# Implementation of telemedicine and social network driven HIV service uptake for comprehensive HIV service integration in rural syringe service programs

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2024 · $1,158,132

## Abstract

7. PROJECT SUMMARY / ABSTRACT
People who inject drugs (PWID) face multilevel barriers to accessing HIV-related services, including low
demand for services, resulting from stigma, low knowledge/awareness of services, and prioritization of
immediate basic needs (e.g., food, housing, addiction) over remote health concerns. In rural areas, these
barriers are exacerbated by service scarcity. Syringe service programs (SSPs), a cornerstone of HIV
prevention among PWID, are trusted by this population and have the potential to extend the reach of other
evidence-based services (pre-exposure prophylaxis [PrEP], medication for opioid use disorder [MOUD], HIV
treatment, etc.). Telemedicine provides a sustainable method to deliver services where they are scarce. We
successfully piloted telehealth delivery of HCV treatment and MOUD for PWID at rural SSPs. We will adapt
and expand on our telemedicine pilot to bring HIV prevention and treatment services to rural SSPs.
However, service availability does not equate to uptake. Social network-based interventions have proven
effective in disseminating health information and HIV risk reduction among PWID. Peer-based interventions
have an unparalleled potential to overcome stigma and trust barriers in marginalized groups, reach “hidden”
group members (i.e., those who do not access services at the SSP), and empower individuals to make positive
changes. Low rates of HIV testing and diagnosis among PWID remain a barrier to linkage to antiretroviral
therapy initiation (for HIV infected) and PrEP (for HIV-uninfected). A key innovation of our intervention will be to
combine dissemination of information with distribution of HIV self-testing kits through PWID networks. HIV
self-testing strategies are endorsed by the World Health Organization and have been shown to increase testing
coverage and new HIV diagnoses in high prevalence regions of sub-Saharan Africa and among MSM, but
have been little explored among PWID. We propose to evaluate a model that leverages peer educators to
disseminate HIV self-testing kits and information while also providing peer navigation to network
members for HIV prevention and treatment services uptake via telemedicine at rural SSPs
We plan a hybrid effectiveness/implementation approach. Aim 1a: We will use a community-engaged approach
to adapt a preexisting PWID-focused network intervention to a rural context with the goal of increasing HIV
self-testing and HIV service uptake. Aim 1b: We will determine the effectiveness of the intervention compared
with an equal-attention control condition, using a rigorous randomized trial design. Aim 2a: In contemplation of
adoption and sustainability, we will use mixed methods to characterize implementation processes and
outcomes. Aim 2b: to explore intervention mechanisms, we will establish the extent to which SSP and HIV
service uptake are related to experiences of social influence and stigma.

## Key facts

- **NIH application ID:** 10894036
- **Project number:** 5R01DA058387-02
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Oluwaseun Falade-Nwulia
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,158,132
- **Award type:** 5
- **Project period:** 2023-08-01 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10894036

## Citation

> US National Institutes of Health, RePORTER application 10894036, Implementation of telemedicine and social network driven HIV service uptake for comprehensive HIV service integration in rural syringe service programs (5R01DA058387-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10894036. Licensed CC0.

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