Pathways to Prevention - Abstract: Pathways to Prevention Project Summary: San Antonio Metropolitan Health District (SAMHD), in collaboration with partnering organizations, will offer the Pathways to Prevention Project in Bexar County, Texas, to prevent and reduce opioid substance use, raise awareness about HIV/STD/VH, and provide linkage to service provisions to at-risk, racial/ethnic minority, 13-24 years of age youth and young adults who identify as MSM, HRH, CSW, PWID, and/or TG. Problem: Opioid substance use (OSU) and HIV infection have a syndemic relationship in that PLWH are at risk for opioid-related complications including opioid misuse, addiction, and overdose (Clark, J., Fairbairn, N., et. al. 2019). Additionally, OSU has continued to increase in Bexar County and contributes to more than 10% of HIV exposures, with 5.6% identified specifically among MSM/PWID (Texas DSHS 2016; Texas DSHS 2018). Bexar County youth are especially at high risk due to (1) early initiation of opioid use with an average age of first use of 13.5 years of age (Marchbanks, M.P., Peairson, S., et. al. 2018) and (2) HIV infection due to the 21.9 cases/100,000 identified in 2018 (Texas DSHS 2018). Project objectives include (1) providing HIV/STD/VH testing to 1500, at-risk, racial/ethnic minority, youth and young adults, 13-24 years of age (FY1:225, FY2:300, FY3:550, FY4:300, FY5:225) in Bexar County, (2) providing opioid misuse prevention education to prevent OSU and comorbidity of OSU and HIV to 700 unduplicated, at-risk, racial/ethnic minority, youth and young adults, 13-24 years of age (FY1:115, FY2:150, FY3:170, FY4:150, FY5:115) who identify as MSM, HRH, CSW, PWID, and/or TG and 70 pharmacist and medical providers (FY1:10, FY2:15, FY3:20, FY4:15, FY5:10) through the University of Texas at San Antonio (UTSA); (3) provide linkage to services to PLWH through HIV specialty and primary care service providers to the San Antonio AIDS Foundation (SAAF) and Centromed’s Santa Rosa Clinic, (4) provide linkage to substance use treatment through the Best Option, LLC. Strategies: The evidence-based prevention curriculum will focus on preventing and reducing OSU and be tailored to the needs of the target population. EBP participant’s behaviors and beliefs will be assessed using the Center for Substance Abuse Prevention’s Youth & Adult National Outcome Measures, administered at baseline and 3 month follow up, and local risk-assessment forms. Change in pharmaceutical and medical provider opioid prescription practices will be assessed by local assessment and evaluation forms.
