Developing a Service Planning Tool to Address the Combined HIV and Opioid Epidemics - Abstract The complex relationship between HIV, HCV and opioid use disorder has resulted in an acceleration of several inter-related public health emergencies that include new HIV and HCV infections and unparalleled overdose deaths in the United States. Despite a number of evidence-based practices to address these inter-related epidemics, they are often not adequately scaled to meet the unique needs of the specific community. While evidence-based practices such as opioid agonist therapies, syringe services programs, pre-exposure prophylaxis and antiretroviral therapy are core elements of an HIV prevention and response toolkit, these interventions are often unavailable or under-scaled in many settings. Moreover, other evidence-based practices like overdose education and naloxone distribution and direct-acting antiviral medications for HCV may not tackle HIV related outcomes, but could influence opioid and HCV outcomes, respectively. Determining the scale of each intervention within the constraints of a specific intervention allows a multi-pronged approach to addressing overlapping conditions. Public health and policy experts need new and comprehensive tools to plan an effective strategy to address inter-related risks for diseases that are often financed through different funding streams. Our proposal aims to guide the public health and service planning to response to diverse epidemics. Specifically, this project will: 1) Develop a cost-based epidemiological planning tool to identify the optimal portfolio of EBPs to disrupt the adverse consequences of the HIV, HCV and OUD epidemics in the 50 states. The model will be implemented as an interactive, web-based dashboard to assist policy makers in planning an effective response and provide improved estimates of state-wide and local epidemic trajectories; 2) Conduct early usability and feasibility testing of the dashboard by collaborating with a team of state and local public health officials in order to optimize the future implementation of this dashboard. This portal will disseminate the epidemic model that can be used by local public health experts to test the impact of various HIV and HCV rapid responses through simulation. The proposed study may help guide a more efficient allocation of scarce resources to stem the HIV epidemic and consequently improve health outcomes among PWID in a high-risk HIV setting. As part of this exploratory R21, future directions will include assessing implementation strategies to improve use of the newly developed dashboard to guide a public health response.
