID-19 will increase
individual and social network instability sufficiently to promote HIV outbreaks among PWID populations. We
propose the following three specific aims: 1) To examine threats to psychosocial, economic and behavioral
stability and HIV control among an existing cohort of PWID during the COVID-19 pandemic; 2) To understand
social and drug-use network stability during and following the COVID-19 pandemic; and 3) To estimate the
potential for HIV resurgence among PWID as a result of the COVID-19 pandemic. To achieve these aims, we
will leverage ongoing behavioral, laboratory and clinical data collection within the AIDS Linked to the
IntraVenous Experience (ALIVE) cohort and collect new longitudinal social network data and qualitative data to
characterize the disruption due to COVID-19. Importantly, we will advance our understanding of how individual
substance use, HIV-related risk behaviors, and social network characteristics have changed as a result of
COVID-19, relationships that are entirely uncharacterized. The evidence generated from this proposed
research will inform the ongoing design of interventions targeted to PWID, not only to prevent emerging HIV
outbreaks, but to support efforts to improve the health of PWID in the context of disruptions to care and
services. Given that the COVID-19 pandemic will likely have prolonged impacts on PWID due to continued
SARS-CoV-2 transmission in urban areas and continual cycling of non-pharmaceutical interventions (NPIs)
until more effective prevention and treatment strategies are available, the research proposed here will hav...

## Key facts

- **NIH application ID:** 10159596
- **Project number:** 1R01DA053136-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Becky Lynn Genberg
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $665,811
- **Award type:** 1
- **Project period:** 2020-09-30 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10159596

## Citation

> US National Institutes of Health, RePORTER application 10159596, When pandemics collide: The intersection of the opioid crisis, COVID-19 and HIV pandemics among people who inject drugs in the United States (1R01DA053136-01). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10159596. Licensed CC0.

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