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SMART: strengthening motivation and adherence to HIV prevention and treatment among people who use drugs in Atlanta

Award Number: R34DA067290
ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/30/2026
PERIOD OF PERFORMANCE END DATE: 08/31/2029

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SMART: strengthening motivation and adherence to HIV prevention and treatment among people who use drugs in Atlanta - Substance use disorders, HIV and Hepatitis C significantly affect people who use drugs (PWUD). This health burden persists despite available evidence-based interventions such as medications for opioid use disorder (MOUD), highly effective HIV treatment and pre-exposure prophylaxis (PrEP), and vaccination and treatment for viral hepatitis. However, many PWUD, especially unhoused or unstably housed PWUD, still experience barriers consistently accessing and using these services. PWUD have a multitude of daily stressors beyond substance use disorder. An intervention combining stress-reduction and financial incentive components complementing low-threshold services may address these barriers to care. Guided by Andersen’s behavioral model for vulnerable populations, we will develop and pilot test the SMART (Strengthening Motivation and Adherence to HIV PRevention and Treatment) integrated behavioral intervention to promote uptake and adherence to evidence-based clinical services for unhoused or unstably housed PWUD. SMART includes two primary components to address the barriers to uptake and sustained use of HIV care, substance use disorder and hepatitis services: 1) Mindfulness-Oriented Recovery Enhancement (MORE) encompassing mindfulness training, cognitive behavioral therapy, and positive psychology principles; and 2) contingency management, which provides tangible incentives to participants accomplishing desired behavioral milestones. We will partner with GHRC, a community-based provider offering comprehensive HIV/STI prevention and care and substance use disorder services in an Ending the HIV Epidemic in the US (EHE) priority area. We will pursue the following Aims: Aim 1. Develop SMART intervention model. We will iteratively engage GHRC clients, staff, health care providers and a community advisory board to develop, pre-test and finalize the intervention model including the mindfulness and contingency management components. Aim 2. Pilot-test SMART intervention model. Using a pre-and posttest randomized controlled design, we will conduct a 6-month pilot trial among 120 unhoused or unstably housed PWUD. Participants will be randomized 1:1 to SMART intervention or treatment as usual. The pilot trial will generate data on the intervention and trial feasibility, as well as preliminary data on uptake and adherence to clinical services (MOUD, PrEP, HIV and HCV treatment) to inform future large-scale testing and implementation. Aim 3. Assess the model feasibility and implementation. We will assess the feasibility, acceptability and appropriateness of SMART intervention, and identify implementation barriers and strategies to successful adoption and maintenance. The study will advance the EHE strategies of rapid and effective HIV treatment and prevention of new infections via PrEP, HIV treatment and MOUD among PWUD. Findings will inform a future multi-center hybrid implementation-effectiveness study of the intervention.


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: 2027 ( Subtotal = $0 )
2027	2026	FLORIDA STATE UNIVERSITY	874 TRADITIONS WAY	TALLAHASSEE	FL	32306	LEON	USA	Drug Use and Addiction Research Programs	000	1	10/14/2026	NEW	$0
														Subtotal = $0

Issue Date FY: 2026 ( Subtotal = $233,666 )
2026	2026	FLORIDA STATE UNIVERSITY	874 TRADITIONS WAY	TALLAHASSEE	FL	32306	LEON	USA	Drug Use and Addiction Research Programs	000	1	9/17/2026	NEW	$233,666
														Subtotal = $233,666

Grand Total All Awards = $233,666

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SMART: strengthening motivation and adherence to HIV prevention and treatment among people who use drugs in Atlanta

Award Number: R34DA067290

ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 09/30/2026

PERIOD OF PERFORMANCE END DATE: 08/31/2029

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