# Optimizing evidence-based HIV prevention targeting people who inject drugs on PrEP

> **NIH NIH R01** · UNIVERSITY OF CONNECTICUT STORRS · 2023 · $569,423

## Abstract

Framed by the multiphase optimization strategy (MOST), and building on our recent
preliminary studies, we are requesting 5 years of support to conduct an optimization trial among
people who inject drugs (PWID) and newly enrolled on medication for opioid use disorder
(MOUD). The goal is to assess the performance of four intervention components (Attention,
Executive Functioning, Memory, and Information Processing) aimed at enhancing the ability of
PWID on MOUD to process and utilize evidence-based HIV prevention content, leading to
improvements in Pre-Exposure Prophylaxis (PrEP) adherence and HIV risk reduction. Existing
evidence-based interventions require participants to have at least moderate levels of cognitive
functioning but do not acknowledge or accommodate participants with cognitive dysfunction.
This is a crucial weakness as cognitive dysfunction is a common feature among PWID, and one
that can directly impede their ability to process and utilize intervention content. In fact, our
recent studies comparing objective and self-report cognitive assessments (e.g., NIH toolbox)
show that ~67% of PWID experience substantial levels of cognitive dysfunction across tasks
involving attention, executive function, memory, and information processing that, in turn,
disrupt the expected intervention outcomes (e.g., medication adherence, HIV risk reduction).
Our recent work also suggests that PWID newly enrolled on MOUD would benefit from an
intervention approach that incorporates ‘compensatory strategies’ to accommodate their
cognitive dysfunction. A number of well-established compensatory strategies have been
successfully applied to other patient populations (e.g., traumatic brain injury, ADHD,
Alzheimer’s/dementia) and have been identified by our team as promising intervention
components that could enhance evidence-based PrEP-focused primary HIV prevention
approaches targeting PWID on MOUD. To date, however, no studies have examined the
potential impact and cost of incorporating such intervention components, either individually or
in various combinations, in terms of enhancing PWID’s ability to process and utilize HIV
prevention content. This innovative trial will be the first to use the MOST framework to optimize
an evidence-based HIV prevention approach by compensating for cognitive features that are
characteristic of PWID on MOUD, and maximizing PrEP adherence outcomes within real world
budget constraints.

## Key facts

- **NIH application ID:** 10692794
- **Project number:** 5R01DA055534-02
- **Recipient organization:** UNIVERSITY OF CONNECTICUT STORRS
- **Principal Investigator:** MICHAEL COPENHAVER
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $569,423
- **Award type:** 5
- **Project period:** 2022-09-01 → 2027-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10692794

## Citation

> US National Institutes of Health, RePORTER application 10692794, Optimizing evidence-based HIV prevention targeting people who inject drugs on PrEP (5R01DA055534-02). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10692794. Licensed CC0.

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