2024
Integrating methadone into primary care settings in Ukraine: effects on provider stigma and knowledge
Bromberg D, Machavariani E, Madden L, Dumchev K, LaMonaca K, Earnshaw V, Pykalo I, Filippovych M, Haddad M, Dvoriak S, Altice F. Integrating methadone into primary care settings in Ukraine: effects on provider stigma and knowledge. Journal Of The International AIDS Society 2024, 27: e26202. PMID: 38379179, PMCID: PMC10879646, DOI: 10.1002/jia2.26202.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidHIV InfectionsHumansMethadonePrimary Health CareSubstance Abuse, IntravenousUkraineConceptsPrimary care clinicsStigma reduction interventionsOpioid agonist therapyClinicians' attitudesStigma constructsHIV preventionReduction interventionsEvidence-based HIV preventionCluster randomized controlled trialEvidence-based carePrimary care settingIntegrated care sitesDirect providersRandomized controlled trialsProvider stigmaCare clinicsCare sitesHIV careCare settingsHealth outcomesClinical staffSubstance use disordersLinear mixed-effects modelsTreatment continuumImprove attitudes
2023
High perceived stress in patients on opioid agonist therapies during rapid transitional response to the COVID-19 pandemic in Ukraine
Galvez S, Altice F, Meteliuk A, Ivasiy R, Machavariani E, Farnum S, Fomenko T, Islam Z, Madden L. High perceived stress in patients on opioid agonist therapies during rapid transitional response to the COVID-19 pandemic in Ukraine. Frontiers In Public Health 2023, 11: 1231581. PMID: 38098837, PMCID: PMC10720365, DOI: 10.3389/fpubh.2023.1231581.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidCOVID-19HumansOpioid-Related DisordersPandemicsStress, PsychologicalSubstance Abuse, IntravenousUkraineConceptsOpioid agonist therapyOpioid use disorderAgonist therapyOAT patientsCOVID-19 pandemicSubstance useTake-home dosingAdditional psychosocial supportHigher perceived stressHigh riskPerceived Stress ScalePsychiatric disordersUse disordersPatientsPatient stressPsychosocial supportCertain subgroupsSevere levelsHigh levelsHealthcare deliveryStress ScalePerceived stressTherapyExtraordinary high levelsDisordersEarly disruptions to syringe services programs during the Russian invasion of Ukraine
Nikitin B, Bromberg D, Pykalo I, Ivasiy R, Islam Z, Altice F. Early disruptions to syringe services programs during the Russian invasion of Ukraine. Frontiers In Public Health 2023, 11: 1229057. PMID: 38074770, PMCID: PMC10702598, DOI: 10.3389/fpubh.2023.1229057.Peer-Reviewed Original ResearchConceptsSyringe service programsHIV prevention servicesHarm reduction servicesService programsWidespread HIV epidemicsSemi-structured interviewsIllicit drug usePreventive servicesHIV/AIDS preventionOutreach workersHIV epidemicReduction servicesClients transitionClient’s opennessHIV outbreakService provisionUnique clientsDrug useInterviewsPWIDHarmServicesNGO supportClientsInjection paraphernaliaChallenges to Achieving HCV Micro-Elimination in People With HIV in the United States: Provider Perspectives and the Role of Implicit Bias
DiDomizio E, Chandra D, Nichols L, Villanueva M, Altice F. Challenges to Achieving HCV Micro-Elimination in People With HIV in the United States: Provider Perspectives and the Role of Implicit Bias. Health Promotion Practice 2023, 24: 998-1008. PMID: 37440258, DOI: 10.1177/15248399231169928.Peer-Reviewed Original ResearchMeSH KeywordsBias, ImplicitDrug UsersHepacivirusHepatitis CHIV InfectionsHumansSubstance Abuse, IntravenousUnited StatesConceptsNominal group techniqueHealth care decisionsProvider perspectivesEligibility criteriaHIV/HCVEffective antiviral medicationsPatient eligibility criteriaFacilitators of treatmentMicro-EliminationHCV treatmentAntiviral medicationsOpioid epidemicProvider knowledgePatient involvementPatient engagementDifferent clinicsRelated stigmaHCVCare decisionsHIVPatientsTreatmentGroup sessionsMost barriersFocus group sessionsDesign, implementation and preliminary results of a type-2 hybrid cluster-randomized trial of integrating screening and treatment for major depressive disorder into specialty clinics providing opioid agonist therapies in Ukraine
Machavariani E, Bromberg D, Dumchev K, Dvoriak S, Zeziulin O, Morozova O, Esserman D, Pykalo I, Saichuk N, Ivasiy R, Haddad M, Altice F. Design, implementation and preliminary results of a type-2 hybrid cluster-randomized trial of integrating screening and treatment for major depressive disorder into specialty clinics providing opioid agonist therapies in Ukraine. Contemporary Clinical Trials 2023, 131: 107248. PMID: 37263492, PMCID: PMC10527419, DOI: 10.1016/j.cct.2023.107248.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidDepressive Disorder, MajorHumansOpioid-Related DisordersSubstance Abuse, IntravenousUkraineConceptsOpioid agonist therapyMajor depressive disorderCo-occurring disordersAgonist therapyDepressive disorderSpecialty clinicPsychiatric disordersPatient-level outcomesPrevalent psychiatric disordersCluster-randomized trialPoor health outcomesProvider-level dataMDD treatmentTreatment algorithmExperimental armHigh prevalenceDelivery outcomesHealth outcomesSerial surveysClinicPatientsProject ECHOSubstance useMonthsDisordersModelling the impact and cost‐effectiveness of non‐governmental organizations on HIV and HCV transmission among people who inject drugs in Ukraine
Stone J, Trickey A, Walker J, Bivegete S, Semchuk N, Sazonova Y, Varetska O, Altice F, Saliuk T, Vickerman P. Modelling the impact and cost‐effectiveness of non‐governmental organizations on HIV and HCV transmission among people who inject drugs in Ukraine. Journal Of The International AIDS Society 2023, 26: e26073. PMID: 37012669, PMCID: PMC10070931, DOI: 10.1002/jia2.26073.Peer-Reviewed Original ResearchMeSH KeywordsCost-Benefit AnalysisDrug UsersHepacivirusHepatitis CHIV InfectionsHumansSubstance Abuse, IntravenousUkraineConceptsAntiretroviral therapyHepatitis C virusHCV incidenceHCV infectionHIV/HCV testingHIV/HCV infectionHCV transmission modelNeedles/syringesHCV testingHCV eliminationHCV transmissionAgonist treatmentC virusNew HIVHigh prevalencePWIDHIVCondom useSubstantial detrimental impactInfectionIncidencePreventative impactDrugsCoverage levelsDALYs
2022
Using nominal group technique to identify barriers and facilitators to preventing HIV using combination same-day pre-exposure prophylaxis and medications for opioid use disorder
Eger WH, Altice FL, Lee J, Vlahov D, Khati A, Osborne S, Wickersham JA, Bohonnon T, Powell L, Shrestha R. Using nominal group technique to identify barriers and facilitators to preventing HIV using combination same-day pre-exposure prophylaxis and medications for opioid use disorder. Harm Reduction Journal 2022, 19: 120. PMID: 36307817, PMCID: PMC9616614, DOI: 10.1186/s12954-022-00703-8.Peer-Reviewed Original ResearchMeSH KeywordsAnti-HIV AgentsHIV InfectionsHumansOpioid-Related DisordersPre-Exposure ProphylaxisSubstance Abuse, IntravenousConceptsSame-day prescriptionPre-exposure prophylaxisOpioid use disorderHIV transmissionUse disordersClinical stakeholdersAvailability of providersSystems of careHealth care systemCoordinated careNew practice modelClinical careMedicationsPharmacy deliveryMOUDNominal group techniqueLocal prescribersPWIDSexual riskPrEPCare systemHealth benefitsCareMultiple visitsProphylaxisReinfection and Risk Behaviors After Treatment of Hepatitis C Virus Infection in Persons Receiving Opioid Agonist Therapy : A Cohort Study.
Grebely J, Dore GJ, Altice FL, Conway B, Litwin AH, Norton BL, Dalgard O, Gane EJ, Shibolet O, Nahass R, Luetkemeyer AF, Peng CY, Iser D, Gendrano IN, Kelly MM, Hwang P, Asante-Appiah E, Haber BA, Barr E, Robertson MN, Platt H. Reinfection and Risk Behaviors After Treatment of Hepatitis C Virus Infection in Persons Receiving Opioid Agonist Therapy : A Cohort Study. Annals Of Internal Medicine 2022, 175: 1221-1229. PMID: 35939812, DOI: 10.7326/m21-4119.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAnalgesics, OpioidCohort StudiesHepatitis C, ChronicHumansReinfectionRisk-TakingSubstance Abuse, IntravenousConceptsOpioid agonist therapyLong-term extension studyHCV reinfectionDrug useExtension studyAgonist therapySuccessful treatmentHepatitis C virus (HCV) reinfectionHepatitis C virus infectionBenefits of cureC virus infectionChronic HCV infectionRate of reinfectionUrine drug screeningOngoing drug useClinical trial sitesSubsidiary of MerckHCV infectionCohort studyVirus reinfectionDohme Corp.Treatment completionGenotype 1Virus infectionHigh riskHIV, substance use, and mental health care in prisons
Fazel S, Bromberg DJ, Altice FL. HIV, substance use, and mental health care in prisons. The Lancet Psychiatry 2022, 9: 694-695. PMID: 35843228, PMCID: PMC9827418, DOI: 10.1016/s2215-0366(22)00243-7.Peer-Reviewed Original ResearchHIV InfectionsHumansMental HealthPrisonersPrisonsSubstance Abuse, IntravenousSubstance-Related DisordersExtending a lifeline to people with HIV and opioid use disorder during the war in Ukraine
Altice FL, Bromberg DJ, Dvoriak S, Meteliuk A, Pykalo I, Islam Z, Azbel L, Madden LM. Extending a lifeline to people with HIV and opioid use disorder during the war in Ukraine. The Lancet Public Health 2022, 7: e482-e484. PMID: 35358424, PMCID: PMC9818031, DOI: 10.1016/s2468-2667(22)00083-4.Peer-Reviewed Original Research
2021
Treatment of Hepatitis C virus among people who inject drugs at a syringe service program during the COVID-19 response: The potential role of telehealth, medications for opioid use disorder and minimal demands on patients
Sivakumar A, Madden L, DiDomizio E, Eller A, Villanueva M, Altice FL. Treatment of Hepatitis C virus among people who inject drugs at a syringe service program during the COVID-19 response: The potential role of telehealth, medications for opioid use disorder and minimal demands on patients. International Journal Of Drug Policy 2021, 101: 103570. PMID: 34954493, PMCID: PMC8685180, DOI: 10.1016/j.drugpo.2021.103570.Peer-Reviewed Original ResearchConceptsOpioid use disorderHepatitis C virusSyringe services programDifferentiated care modelPerson visitsC virusCare modelUse disordersInitiation of DAAChronic HCV infectionEvidence-based treatmentsCOVID-19Initial phlebotomyVirological responseHCV infectionHCV treatmentAdditional patientsElevated riskPatientsClient-centred approachPWIDHIVPerson contactTreatment demandLaboratory screeningMethadone within prison and linkage to and retention in treatment upon community release for people with opioid use disorder in Kyrgyzstan: Evaluation of a national program
Bachireddy C, Shrestha R, Bromberg DJ, Azbel L, Kurmanalieva A, Wegman M, Shumskaya N, Rozanova J, Meyer JP, Altice FL. Methadone within prison and linkage to and retention in treatment upon community release for people with opioid use disorder in Kyrgyzstan: Evaluation of a national program. International Journal Of Drug Policy 2021, 101: 103558. PMID: 34915426, PMCID: PMC9998103, DOI: 10.1016/j.drugpo.2021.103558.Peer-Reviewed Original ResearchMeSH KeywordsFemaleHIV InfectionsHumansKyrgyzstanMaleMethadoneOpioid-Related DisordersPrisonersPrisonsRetrospective StudiesSubstance Abuse, IntravenousConceptsHIV statusMean treatment durationOpioid use disorderPositive HIV statusDuration of treatmentMethadone doseHIV incidenceMethadone servicesMethadone treatmentIndependent correlatesHIV preventionUse disordersTreatment durationMethadoneNational programTreatmentHIVAdministrative dataCommunity releaseMonthsKyrgyz prisonsFirst evaluationIncarcerated peopleDurationReleaseCosts and impact on HIV transmission of a switch from a criminalisation to a public health approach to injecting drug use in eastern Europe and central Asia: a modelling analysis
Ward Z, Stone J, Bishop C, Ivakin V, Eritsyan K, Deryabina A, Low A, Cepeda J, Kelly SL, Heimer R, Cook R, Altice FL, Litz T, Terlikbayeva A, El-Bassel N, Havarkov D, Fisenka A, Boshnakova A, Klepikov A, Saliuk T, Deshko T, Vickerman P. Costs and impact on HIV transmission of a switch from a criminalisation to a public health approach to injecting drug use in eastern Europe and central Asia: a modelling analysis. The Lancet HIV 2021, 9: e42-e53. PMID: 34895484, PMCID: PMC8762142, DOI: 10.1016/s2352-3018(21)00274-5.Peer-Reviewed Original ResearchMeSH KeywordsAsiaCost-Benefit AnalysisEurope, EasternHIV InfectionsHumansPublic HealthSubstance Abuse, IntravenousSubstance-Related DisordersConceptsOpioid agonist therapyAgonist therapyAntiretroviral therapyPublic health approachHIV transmissionDrug useDynamic HIV transmission modelHealth approachIncremental cost-effectiveness ratioHIV transmission modelNational InstituteCost-effectiveness ratioCountry-specific costsHIV incidenceUNAIDS 90US National InstitutesART coverageWHO targetPWIDTherapyPay thresholdsInfectious diseasesCost savingsDrug abuseIncremental costMulti-level implementation factors that influence scale-up of methadone maintenance treatment in Moldovan prisons: A qualitative study
O'Hara GL, Liberman AR, Polonsky M, Azbel L, Marcus R, Doltu S, Cugut S, Altice FL. Multi-level implementation factors that influence scale-up of methadone maintenance treatment in Moldovan prisons: A qualitative study. Journal Of Substance Use And Addiction Treatment 2021, 136: 108660. PMID: 34801282, PMCID: PMC10879837, DOI: 10.1016/j.jsat.2021.108660.Peer-Reviewed Original ResearchMeSH KeywordsHIV InfectionsHumansMethadoneOpiate Substitution TreatmentPrisonersPrisonsSubstance Abuse, IntravenousConceptsMethadone maintenance treatmentCentral Asian regionNegative personal attitudesPrison hierarchySocial forcesInformal hierarchyMaintenance treatmentThematic barriersQualitative interviewsPrison populationInterview dataAsian regionPrisonPrison settingQualitative studyQuantitative surveyKey barriersNew HIV infectionsOpioid use disorderContent analysisComplete interview dataQualitative analysisDistrustPersonal attitudesPrisonersSuccessful transfer of stable patients on opioid agonist therapies from specialty addiction treatment to primary care settings in Ukraine: A pilot study
Meteliuk A, Galvez S, Fomenko T, Kalandiia H, Iaryi V, Farnum SO, Islam Z, Altice FL, Madden LM. Successful transfer of stable patients on opioid agonist therapies from specialty addiction treatment to primary care settings in Ukraine: A pilot study. Journal Of Substance Use And Addiction Treatment 2021, 134: 108619. PMID: 34579978, DOI: 10.1016/j.jsat.2021.108619.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnalgesics, OpioidFemaleHIV InfectionsHumansMaleOpiate Substitution TreatmentOpioid-Related DisordersPilot ProjectsPrimary Health CareSubstance Abuse, IntravenousUkraineConceptsOpioid agonist therapyPrimary care clinicsPrimary care settingOAT coverageAgonist therapyStable patientsCare clinicsSubstance useCare settingsNegative urine drug testsSpecialty addictions treatmentUrine drug testsSymptom Identification ScaleMental health symptomsAddiction treatment clinicsHIV transmissionPrimary careTreatment clinicsOAT patientsBASIS-24PatientsHealth symptomsEmotional labilityAddiction treatmentPilot studyAcceptability of an mHealth App That Provides Harm Reduction Services Among People Who Inject Drugs: Survey Study
Shelby T, Zhou X, Barber D, Altice F. Acceptability of an mHealth App That Provides Harm Reduction Services Among People Who Inject Drugs: Survey Study. Journal Of Medical Internet Research 2021, 23: e25428. PMID: 34259640, PMCID: PMC8319773, DOI: 10.2196/25428.Peer-Reviewed Original ResearchMeSH KeywordsHarm ReductionHIV InfectionsHumansMaleMiddle AgedMobile ApplicationsPharmaceutical PreparationsSubstance Abuse, IntravenousSurveys and QuestionnairesTelemedicineConceptsSyringe services programHarm reduction servicesReduction servicesSecondary outcomesMHealth appsParticipant characteristicsHarm reduction needsHome deliveryMost participantsRespondent-driven samplingPrimary outcomeSuboptimal accessIndependent correlatesMedical recordsDrug injectionMobile health appsPWIDSummary scoresMedication remindersSSP usePoisson regressionUnstable housingVulnerable populationsSyringe deliveryHealth appsPurposeful Fentanyl Use and Associated Factors among Opioid-Dependent People Who Inject Drugs
Chandra DK, Altice FL, Copenhaver MM, Zhou X, Didomizio E, Shrestha R. Purposeful Fentanyl Use and Associated Factors among Opioid-Dependent People Who Inject Drugs. Substance Use & Misuse 2021, 56: 979-987. PMID: 33769199, DOI: 10.1080/10826084.2021.1901931.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidConnecticutCross-Sectional StudiesFentanylHumansOpioid-Related DisordersPharmaceutical PreparationsSubstance Abuse, IntravenousConceptsOpioid-dependent PWIDFentanyl useOpioid-dependent peopleIndependent correlatesSevere depressionSex-related risk behaviorsMethadone-maintained patientsMultivariable logistic regressionOpioid-related mortalityRecent cocaine useCross-sectional surveySelf-reported drugMethadone dosageYoung PWIDDaily injectionsMethadone clinicsAssociated FactorsFentanyl exposureHigh prevalencePWIDSynthetic opioidsCocaine useYounger ageRisk behaviorsLogistic regressionUse of Pre-exposure Prophylaxis Among People Who Inject Drugs: Exploratory Findings of the Interaction Between Race, Homelessness, and Trust
Zhou X, Altice FL, Chandra D, Didomizio E, Copenhaver MM, Shrestha R. Use of Pre-exposure Prophylaxis Among People Who Inject Drugs: Exploratory Findings of the Interaction Between Race, Homelessness, and Trust. AIDS And Behavior 2021, 25: 3743-3753. PMID: 33751313, DOI: 10.1007/s10461-021-03227-7.Peer-Reviewed Original ResearchMeSH KeywordsAnti-HIV AgentsCross-Sectional StudiesHIV InfectionsHumansIll-Housed PersonsPharmaceutical PreparationsPre-Exposure ProphylaxisSubstance Abuse, IntravenousTrustConceptsPre-exposure prophylaxisPrEP useProvider trustPatient-level factorsOpioid-dependent patientsLogistic regression analysisNon-homeless participantsHomeless participantsRace/ethnicityEligibility criteriaCross-sectional dataPrEPProphylaxisMethadoneRegression analysisDrugsExploratory findingsParticipantsPotential moderatorsPWIDPatientsSignificant moderatorModelling the intervention effect of opioid agonist treatment on multiple mortality outcomes in people who inject drugs: a three-setting analysis
Stone J, Degenhardt L, Grebely J, Larney S, Altice FL, Smyrnov P, Rahimi-Movaghar A, Alavi M, Young AM, Havens JR, Miller WC, Hickman M, Vickerman P. Modelling the intervention effect of opioid agonist treatment on multiple mortality outcomes in people who inject drugs: a three-setting analysis. The Lancet Psychiatry 2021, 8: 301-309. PMID: 33640039, PMCID: PMC8255389, DOI: 10.1016/s2215-0366(20)30538-1.Peer-Reviewed Original ResearchConceptsOpioid agonist treatmentDrug-related deathsOAT coverageDrug-related harmAgonist treatmentHepatitis C virus transmissionC virus transmissionOverall health benefitsUK National InstituteNational InstituteHIV 0OAT retentionHIV mortalityInjury 3Opioid dependenceMortality outcomesUS National InstitutesHCV-2Overdose deathsSignificant additional effectIntervention effectsDrug abuseHealth benefitsMortalityDeath
2020
A qualitative study of diphenhydramine injection in Kyrgyz prisons and implications for harm reduction
Meyer JP, Culbert GJ, Azbel L, Bachireddy C, Kurmanalieva A, Rhodes T, Altice FL. A qualitative study of diphenhydramine injection in Kyrgyz prisons and implications for harm reduction. Harm Reduction Journal 2020, 17: 86. PMID: 33129341, PMCID: PMC7603760, DOI: 10.1186/s12954-020-00435-7.Peer-Reviewed Original ResearchMeSH KeywordsDiphenhydramineFemaleHarm ReductionHIV InfectionsHumansMalePrisonersPrisonsSubstance Abuse, IntravenousConceptsNeedle/syringe programsMethadone maintenance therapyHIV prevention effortsMental health consequencesDiphenhydramine injectionMaintenance therapyOpioid dependenceHIV transmissionState of euphoriaSyringe programsIllicit injectionSkin infectionsMethadone utilizationStudy participantsHarmful drugsHealth consequencesMethadonePrevention effortsHarm reductionAntihistaminesInjectionFurther investigationKyrgyz prisonsVisible woundsQualitative study