Objective:

Assess whether mobile medical units integrating HIV prevention and substance use disorder services, alongside peer navigation, improved outcomes for people who inject drugs and were at risk for HIV.

Approach:

• Study: NIH-funded HPTN 094 enrolled 409 adults without HIV who injected drugs, had opioid use disorder, were not using MOUD at enrollment, and were willing to consider it.
• Intervention and comparison: Across five U.S. cities, participants received 26 weeks of either mobile-unit care combining peer navigation, PrEP, MOUD, and limited clinical and supportive services, or peer navigation linking them to community services.

Key Findings:

• All-cause mortality was 71% lower in the mobile-unit group than in the peer-navigation-only group; this secondary outcome was statistically significant.
• The groups did not differ in daily oral PrEP use or MOUD utilization.
• Verified PrEP uptake was low in both groups. Fourteen percent of participants were using MOUD at both weeks 26 and 52, despite none using MOUD at enrollment.

Interpretation:

Study investigators and NIDA Director Nora D. Volkow said the findings indicate that low-threshold mobile services could save lives. Researchers noted that oral PrEP use was infrequent and called for assessment of long-acting PrEP formulations in this population.

Limitations:

• The article states that replication is necessary.
• The study enrolled a specific population: adults without HIV who injected drugs, had opioid use disorder, were not using MOUD at enrollment, and were willing to consider MOUD.
• PrEP uptake was low, and the study found no between-group difference in PrEP use or MOUD utilization.

Conclusion:

In this trial, integrated care delivered through mobile medical units with peer navigation was associated with lower all-cause mortality than peer navigation linking participants to community services alone.

Sources:

• Article context provided by the user