Substance Use Screening for People with HIV

(ePORTAL-HIV-S Trial)

Overseen By NeNe Clark

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Chicago

Disqualifiers: Substance use screening, Provider assent, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

Duration: 1 year

900 Participants Needed

Trial Summary

Do I need to stop my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment ePORTAL HIV-S for substance use screening in people with HIV?

Integrating substance use services into HIV care has been shown to improve patient outcomes, suggesting that treatments like ePORTAL HIV-S could be effective in enhancing care for people with HIV. ^{1 2 3 4 5}

How is the ePORTAL HIV-S treatment different from other treatments for HIV?

The ePORTAL HIV-S treatment is unique because it integrates substance use screening into HIV care, which is not commonly done in standard HIV treatments. This approach aims to improve treatment outcomes by addressing substance use, which is a known factor that can negatively impact adherence to HIV medications. ^{1 3 6 7 8}

What is the purpose of this trial?

This study aims to achieve health equity in substance use disorder (SUD) screening and treatment among Black people living with human immunodeficiency virus (HIV) by implementing interventions to decrease barriers to screening (clinic-based, in-person) and treatment (referral-focused), a program the study investigators call Achieving Equity in Patient Outcome Reporting for Timely Assessments of Life With HIV and Substance Use (ePORTAL HIV-S). The ePORTAL HIV-S randomized control trial will focus on portal-based screening in the HIV clinic, regardless of whether the patient has a scheduled appointment with their HIV provider. The study includes a clinic-based treatment program implemented at the Chicago Department of Public Health-funded South Side Health Home (S2H2), the main provider of HIV prevention and care services for Chicago's South Side.

Research Team

Neda Laiteerapong, MD, MS

Principal Investigator

University of Chicago

Jessica P. Ridgway, MD

Principal Investigator

University of Chicago

Eligibility Criteria

This trial is for Black individuals living with HIV who may also be dealing with drug addiction or substance use disorders. Participants should be comfortable using a patient portal for health screenings and not currently enrolled in other SUD treatment studies.

Inclusion Criteria

Provider has assented

Speaks English

I have been diagnosed with HIV.

Exclusion Criteria

Patients who have been screened for substance use disorder at the clinic in the last year using the NIDA Quick Screen

Patient's provider has not assented to the intervention

I am under 18 years old.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person) or via patient portal

Treatment

Participants receive referral-focused treatment for substance use disorder

1 year

Clinic-based treatment visits

Follow-up

Participants are monitored for retention in care and HIV viral suppression

1 year

Regular clinic visits

Long-term Follow-up

Participants are monitored for retention in care in the year post-screening

2 years

Treatment Details

Interventions

• ePORTAL HIV-S
• Usual Care Substance Use Involvement Screening

Trial Overview The study tests if a population-level patient portal can improve substance use disorder screening over the usual care methods in an HIV clinic setting. It's a randomized control trial, meaning people are put into groups by chance to compare outcomes.

Participant Groups

Group I: Usual Care SUD Screening Experimental Treatment 1 Intervention

Participants randomized to this intervention will receive the NIDA Quick Screen V1.0 if they attend their scheduled appointment with their HIV clinician.

Group II: Patient portal population level substance involvement risk screener Experimental Treatment 1 Intervention

Participants randomized to this group will receive a National Institute on Drug Abuse (NIDA) Quick Screen V1.0 substance involvement screener over the patient portal regardless of having a scheduled appointment with their HIV clinician. If they do not complete the screener via the portal, they will be screened at HIV clinic appointments.

Who Is Running the Clinical Trial?

University of Chicago

Lead Sponsor

Trials

1,086

Recruited

844,000+

National Institute on Drug Abuse (NIDA)

Collaborator

Trials

2,658

Recruited

3,409,000+

Findings from Research

A survey of 286 HIV care sites in 45 countries showed that from 2014-2015 to 2017, there was a notable increase in the provision of substance use education (up 9%), screening (up 16%), and referrals (up 8%) for patients, indicating a positive trend in integrating substance use services into HIV care.

Despite these improvements, significant gaps remain, especially in screening and referral services for children and adolescents, and in lower-income countries, highlighting the need for continued efforts to enhance these services in resource-constrained settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Substance use service availability in HIV treatment programs: Data from the global IeDEA consortium, 2014-2015 and 2017. Parcesepe, AM., Lancaster, K., Edelman, EJ., et al.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

Substance use service availability in HIV treatment programs: Data from the global IeDEA consortium, 2014-2015 and 2017. [2023]

2. England pubmed.ncbi.nlm.nih.gov

Excess mortality among HIV-infected patients diagnosed with substance use dependence or abuse receiving care in a fully integrated medical care program. [2021]

3. Ireland pubmed.ncbi.nlm.nih.gov

Substance use among HIV-infected patients in Rio de Janeiro, Brazil: Agreement between medical records and the ASSIST questionnaire. [2018]

4. Ireland pubmed.ncbi.nlm.nih.gov

Predictors of substance use frequency and reductions in seriousness of use among persons living with HIV. [2022]

5. England pubmed.ncbi.nlm.nih.gov

Integrated HIV care is associated with improved engagement in treatment in an urban methadone clinic. [2018]

6. England pubmed.ncbi.nlm.nih.gov

Viral suppression and antiretroviral medication adherence among alcohol using HIV-positive adults. [2022]

7. Italy pubmed.ncbi.nlm.nih.gov

Illicit drugs, alcohol, and addiction in human immunodeficiency virus. [2016]

8. United States pubmed.ncbi.nlm.nih.gov

Prevalence and Predictors of Substance Use Disorders Among HIV Care Enrollees in the United States. [2022]