# Ending the HIV Epidemic: Peer-supported collaborative care for mental health and substance use disorder care integration into HIV care settings

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2022 · $663,651

## Abstract

Project Abstract
Despite the effectiveness of antiretroviral medications for HIV suppression, people with HIV who also have
mental health and or substance use disorders suffer disparities in rates of HIV suppression and retention in
HIV care. Evidence based treatment for mental health disorders (MHD) and substance use disorders (SUD),
including use of medications and self-management support have been associated with improved engagement
in HIV care. However, a key gap in many HIV care settings is an inability to consistently screen and provide
treatment for MHD/SUD. Barriers include limited provider knowledge of, and comfort with, MHD/SUD screening
and treatment; time constraints; and absence of support staff to facilitate linkage and retention in MHD/SUD
care. We propose a Hybrid Type 1 implementation- effectiveness trial of an adapted collaborative care
model with peer-specialists as care managers, to enhance screening and treatment for MHD/SUD with
resultant improvement in rates of HIV viral suppression and care engagement in an HIV clinic setting.
Collaborative care (CC), the use of a care manager/team to facilitate and coordinate integration of mental
health and substance use services with primary care, is a well-established evidence-based model. We intend
to adapt CC by training and supporting peer specialist to function as care managers. We will then rigorously
evaluate peer-supported CC as a component of a multidisciplinary team including the HIV care provider and an
addiction psychiatry consultant as an implementation strategy for MHD/SUD screening and treatment in a
continuity HIV care practice. We will compare this peer-supported CC to usual care (UC) referral to psychiatric
care or a SUD treatment program at the discretion of the primary care provider and evaluate the
implementation process using the RE-AIM framework. Our specific aims are as follows
Specific Aim 1: In a randomized trial, compare the proportion of patients with MHD/SUD with HIV
suppression randomized to the collaborative care (CC) and the usual care (UC) referral strategy. We will
randomize 400 patients 1:1 to CC versus UC and compare the proportion of patients with HIV suppression
(defined as HIV RNA <200 copies/ml) at 12 months.
Specific Aim 2: Characterize processes of CC implementation including reach, adoption, fidelity, and
provider acceptability, maintenance over time, and costs associated with the approach. We propose a
mixed methods approach to measure the implementation processes guided by the RE-AIM Framework. In sub
Aim 2b, we will conduct a cost analysis for the peer-supported CC model.
Specific Aim 3: Determine the mediators of the CC intervention on HIV viral load suppression and
retention in care. We will utilize a structured questionnaire and clinical data to assess mediators of the CC
intervention on HIV outcomes and qualitatively assess overall experiences with the peer supported CC model
and explore if patient characteristics impact experience.

## Key facts

- **NIH application ID:** 10452699
- **Project number:** 5R01DA052297-03
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Oluwaseun Falade-Nwulia
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $663,651
- **Award type:** 5
- **Project period:** 2020-09-30 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10452699

## Citation

> US National Institutes of Health, RePORTER application 10452699, Ending the HIV Epidemic: Peer-supported collaborative care for mental health and substance use disorder care integration into HIV care settings (5R01DA052297-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10452699. Licensed CC0.

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