# Building on Needle Exchange to Optimize HIV Prevention/Treatment

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2021 · $997,878

## Abstract

7. PROJECT SUMMARY
Biomedical interventions that have direct applicability to people who inject drugs (PWID) have flourished over
the past 15 years (HIV treatment as prevention, pre-exposure prophylaxis, office-based medication-assisted
treatment (MAT) with buprenorphine, and hepatitis C virus (HCV) treatment with direct acting agents).
However, penetration of these interventions among PWID is low relative to the potential benefits. Syringe
service programs (SSP) are an essential risk reduction service for PWID, and represent the outermost reach of
public health services for this population. The Baltimore City Health Department (BCHD) and investigators at
Johns Hopkins University are developing a dedicated integrated care van (ICV) to complement the city's
mobile SSP, with the goals of optimizing the HIV care cascade in HIV-positive clients and extending needed
biomedical interventions to PWID. A nurse practitioner, case worker, and peer navigators will engage HIV-
positive clients (known and newly diagnosed) and collaborate closely with local HIV clinics to promote progress
toward durable viral suppression. To support the ICV's role in HIV care facilitation, we propose an innovative
application of the CDC-sponsored “Data to Care” initiative - a multi-source health service database designed to
assist health departments track the HIV care cascade in real time. Additionally, the ICV will provide rapid HIV
testing, PrEP screening and initiation, buprenorphine-based MAT, HCV testing and referrals to treatment, and
wound care. Using a cluster-randomized trial design, we propose to determine whether the ICV intervention
advances the HIV care cascade among HIV-positive PWID, improves the PrEP continuum, and increases
uptake of MAT and HCV treatment (Aim 1). Additionally, we will examine the implementation of the ICV
intervention using a mixed methods approach among PWID, local/state public health stakeholders, and
medical providers to examine the intervention's feasibility, acceptability, coverage, fidelity, and sustainability
(Aim 2). Finally, we will determine the incremental cost-effectiveness of the ICV intervention (Aim 3). We have
assembled a multi-disciplinary team with methodological expertise in PWID interventions and cost-
effectiveness evaluations, and longstanding collaboration with our partners at the BCHD. Our team is
enthusiastic to propose a hybrid effectiveness-implementation trial of a structural intervention designed to bring
low-threshold, evidence-based biomedical interventions to SSP clients and their injecting network members.

## Key facts

- **NIH application ID:** 10219216
- **Project number:** 5R01DA045556-05
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** GREGORY M LUCAS
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $997,878
- **Award type:** 5
- **Project period:** 2017-09-15 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10219216

## Citation

> US National Institutes of Health, RePORTER application 10219216, Building on Needle Exchange to Optimize HIV Prevention/Treatment (5R01DA045556-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10219216. Licensed CC0.

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