# Race and sex as moderators of harm reduction pharmacobehavioral treatment outcomes for alcohol use disorder among people experiencing homelessness

> **NIH NIH F31** · UNIVERSITY OF RHODE ISLAND · 2022 · $36,395

## Abstract

PROJECT SUMMARY/ABSTRACT
Alcohol use disorder (AUD) is a pervasive and problematic public health concern among populations
characterized by homelessness. This health disparity among individuals who are homeless is reflected in the
high rates of alcohol-related mortality and morbidity. Racial minorities and women experience disproportionate
alcohol-related harm and high rates of alcohol-related mortality and morbidity. This disparity is elevated among
racial minorities and women who are homeless. A recent randomized controlled trial (RCT), the Harm
Reduction Treatment with Pharmacotherapy study (HaRP; R01AA022309; PI: Dr. Susan Collins), tested the
efficacy of harm reduction treatment with extended-release naltrexone (XR-NTX; VIVITROL®) among urban
adults experiencing homelessness and AUD. This 4-arm RCT assessed the effects of extended-release
naltrexone and harm reduction counseling (XR-NTX + HRC), a placebo medication group and harm reduction
counseling (placebo + HRC), and harm reduction counseling alone (HRC), compared to community-based
supportive services (TAU). Behavioral harm reduction treatment combined with XR-NTX was shown to improve
alcohol and quality of life outcomes, underscoring its utility for people experiencing homelessness and AUD.
While behavioral harm reduction treatment combined with XR-NTX has been found to be feasible, acceptable,
and efficacious among people experiencing homelessness with AUD, there is a dearth of research on XR-NTX
for AUD among NAI and Black adults and women, and no studies of XR-NTX paired with behavioral harm
reduction treatment in these historically underrepresented groups for AUD treatment research. Examination of
pharmacobehavioral harm reduction treatment for marginalized populations aligns with NIH/NIAAA's recent
strategic plan, including their commitment to “supporting studies to better understand health disparities and to
develop interventions for at-risk groups.” The proposed study will use content analysis to assess if HaRP is an
acceptable treatment across race and sex (Aim 1). Additionally, the study will use invariance testing to assess
the efficacy of HaRP across race and sex (Aim 2). Specifically, it will test the hypothesis that the intervention
effects of each HaRP treatment group (HRC+XR-NTX, HRC+Placebo, HRC) compared to the TAU are
invariant across race (NAI, Black, white) and sex (female and male). Research findings will serve as pilot data
to inform future treatment development for underrepresented minorities among a marginalized, transient
population. Additionally, the proposed study would provide the Applicant with training experiences that will
inform her research program on harm reduction treatment among marginalized populations. Specifically, the
proposed training and research would facilitate the acquisition and integration of knowledge on alcohol
interventions; RCT methodology and data analysis; alcohol-related health inequities; and treatment
development among marginalize...

## Key facts

- **NIH application ID:** 10569499
- **Project number:** 5F31AA029274-02
- **Recipient organization:** UNIVERSITY OF RHODE ISLAND
- **Principal Investigator:** Silvi Cara Goldstein
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $36,395
- **Award type:** 5
- **Project period:** 2021-09-13 → 2024-06-05

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10569499

## Citation

> US National Institutes of Health, RePORTER application 10569499, Race and sex as moderators of harm reduction pharmacobehavioral treatment outcomes for alcohol use disorder among people experiencing homelessness (5F31AA029274-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10569499. Licensed CC0.

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