2024
Comparing the brief Holistic Health for HIV (3H+) to the Holistic Health Recovery Program (HHRP+) among people with HIV and opioid use disorder: Results from a randomized, controlled non-inferiority trial
Zelenev A, Huedo-Medina T, Shrestha R, Mistler C, Altice F, Sibilio B, Copenhaver M. Comparing the brief Holistic Health for HIV (3H+) to the Holistic Health Recovery Program (HHRP+) among people with HIV and opioid use disorder: Results from a randomized, controlled non-inferiority trial. PLOS ONE 2024, 19: e0312165. PMID: 39509356, PMCID: PMC11542883, DOI: 10.1371/journal.pone.0312165.Peer-Reviewed Original ResearchConceptsHolistic Health Recovery ProgramEvidence-based interventionsHolistic healthHIV treatmentRisk behaviorsReduce HIV risk behaviorsDifference-in-differencesEnd-of-interventionControlled non-inferiority trialHIV Epidemic goalsDrug treatment settingsAttainment of viral suppressionNon-inferiority trialRecovery programViral suppressionHigh ART adherenceHIV risk behaviorsNon-inferiorityHHRP+ART adherenceBehavioral interventionsReal-world settingsNon-parametric bootstrappingCondom useOpioid-dependent people
2022
Prevalence and Correlates of Active Amphetamine-Type Stimulant Use Among Female Sex Workers in Malaysia
Pedersen CJ, Wickersham JA, Altice FL, Kamarulzaman A, Khoshnood K, Gibson BA, Khati A, Maviglia F, Shrestha R. Prevalence and Correlates of Active Amphetamine-Type Stimulant Use Among Female Sex Workers in Malaysia. Frontiers In Psychiatry 2022, 13: 879479. PMID: 35774093, PMCID: PMC9237260, DOI: 10.3389/fpsyt.2022.879479.Peer-Reviewed Original ResearchFemale sex workersATS useSubstance use disordersAmphetamine-type stimulantsUse disordersSevere substance use disordersAmphetamine-type stimulant useSex workersAdverse health outcomesLogistic regression analysisAdverse health consequencesSexual risk behaviorsBehavioral health issuesUse of drugsHarm reduction strategiesSex work clientsRespondent-driven samplingHIV transmissionMultivariable modelHigh prevalenceHealth outcomesDrug useSex workTransgender womenRisk behaviorsRace, Trust, and COVID-19 Vaccine Hesitancy in People with Opioid Use Disorder
Sullivan MC, Mistler C, Copenhaver MM, Wickersham JA, Ni Z, Kim RS, Shrestha R. Race, Trust, and COVID-19 Vaccine Hesitancy in People with Opioid Use Disorder. Health Psychology 2022, 41: 115-120. PMID: 34855415, PMCID: PMC9754617, DOI: 10.1037/hea0001120.Peer-Reviewed Original ResearchConceptsOpioid use disorderMethadone maintenance programEffective vaccineVaccine hesitancyUse disordersCOVID-19 vaccine hesitancyInjection drug useEffective COVID-19 vaccineCoronavirus disease 2019COVID-19 vaccineCOVID-19Sexual risk behaviorsSocial risk factorsVaccine uptakeRisk factorsVaccination willingnessRisk groupsDisease 2019Psychosocial factorsDrug useProactive outreachPhysician ScaleRisk behaviorsHealth disparitiesVaccine
2021
Purposeful 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 ResearchConceptsOpioid-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 regressionWillingness to initiate pre-exposure prophylaxis (PrEP) and its use among opioid-dependent individuals in drug treatment
Ni Z, Altice FL, Wickersham JA, Copenhaver MM, DiDomizio EE, Nelson LE, Shrestha R. Willingness to initiate pre-exposure prophylaxis (PrEP) and its use among opioid-dependent individuals in drug treatment. Drug And Alcohol Dependence 2021, 219: 108477. PMID: 33422864, PMCID: PMC7946167, DOI: 10.1016/j.drugalcdep.2020.108477.Peer-Reviewed Original ResearchConceptsOpioid-dependent individualsPre-exposure prophylaxisPrEP useHIV riskHealthcare providersSex-related risk behaviorsMultivariable logistic regression analysisAwareness of PrEPUrban methadone clinicMultiple logistic regressionDisproportionate HIV burdenLogistic regression analysisCross-sectional surveyHIV burdenHIV infectionHIV testingIndependent correlatesMethadone clinicsDrug treatmentRisk behaviorsLogistic regressionPrEPPrevious useHigher likelihoodProphylaxis
2019
Use of Smartphone to Seek Sexual Health Information Online Among Malaysian Men Who Have Sex with Men (MSM): Implications for mHealth Intervention to Increase HIV Testing and Reduce HIV Risks
Shrestha R, Lim SH, Altice FL, Copenhaver M, Wickersham JA, Saifi R, Ab Halim MA, Naning H, Kamarulzaman A. Use of Smartphone to Seek Sexual Health Information Online Among Malaysian Men Who Have Sex with Men (MSM): Implications for mHealth Intervention to Increase HIV Testing and Reduce HIV Risks. Journal Of Community Health 2019, 45: 10-19. PMID: 31375976, PMCID: PMC6957731, DOI: 10.1007/s10900-019-00713-x.Peer-Reviewed Original ResearchConceptsSexual health informationHIV testingHealth informationOnline sexual health informationSexual partnersRecent HIV testingHigh-risk MSMHIV/STIsHIV risk behaviorsHIV prevention activitiesCross-sectional online surveyHealth Information OnlineMalaysian MSMSTI preventionIndependent correlatesGeosocial networking appsHIV riskMHealth interventionsMHealth strategiesMHealth toolsRisk behaviorsOlder ageLogistic regressionMSMPrevention activities
2018
HIV Sero-Status Non-disclosure Among HIV-Infected Opioid-Dependent Individuals: The Roles of HIV-Related Stigma, Risk Behavior, and Social Support
Shrestha R, Altice FL, Sibilio B, Copenhaver MM. HIV Sero-Status Non-disclosure Among HIV-Infected Opioid-Dependent Individuals: The Roles of HIV-Related Stigma, Risk Behavior, and Social Support. Journal Of Community Health 2018, 44: 112-120. PMID: 30043195, PMCID: PMC6330145, DOI: 10.1007/s10900-018-0560-7.Peer-Reviewed Original ResearchConceptsOpioid-dependent individualsOpioid-dependent patientsHIV statusFamily/friendsSexual partnersHIV disclosureHIV sero-status disclosureRisk behaviorsHIV sero statusAntiretroviral therapy adherenceHigh-risk HIVRole of HIVMultivariable logistic regressionSubstance abuse treatment settingsHIV risk behaviorsInconsistent condom useMultiple sex partnersSocial supportHigh HIVSero statusHIV transmissionTherapy adherenceIndependent correlatesHIV riskHIV stigmaExploring the Use of Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among High-Risk People Who Use Drugs in Treatment
Shrestha R, Copenhaver M. Exploring the Use of Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among High-Risk People Who Use Drugs in Treatment. Frontiers In Public Health 2018, 6: 195. PMID: 30062091, PMCID: PMC6054971, DOI: 10.3389/fpubh.2018.00195.Peer-Reviewed Original ResearchPre-exposure prophylaxisPrEP adherenceHIV preventionHigh-risk PWUDSubstance abuse treatment settingsUse of PrEPHigh-risk peopleHIV risk behaviorsHIV prevention approachesPrEP servicesDaily dosingPrEP useHigh adherenceDepth semi-structured qualitative interviewsSemi-structured qualitative interviewsTreatment settingsPocket costsRisk behaviorsDisclosure statusPrEPAdherencePrevention approachesProphylaxisPreliminary evidencePWUDIntegrated Bio-behavioral Approach to Improve Adherence to Pre-exposure Prophylaxis and Reduce HIV Risk in People Who Use Drugs: A Pilot Feasibility Study
Shrestha R, Altice FL, Karki P, Copenhaver MM. Integrated Bio-behavioral Approach to Improve Adherence to Pre-exposure Prophylaxis and Reduce HIV Risk in People Who Use Drugs: A Pilot Feasibility Study. AIDS And Behavior 2018, 22: 2640-2649. PMID: 29582199, PMCID: PMC6051885, DOI: 10.1007/s10461-018-2099-0.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnalgesics, OpioidBiobehavioral SciencesCondomsFeasibility StudiesFemaleHIV InfectionsHumansMaleMedication AdherenceMethadoneMiddle AgedMotivationOpiate Substitution TreatmentOpioid-Related DisordersPatient Acceptance of Health CarePilot ProjectsPre-Exposure ProphylaxisProspective StudiesRisk Reduction BehaviorSexual BehaviorSexual PartnersSubstance Abuse, IntravenousConceptsPre-exposure prophylaxis adherenceSelf-reported PrEP adherenceSex-related risk behaviorsHIV risk reduction behaviorsBio-behavioral interventionPre-exposure prophylaxisProspective clinical trialsHigh-risk peopleHIV prevention interventionsHIV risk behaviorsPilot feasibility studyPost-intervention assessmentPrEP adherenceProphylaxis adherencePreliminary efficacyClinical trialsIntervention groupHIV riskPrevention interventionsRisk behaviorsBio-behavioral approachAdherenceInterventionHigh acceptabilityPrEP
2017
Measuring Acceptability and Preferences for Implementation of Pre-Exposure Prophylaxis (PrEP) Using Conjoint Analysis: An Application to Primary HIV Prevention Among High Risk Drug Users
Shrestha R, Karki P, Altice FL, Dubov O, Fraenkel L, Huedo-Medina T, Copenhaver M. Measuring Acceptability and Preferences for Implementation of Pre-Exposure Prophylaxis (PrEP) Using Conjoint Analysis: An Application to Primary HIV Prevention Among High Risk Drug Users. AIDS And Behavior 2017, 22: 1228-1238. PMID: 28695388, PMCID: PMC5762432, DOI: 10.1007/s10461-017-1851-1.Peer-Reviewed Original ResearchConceptsPre-exposure prophylaxisSex-related risk behaviorsHigh-risk drug usersAcceptability of PrEPHigh-risk PWUDPrimary HIV preventionHIV prevention approachesDrug treatment settingsKey risk populationsHIV-negative PWUDHigh acceptabilityHIV clinicPrEP acceptabilityHIV testingPrEP uptakeMethadone clinicsHIV preventionRisk populationsSide effectsTreatment settingsDrug usersPrEP attributesRisk behaviorsPrEPUnderserved populationsDeveloping an Integrated, Brief Biobehavioral HIV Prevention Intervention for High-Risk Drug Users in Treatment: The Process and Outcome of Formative Research
Shrestha R, Altice F, Karki P, Copenhaver M. Developing an Integrated, Brief Biobehavioral HIV Prevention Intervention for High-Risk Drug Users in Treatment: The Process and Outcome of Formative Research. Frontiers In Immunology 2017, 8: 561. PMID: 28553295, PMCID: PMC5425476, DOI: 10.3389/fimmu.2017.00561.Peer-Reviewed Original ResearchNeurocognitive impairmentHigh-risk drug usersBehavioral interventionsHigh-risk PWUDHIV prevention behavioral interventionBiobehavioral approachHIV risk reductionHIV prevention interventionsDrug treatment settingsFormative researchHIV prevention effortsTarget populationPrEP adherencePrEP uptakeRisk reduction outcomesHIV preventionDrug treatmentPrevention interventionsFocus groupsTreatment settingsDrug usersRecovery programStructured focus groupsRisk behaviorsTarget population membersInterest in use of mHealth technology in HIV prevention and associated factors among high-risk drug users enrolled in methadone maintenance program
Shrestha R, Karki P, Copenhaver M. Interest in use of mHealth technology in HIV prevention and associated factors among high-risk drug users enrolled in methadone maintenance program. AIDS Care 2017, 29: 1144-1148. PMID: 28478706, PMCID: PMC6081193, DOI: 10.1080/09540121.2017.1325439.Peer-Reviewed Original ResearchConceptsHigh-risk PWUDMethadone maintenance programHIV preventionMedication remindersHIV risk reduction informationRisk behaviorsSex-related risk behaviorsHigh-risk drug usersMHealth technologiesHIV prevention toolHIV risk reductionHIV prevention approachesHIV risk behaviorsDrug treatment settingsRisk Behavior AssessmentHIV prevention effortsHIV-negative PWUDUse of mHealthNew intervention strategiesDepressive symptomsTreatment settingsDrug usersHealthcare providersMultivariate analysisPrevention effortsDesign and implementation of a factorial randomized controlled trial of methadone maintenance therapy and an evidence-based behavioral intervention for incarcerated people living with HIV and opioid dependence in Malaysia
Bazazi AR, Wickersham JA, Wegman MP, Culbert GJ, Pillai V, Shrestha R, Al-Darraji H, Copenhaver MM, Kamarulzaman A, Altice FL. Design and implementation of a factorial randomized controlled trial of methadone maintenance therapy and an evidence-based behavioral intervention for incarcerated people living with HIV and opioid dependence in Malaysia. Contemporary Clinical Trials 2017, 59: 1-12. PMID: 28479216, PMCID: PMC5557499, DOI: 10.1016/j.cct.2017.05.006.Peer-Reviewed Original ResearchConceptsMethadone maintenance therapyHIV transmission risk behaviorsMaintenance therapyTransmission risk behaviorsEvidence-based behavioral interventionsOpioid dependencePoor HIV treatment outcomesRisk behaviorsBehavioral interventionsHIV treatment outcomesProspective clinical trialsEvidence-based treatmentsHealth-related outcomesOpioid useTreatment receiptClinical trialsTreatment outcomesIncarcerated peopleTherapyStudy participantsFactorial trialHIVTrialsInterventionOutcomesAn explanatory factor analysis of a brief self-report scale to detect neurocognitive impairment among HIV-positive men who have sex with men and transgender women in Peru
Weikum D, Shrestha R, Ferro EG, Vagenas P, Copenhaver M, Spudich S, Alpert MD, Cabello R, Lama JR, Sanchez J, Altice FL. An explanatory factor analysis of a brief self-report scale to detect neurocognitive impairment among HIV-positive men who have sex with men and transgender women in Peru. AIDS Care 2017, 29: 1297-1301. PMID: 28449599, PMCID: PMC6337065, DOI: 10.1080/09540121.2017.1322681.Peer-Reviewed Original ResearchConceptsHIV-positive menNeuropsychological Impairment ScaleNeurocognitive impairmentTransgender womenAntiretroviral therapyHIV-positive MSMPoor clinical outcomeHIV risk behaviorsClinical care settingsHealth-related outcomesExploratory factor analysisART adherenceClinical outcomesPatient populationCare settingsImpairment ScaleRisk behaviorsImpairmentMenPrincipal axis factoringSelf-report scalesOrthogonal varimax rotationWomenBrief self-report scaleOutcomesIntent to Use Preexposure Prophylaxis (PrEP), HIV Risk Behaviors, and Self-Report Neurocognitive Symptoms by High-Risk Drug Users: A Mediation Analysis
Shrestha R, Karki P, Huedo-Medina TB, Copenhaver M. Intent to Use Preexposure Prophylaxis (PrEP), HIV Risk Behaviors, and Self-Report Neurocognitive Symptoms by High-Risk Drug Users: A Mediation Analysis. Journal Of The Association Of Nurses In AIDS Care 2017, 28: 612-621. PMID: 28478870, PMCID: PMC7451137, DOI: 10.1016/j.jana.2017.04.005.Peer-Reviewed Original ResearchConceptsHIV risk behaviorsNeurocognitive impairmentRisk behaviorsPreexposure prophylaxisSelf-reported neurocognitive symptomsHigh-risk drug usersHigh-risk PWUDPrEP uptakeNeurocognitive symptomsHIV riskDrug usersSimilar outcomesUnderserved populationsSignificant correlatesProphylaxisImportant unanswered questionsPreliminary evidencePrEPDissemination effortsMediation analysisUnanswered questionsVariables of interestHIVSymptomsCliniciansCorrelates of willingness to initiate pre-exposure prophylaxis and anticipation of practicing safer drug- and sex-related behaviors among high-risk drug users on methadone treatment
Shrestha R, Karki P, Altice FL, Huedo-Medina TB, Meyer JP, Madden L, Copenhaver M. Correlates of willingness to initiate pre-exposure prophylaxis and anticipation of practicing safer drug- and sex-related behaviors among high-risk drug users on methadone treatment. Drug And Alcohol Dependence 2017, 173: 107-116. PMID: 28214391, PMCID: PMC5366273, DOI: 10.1016/j.drugalcdep.2016.12.023.Peer-Reviewed Original ResearchConceptsPre-exposure prophylaxisHIV risk reductionDrug injectionHIV riskRisk behaviorsHigh-risk drug usersHigh-risk PWUDOpioid-dependent personsHIV prevention approachesRecent risk behaviorsCross-sectional studyConsistent condom useHigh-risk behaviorsRisk reductionCorrelates of willingnessPrEP deliveryMethadone treatmentIndependent correlatesMethadone programsSafe drugElevated riskCasual partnersNeurocognitive impairmentDrug usersKey populations
2016
Examining the Acceptability of mHealth Technology in HIV Prevention Among High-Risk Drug Users in Treatment
Shrestha R, Huedo-Medina TB, Altice FL, Krishnan A, Copenhaver M. Examining the Acceptability of mHealth Technology in HIV Prevention Among High-Risk Drug Users in Treatment. AIDS And Behavior 2016, 21: 3100-3110. PMID: 28025735, PMCID: PMC5484759, DOI: 10.1007/s10461-016-1637-x.Peer-Reviewed Original ResearchMeSH KeywordsAcquired Immunodeficiency SyndromeAdultCell PhoneConnecticutDelivery of Health CareDrug UsersFemaleHIV InfectionsHumansInternetMaleMethadoneNeurocognitive DisordersOpiate Substitution TreatmentPatient Acceptance of Health CarePrevalenceRisk FactorsRisk-TakingSexual BehaviorSmartphoneSubstance Abuse, IntravenousTelemedicineText MessagingConceptsSex-related risk behaviorsNeurocognitive impairmentDrug usersRisk behaviorsHIV-negative drug usersHigh-risk drug usersHigh-risk populationHigh-risk peopleHIV prevention effortsUse of mHealthMethadone clinicsHIV preventionHigh prevalenceMedication remindersHealth programsMHealth acceptancePrevention effortsHealth conditionsMHealth technologiesConvenience sampleDrugsStandardized assessmentReal-world acceptanceMobile healthPhone callsWillingness to Use Pre-Exposure Prophylaxis (PrEP): An Empirical Test of the Information-Motivation-Behavioral Skills (IMB) Model among High-Risk Drug Users in Treatment
Shrestha R, Altice FL, Huedo-Medina TB, Karki P, Copenhaver M. Willingness to Use Pre-Exposure Prophylaxis (PrEP): An Empirical Test of the Information-Motivation-Behavioral Skills (IMB) Model among High-Risk Drug Users in Treatment. AIDS And Behavior 2016, 21: 1299-1308. PMID: 27990587, PMCID: PMC5380590, DOI: 10.1007/s10461-016-1650-0.Peer-Reviewed Original ResearchConceptsHigh-risk PWUDBehavioral skills modelCommunity-based methadone maintenance treatmentPre-exposure prophylaxis trialsSex-related HIV risk behaviorsHigh-risk drug usersPre-exposure prophylaxisIMB modelMethadone maintenance treatmentEfficacy of PrEPUse of PrEPHIV risk behaviorsKey risk populationsHealth behavior changeHIV acquisitionProphylaxis trialsHIV infectionMaintenance treatmentHIV preventionRisk populationsDrug usersRisk behaviorsPrEPPWUDIntervention developmentTreatment Engagement Moderates the Effect of Neurocognitive Impairment on Antiretroviral Therapy Adherence in HIV-Infected Drug Users in Treatment
Shrestha R, Karki P, Huedo-Medina TB, Copenhaver M. Treatment Engagement Moderates the Effect of Neurocognitive Impairment on Antiretroviral Therapy Adherence in HIV-Infected Drug Users in Treatment. Journal Of The Association Of Nurses In AIDS Care 2016, 28: 85-94. PMID: 27769735, PMCID: PMC5183513, DOI: 10.1016/j.jana.2016.09.007.Peer-Reviewed Original ResearchThe Use of Female Sex Workers Among Men in Nepal: Prevalence, STIs/HIV-Related Risk Behaviors, and Gender Ideology
Shrestha R, Karki P, Copenhaver M. The Use of Female Sex Workers Among Men in Nepal: Prevalence, STIs/HIV-Related Risk Behaviors, and Gender Ideology. Primary Prevention Insights 2016, 6: 11-17. PMID: 27358577, PMCID: PMC4922505, DOI: 10.4137/ppri.s39664.Peer-Reviewed Original ResearchFemale sex workersSexual contactRisk behaviorsMultivariate logistic regression modelHistory of STISex workersCigarette smoking statusHealth Survey 2011HIV prevention effortsPrevalence of useMale clientsLogistic regression modelsEarly sexual debutRegression modelsSmoking statusSexual partnersSexual debutWealth indexPrevention effortsHeterosexual sexMenEducational levelPrevalenceTotal sampleEmployment status