# Testing an integrated bio-behavioral primary HIV prevention intervention among high-risk people who use drugs

> **NIH NIH R01** · UNIVERSITY OF CONNECTICUT STORRS · 2021 · $590,105

## Abstract

We are requesting 5 years of support to conduct a RCT to test the efficacy and cost-effectiveness of the bio-
behavioral community-friendly health recovery program (CHRP-BB), which focuses on PrEP adherence and
primary HIV prevention among high risk people who use drugs (PWUD). PWUD remain a priority
population as they represent a critical conduit for new HIV infections, which are transmitted through
preventable drug- and sex-related HIV risk behaviors. Pre-Exposure Prophylaxis (PrEP) – the daily self-
administration of antiretroviral medication - has enormous potential to bolster primary HIV prevention
outcomes among PWUD. PrEP is a FDA-approved biomedical HIV prevention strategy recommended by
the CDC and WHO for key populations, including PWUD. Despite unequivocal evidence supporting PrEP,
its scale-up has been nearly absent among high risk PWUD. Moreover, adherence to PrEP is crucial if it is to
be effective with high risk individuals. Recent research, however, indicates that optimal PrEP adherence may
be compromised by neurocognitive impairment (NCI), particularly among PWUD. Due to chronic drug use,
related lifestyle experiences, and other health challenges, many PWUD experience NCI to the extent that it
impedes medication adherence, HIV risk reduction, and treatment retention. In a recent HIV prevention trial,
over a third of high risk PWUD on opioid replacement therapy (ORT) had moderate to high levels of NCI
and, moreover, were less likely to reduce their HIV transmission risk vs. those without NCI. The potentially
disruptive impact of NCI must therefore be addressed when designing contemporary intervention strategies
targeting PWUD. Contemporary approaches must also be cost-effective and usable in real-world treatment
settings, such as methadone maintenance programs (MMPs) where high risk PWUD are concentrated and
can be readily reached with primary prevention. To date, however, primary prevention efforts have largely
relied on singular strategies (e.g., methadone or PrEP alone) with modest HIV risk reduction outcomes for
PWUD. Instead, advancing combination approaches capable of harnessing the synergy and efficiency
possible via multiple evidence-based strategies is most effective. This combination strategy is especially
important when intervening with high risk PWUD with NCI due to the potential decreased effectiveness of
PrEP when adherence is suboptimal, thereby necessitating behavioral interventions that focus on reducing
HIV risk and increasing PrEP adherence. Building on promising preliminary work, the proposed trial will fill a
critical void by testing an integrated bio-behavioral approach that incorporates the use of PrEP with an
evidence-based behavioral approach and, using innovative strategies, enhances PrEP adherence and HIV risk
behavior in a manner that accommodates NCI among PWUD. If efficacious and cost-effective, the CHRP-
BB intervention could be rapidly disseminated for implementation as part of routine care within c...

## Key facts

- **NIH application ID:** 10197074
- **Project number:** 5R01DA044867-05
- **Recipient organization:** UNIVERSITY OF CONNECTICUT STORRS
- **Principal Investigator:** MICHAEL COPENHAVER
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $590,105
- **Award type:** 5
- **Project period:** 2017-09-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10197074

## Citation

> US National Institutes of Health, RePORTER application 10197074, Testing an integrated bio-behavioral primary HIV prevention intervention among high-risk people who use drugs (5R01DA044867-05). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10197074. Licensed CC0.

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