# Using Geospatial Mapping and Epidemiologic Methods to Identify and Support Persons Who Inject Drugs (PWID) at Risk for HIV in Alabama

> **NIH NIH P30** · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2023 · $222,750

## Abstract

SUMMARY
Due to the large, rural burden of HIV in the state, Alabama (AL) is one of seven priority states for the Ending the
HIV Epidemic (EHE) initiative. Alabamians struggle with late HIV diagnosis and suboptimal linkage and retention
in HIV care, at least in part due to poverty, rurality, and lack of public health infrastructure and Medicaid
expansion. Further, historic events have impacted HIV efforts in AL in myriad ways, halting progress towards
EHE goals: the pandemic and the Drug Crisis. At UAB Hospital, one hundred of persons who inject drugs (PWID)
are hospitalized with serious complications from drug use annually. Over 25% of them are from rural counties
where the absence of low barrier medical, harm reduction, and addiction services enables high risk injection
practices and infections, like hepatitis C and HIV. Unfortunately, the hospital is a missed opportunity for HIV
prevention: we found that hospitalized PWID are unaware of their HIV risk and providers are unlikely to offer
PrEP to PWID. At the same time, few PWID in AL reside in communities that offer integrated HIV, harm reduction,
and addiction services. Thus, PWID with life-threatening complications of drug use return to communities who
are not equipped to care for them. While it is not feasible to rapidly scale up integrated care across Alabama, a
combination of geospatial mapping and epidemiologic surveillance can allow us to identify and prioritize counties
at greatest risk for an HIV outbreak among PWID. The objective of this application is to 1) leverage hospital and
community-level data to identify AL counties at greatest risk for an HIV outbreak among PWID and 2) engage
community partners to identify needs and opportunities to build community capacity. The overall goal of this
proposal is to inform implementation strategies to integrate person-centered HIV, harm reduction, and addiction
services for PWID in AL. To achieve our overall goal, we propose the following specific aims:
AIM 1A. Using geospatial mapping and statewide HIV and opioid overdose surveillance data, we will identify AL
counties with the greatest risk of an HIV outbreak during the contemporary drug crisis (fentanyl and
methamphetamines).
AIM 1B. Upon identifying counties with the greatest risk, we will work in partnership with our existing Community
Advisory Board (CAB) to develop an engaged community of partners in counties at greatest risk, including health
officials, AIDS Service Organizations, nonprofits, and addiction treatment centers.
AIM 2. We will collaborate with Community Partners to identify hyperlocal opportunities for integrated HIV, harm
reduction, and addiction services. Specifically, we will use qualitative methods to identify barriers and
opportunities for integrated care from the perspective of service organizations and PWID.

## Key facts

- **NIH application ID:** 10814067
- **Project number:** 3P30AI027767-35S5
- **Recipient organization:** UNIVERSITY OF ALABAMA AT BIRMINGHAM
- **Principal Investigator:** Renee A. Heffron
- **Activity code:** P30 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $222,750
- **Award type:** 3
- **Project period:** 1997-03-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10814067

## Citation

> US National Institutes of Health, RePORTER application 10814067, Using Geospatial Mapping and Epidemiologic Methods to Identify and Support Persons Who Inject Drugs (PWID) at Risk for HIV in Alabama (3P30AI027767-35S5). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10814067. Licensed CC0.

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