Ending Transmission of HIV, HCV, and STDs and Overdose in Rural Communities of People Who Inject Drugs (ETHIC)

Study Overview
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Brief Summary
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This study will evaluate the referral to harm reduction services (HRS) including syringe services, naloxone overdose prevention, substance use treatment referral, HIV, HCV, and STD testing and referral and linkage to care through capacity building of existing programs through client services data.

Detailed Description
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This is a prospective longitudinal Type 1 Hybrid Implementation Effectiveness Study on the expansion of harm reduction services for people who inject drugs (PWID) and people who use opioids (PWUO) residing in high risk areas of rural southern Illinois. This study record describes one component of the larger Ending transmission of HIV, HCV, and STDs and overdose in rural communities of people who inject drugs (ETHIC) study Community Response Plan (CRP) framework, specifically the expansion of harm reduction services intervention (HRS). The aim is to assess the effectiveness of expansion of evidenced based harm reduction services through our CRP framework comprising: a) geographically targeted recruitment based on hot spot and vulnerability analyses, b) community engagement, c) recruitment via Respondent Driven Sampling (RDS), d) expanded surveillance for HIV and HCV, and e) concomitant HCV and opioid use treatment capacity expansion through the Extension of Community Healthcare Outcomes (ECHO) model. Examination of facilitators and barriers impacting implementation of service delivery is evaluated through mixed methods process evaluation. The Type 1 Hybrid design is supported by conditions including the existing evidence based for benefits and minimal harm of harm reduction services and strong base for applicability of this intervention in the study setting (ie rural opioid use)

Official Title
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Ending Transmission of HIV, HCV, and STDs and Overdose in Rural Communities of People Who Inject Drugs (ETHIC)

Conditions
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HIV, Hepatitis C, Opioid-use Disorder, Injection Drug Use

Intervention / Treatment
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* Behavioral: Referral to harm reduction services


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 15 years of age and older Injected any drug in the past 30 days Used any opioids non-medically in the past 30 days English speaking Able to provide informed consent at the time of the study visit Exclusion Criteria: Less than 15 years of age Not injected any drug in the past 30 days Not used any opioids non-medically in past 30 days Non-English speaking Has not injected any opioid drug to get high in the past 30 days Unable to provide informed consent at the time of the study visit

Ages Eligible for Study
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Minimum Age: 15 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Referral to harm reduction services<br>Participants will be taken through the study survey and interview, blood and urine toxicology testing and given a referral to a harm reduction organization. | Behavioral: Referral to harm reduction services<br>* Participants are referred to harm reduction services<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Referrals to the harm reduction organization | Number of participants who accept referral to the intervention (divided by the total enrolled) | 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of locations where participants received most of syringes or needles |  | 2 years | 
| Number of times clean syringes and/or equipment obtained from an intervention |  | 2 years | 
| Number of times participants used a syringe or needle that they knew was used by somebody else |  | 2 years | 
| Number of times participants used a cotton, cooker, spoon, or water for rinsing or mixing that they knew was used by somebody else |  | 2 years | 
| Number of times participants let someone else use a cotton, cooker, spoon, or water for rinsing or mixing after they used it |  | 2 years | 
| Amount of time to travel to the nearest syringe or needle exchange |  | 2 years | 
| Number of participants that currently have naloxone |  | 2 years | 
| Number of substance use disorders (SUD) treatment referrals made |  | 2 years | 
| Number of HIV screenings and referrals |  | 2 years | 
| Number of HCV screenings and referrals |  | 2 years | 
| Number of participants with knowledge of PrEP |  | 2 years | 
| Number of participants diagnosed with HIV who have access to HIV care |  | 2 years | 
| Number of participants diagnosed with HCV who have access to HCV care |  | 2 years | 
| Number of participants who have condomless sex (vaginal or anal) |  | 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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HIV, Hepatitis C, Opioid-use Disorder, Injection Drug Use, Harm Reduction Services