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PrEP and MOUD Rapid Access for Persons who Inject Drugs: the CHORUS+ Study

Award Number: R01DA058367
ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/01/2023
PERIOD OF PERFORMANCE END DATE: 06/30/2028

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PrEP and MOUD Rapid Access for Persons who Inject Drugs: the CHORUS+ Study - PROJECT SUMMARY / ABSTRACT The US opioid overdose epidemic has been accompanied by an increase in human immunodeficiency (HIV) among persons who inject drugs. The co-occurrence of HIV and opioid use disorder (OUD) suggests that a comprehensive approach to OUD and its infectious complications has the potential to improve outcomes. HIV pre-exposure prophylaxis (PrEP) and medication for opioid use disorder (MOUD) are evidence-based approaches that are recommended for persons who inject drugs. Unfortunately, these measures have not been widely adopted in real-world settings or accessed by persons at-risk. Foundation for the Proposal: The CHORUS intervention (Comprehensive HIV and Opioid use disorder Response to the Unaddressed Syndemic) is informed by preliminary research, including: (a) quantitative and qualitative research with persons with substance use disorder, (b) a randomized controlled trial of a peer-delivered motivational intervention demonstrating effectiveness in reducing heroin and/or cocaine use, and (c) preliminary studies demonstrating the feasibility and acceptability of peer-delivered motivational interventions in non-traditional settings. During the CHORUS pilot phase, we uncovered that PrEP was initiated late in the intervention. Therefore, we are attempting to accelerate PrEP initiation by providing HIV self-testing (CHORUS +) at baseline. The CHORUS+ intervention includes HIV self-testing, rapid initiation of PrEP and MOUD, and a 6-month peer recovery coach to support adherence to these medications. Conceptual Model: CHORUS+ is a theory-based, peer-delivered, mobile phone-supported intervention focused on enhancing uptake and adherence to HIV PrEP (primary outcome), and receipt of MOUD (secondary outcome) among persons who inject opioids. CHORUS+ aims to improve behavioral skills and self-efficacy while addressing structural barriers. Summary: The current proposal seeks to determine the efficacy of a novel intervention to increase the uptake of evidence-based measures to prevent HIV and treat opioid use disorder. We will compare the CHORUS+ intervention to usual care (passive referral) among persons who inject opioids (aim 1). In addition, we will examine study implementation to facilitate potential future dissemination using a mixed-methods process evaluation of CHORUS+ (aim 2). The study will be performed at Boston Medical Center’s Faster Paths clinic, a low-barrier substance use disorder bridge clinic, and through Victory Programs, which utilizes a mobile outreach van. The proposed intervention will recruit from non-traditional settings in order to reach participants who might not be comfortable in office- based clinics. This project specifically addresses NIDA’s mission of developing effective socio-behavioral interventions to increase uptake of HIV prevention strategies, and accelerating the adoption of evidence-based interventions to address substance use and its infectious complications.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $1,068,172 )
2026	2026	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL	BOSTON	MA	02118	SUFFOLK	USA	Drug Use and Addiction Research Programs	000	4	7/6/2026	NON-COMPETING CONTINUATION	$1,068,172
														Subtotal = $1,068,172

Issue Date FY: 2025 ( Subtotal = $1,113,072 )
2025	2025	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL	BOSTON	MA	02118	SUFFOLK	USA	Drug Use and Addiction Research Programs	000	3	6/18/2025	NON-COMPETING CONTINUATION	$1,113,072
														Subtotal = $1,113,072

Issue Date FY: 2024 ( Subtotal = $1,209,970 )
2024	2024	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL	BOSTON	MA	02118	SUFFOLK	USA	Drug Use and Addiction Research Programs	000	2	6/17/2024	NON-COMPETING CONTINUATION	$1,209,970
														Subtotal = $1,209,970

Issue Date FY: 2023 ( Subtotal = $952,946 )
2023	2023	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL	BOSTON	MA	02118	SUFFOLK	USA	Drug Use and Addiction Research Programs	000	1	8/31/2023	NEW	$952,946
														Subtotal = $952,946

Grand Total All Awards = $4,344,160

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PrEP and MOUD Rapid Access for Persons who Inject Drugs: the CHORUS+ Study

Award Number: R01DA058367

ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/01/2023

PERIOD OF PERFORMANCE END DATE: 06/30/2028

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