# Assessing Care in the Context of an HIV Outbreak among PWID in Appalachia

> **NIH NIH R01** · UNIVERSITY OF KENTUCKY · 2021 · $156,997

## Abstract

ABSTRACT FROM PARENT AWARD
The overarching goal of this renewal application (R01DA033862) is to determine the influence of structural
interventions on engagement in risk reduction and health promotion activities among rural Appalachian drug
users. Results from the three-year R01 that the investigators seek to continue reveal an ever-changing
landscape of prescription drug abuse; an epidemic that is still in its infancy. Unlike many rural and suburban
areas, there is little evidence for the transition to heroin abuse. In this cohort, there has been a marked shift
from abuse of OxyContin® (extended-release oxycodone) to immediate release oxycodone to more recently,
buprenorphine and gabapentin-containing products. In addition, rates of HCV prevalence and incidence are
high, especially given the population density of rural Appalachia. Given the syndemic of opioid abuse and
infectious disease transmission, two structural interventions are particularly relevant to this population of rural
people who use drugs (PWUD). Medicaid (MC) expansion (under the Affordable Care Act [ACA]) and syringe
access programs (SAP) are two structural interventions that may allow for increased engagement in health
promotion among PWUD, but are likely heavily influenced by individual, network, and community-level factors.
Utilizing Latkin’s Dynamic Social Systems model and leveraging the extant, highly successful cohort of rural
PWUD, the aims include: 1) examining how dynamic factors of these structural interventions influence
longitudinal trends in illicit and prescription drug abuse; 2) determining the influence of these structural
interventions on HIV/HCV incidence and engagement in risk reduction; and 3) assessing the influence of these
structural interventions on uptake of substance abuse treatment. This study is highly significant given that
understanding the mechanisms by which these specific structural interventions influence health promotion is
key to improving public health in rural Appalachia. Substance abuse and HCV are two of the most important, if
not the most important health issues facing this region already plagued with marked health disparities. Using
innovative measures of network and geospatial risk, as well as conjoint analysis and multilevel longitudinal
statistical models, results will not only inform development of interventions that optimize uptake and utilization
of risk reduction services such as SAP and substance abuse treatment, but may inform policies surrounding
further implementation of health promotion programs in the rural U.S.

## Key facts

- **NIH application ID:** 10239310
- **Project number:** 3R01DA033862-08S1
- **Recipient organization:** UNIVERSITY OF KENTUCKY
- **Principal Investigator:** Jennifer R Havens
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $156,997
- **Award type:** 3
- **Project period:** 2012-09-01 → 2022-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10239310

## Citation

> US National Institutes of Health, RePORTER application 10239310, Assessing Care in the Context of an HIV Outbreak among PWID in Appalachia (3R01DA033862-08S1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10239310. Licensed CC0.

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