Community Pharmacy-Based Adaptation and Pilot Testing of Integrated HIV and Substance Use Disorder Care - PROJECT SUMMARY/ABSTRACT Significant gaps in care exist in addressing the intersection of HIV and substance use disorder (SUD) treatment. Despite pharmacists providing evidence-based services for HIV prevention and harm reduction, their potential to reach those with co-occurring HIV and SUD has not been fully realized. Dr. Tarfa, a pharmacist and PhD-trained health services researcher at Yale School of Medicine, is uniquely positioned to adapt and implement an integrated training and service provision program in community pharmacies. Dr. Tarfa’s early work showed that people with HIV are receptive to HIV/SUD care in pharmacies, and community pharmacists are willing to provide this care. The strong mentorship team of this K99/R00 will shape her into an independent investigator by supporting her in all aspects of the project. The team includes Dr. Springer, MD (HIV and addiction medicine), Dr. Rabin, PhD, MPH, PharmD (implementation science), Dr. Carpenter, PhD, MSPH (pharmacy workflow and quantitative methods), and Dr. Opara, PhD, LMSW, MPH (co-design), to leverage all stages of the project. During the K99 phase of this project, with the support of her mentorship team, Dr. Tarfa will receive training in addiction medicine, survey methodology, pharmacy service delivery workflow, co-design participatory research, and implementation science. These trainings will directly support the K99 activities to conduct: (1) a community pharmacy assessment to identify implementation determinants, current HIV/SUD service provision, and readiness for integrated care through a state-wide survey as well as focus groups with pharmacists and people with lived experience of HIV and/or SUD; and (2) utilize Community Engagement Studios for intervention adaptation/co-design including people with lived experience, pharmacists, and clinicians, to refine implementation strategies. The R00 phase will pilot the intervention and evaluate the feasibility, acceptability, and early implementation outcomes using PRISM and RE-AIM frameworks. Service uptake (HIV testing, PrEP initiation, ART provision, SUD screening, naloxone dispensing) and post- implementation interviews with pharmacy staff and service users will assess implementation outcomes and inform further refinement. This K99/R00 aligns with three of NIDA’s five strategic priorities by advancing novel prevention, treatment, and harm reduction strategies; accelerating research at the HIV-SUD intersection; and enhancing real-world implementation of community pharmacies care. The successful completion of this K99/R00 will prepare Dr. Tarfa to become an independent investigator, pioneering and evaluating pharmacy- based interventions that integrate HIV and SUD care. This will lay a strong foundation for future R01-funded research that will drive lasting change in the field.
