2023
Application of the multiphase optimisation strategy (MOST) to optimise HIV prevention targeting people on medication for opioid use disorder (MOUD) who have cognitive dysfunction: protocol for a MOST study
Mistler C, Shrestha R, Gunstad J, Collins L, Madden L, Huedo-Medina T, Sibilio B, Copenhaver N, Copenhaver M. Application of the multiphase optimisation strategy (MOST) to optimise HIV prevention targeting people on medication for opioid use disorder (MOUD) who have cognitive dysfunction: protocol for a MOST study. BMJ Open 2023, 13: e071688. PMID: 37399447, PMCID: PMC10314648, DOI: 10.1136/bmjopen-2023-071688.Peer-Reviewed Original ResearchMeSH KeywordsAnti-HIV AgentsCognitive DysfunctionHIV InfectionsHumansOpioid-Related DisordersPre-Exposure ProphylaxisSubstance Abuse, IntravenousConceptsOpioid use disorderMultiphase optimization strategyCognitive dysfunctionHIV preventionUse disordersPromising biomedical interventionsPre-exposure prophylaxisHIV incidence ratesHIV risk reductionHIV prevention interventionsDrug treatment settingsInstitutional review boardInformed consent formPrEP adherenceHIV prevention contentHIV infectionPrEP uptakeStudy protocolIncidence rateRisk groupsPrevention interventionsPWIDTreatment settingsReview boardEffective interventions
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 visitsProphylaxis
2021
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
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 peopleDurationReleaseLimited Risk Compensation Among Women Who Inject Drugs: Results From the Project Sexual Health Equity Preexposure Prophylaxis Demonstration Study in Philadelphia
Tran NK, Van Der Pol B, Shrestha R, Bazzi AR, Bellamy SL, Sherman SG, Roth AM. Limited Risk Compensation Among Women Who Inject Drugs: Results From the Project Sexual Health Equity Preexposure Prophylaxis Demonstration Study in Philadelphia. Sexually Transmitted Diseases 2021, 49: e64-e66. PMID: 34694276, PMCID: PMC9018480, DOI: 10.1097/olq.0000000000001577.Peer-Reviewed Original ResearchMeSH KeywordsFemaleHealth EquityHIV InfectionsHumansMalePhiladelphiaPre-Exposure ProphylaxisSexual BehaviorSubstance Abuse, IntravenousPurposeful 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 regressionThe Impact of COVID-19 on Access to HIV Prevention Services Among Opioid-Dependent Individuals
Mistler CB, Curley CM, Rosen AO, El-Krab R, Wickersham JA, Copenhaver MM, Khati A, Shrestha R. The Impact of COVID-19 on Access to HIV Prevention Services Among Opioid-Dependent Individuals. Journal Of Community Health 2021, 46: 960-966. PMID: 33770334, PMCID: PMC7996112, DOI: 10.1007/s10900-021-00979-0.Peer-Reviewed Original ResearchConceptsOpioid use disorderHIV prevention servicesSTI testingHIV counselorsPrEP prescriptionPrevention servicesCOVID-19Pre-exposure prophylaxis servicesOpioid use disorder treatmentCOVID-19 pandemicClean injection equipmentOpioid-dependent individualsOpioid-dependent peopleUse disorder treatmentInjection equipmentHIV testingInfection testingBlood testingHIV preventionUse disordersPWIDDisorder treatmentDoctor's appointmentAdverse effectsCase managersUse 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 moderator
2020
The Pre-exposure Prophylaxis (PrEP) Care Cascade in People Who Inject Drugs: A Systematic Review
Mistler CB, Copenhaver MM, Shrestha R. The Pre-exposure Prophylaxis (PrEP) Care Cascade in People Who Inject Drugs: A Systematic Review. AIDS And Behavior 2020, 25: 1490-1506. PMID: 32749627, PMCID: PMC7858689, DOI: 10.1007/s10461-020-02988-x.Peer-Reviewed Original ResearchMeSH KeywordsAnti-HIV AgentsHIV InfectionsHumansPharmaceutical PreparationsPre-Exposure ProphylaxisSubstance Abuse, IntravenousConceptsPre-exposure prophylaxisCare cascadeSystematic reviewInjection drug useTransmission of HIVKey risk factorsPrEP eligibilityPrEP carePrEP uptakeHIV incidenceHIV transmissionRisk factorsPRISMA guidelinesPrevention strategiesPWIDDrug useLiterature searchEfficacious strategyProphylaxisPrEPDrugsInterventionHigh awarenessHIVReview
2019
Online HIV information seeking and pre-exposure prophylaxis awareness among people who use drugs
Ranjit YS, Shrestha R, Copenhaver M, Altice FL. Online HIV information seeking and pre-exposure prophylaxis awareness among people who use drugs. Journal Of Substance Use And Addiction Treatment 2019, 111: 16-22. PMID: 32087834, PMCID: PMC7039922, DOI: 10.1016/j.jsat.2019.12.010.Peer-Reviewed Original ResearchMeSH KeywordsCross-Sectional StudiesHIV InfectionsHumansInformation Seeking BehaviorPharmaceutical PreparationsPre-Exposure ProphylaxisSubstance Abuse, IntravenousConceptsHuman immunodeficiency virusHIV informationMethadone treatmentPre-exposure prophylaxis (PrEP) awarenessPre-exposure prophylaxisNew HIV diagnosesHIV-negative PWUDBehavior change continuumCross-sectional surveyMethods of preventionAddiction treatment programsHIV diagnosisImmunodeficiency virusInjection drugsHIV preventionHigh riskGeneral populationSex partnersOverall healthTreatment programPrEPDrugsPWUDChange continuumRiskRationale and design of an integrated bio-behavioral approach to improve adherence to pre-exposure prophylaxis and HIV risk reduction among opioid-dependent people who use drugs: The CHRP-BB study
Shrestha R, Altice FL, Sibilio B, Ssenyonjo J, Copenhaver MM. Rationale and design of an integrated bio-behavioral approach to improve adherence to pre-exposure prophylaxis and HIV risk reduction among opioid-dependent people who use drugs: The CHRP-BB study. Contemporary Clinical Trials 2019, 82: 77-84. PMID: 31229618, PMCID: PMC6639056, DOI: 10.1016/j.cct.2019.06.012.Peer-Reviewed Original ResearchConceptsBio-behavioral interventionHIV risk reductionOpioid-dependent peopleMethadone maintenance programPrEP adherenceHIV transmission risk reductionFirst prospective trialPre-exposure prophylaxisHIV prevention strategiesOngoing drug useRisk reductionBehavioral skills modelProspective trialSecondary outcomesPrimary outcomeRisk reduction outcomesHIV riskWeek 20Prevention strategiesUnmet needDrug useHybrid type IBio-behavioral approachProcess evaluationAdherence
2018
Viral suppression among HIV-infected methadone-maintained patients: The role of ongoing injection drug use and adherence to antiretroviral therapy (ART)
Shrestha R, Copenhaver MM. Viral suppression among HIV-infected methadone-maintained patients: The role of ongoing injection drug use and adherence to antiretroviral therapy (ART). Addictive Behaviors 2018, 85: 88-93. PMID: 29879611, PMCID: PMC6337064, DOI: 10.1016/j.addbeh.2018.05.031.Peer-Reviewed Original ResearchConceptsMethadone maintenance therapyMethadone-maintained patientsOngoing injection drug useViral suppressionAntiretroviral therapyInjection drug useHIV risk behaviorsDrug useSelf-reported HIV risk behaviorsImproved virologic outcomesOptimal ART adherenceHigher CD4 countsSustained viral suppressionMultivariable logistic regressionVirologic outcomesCD4 countMaintenance therapyOptimal adherenceART adherenceHIV treatmentIndependent correlatesTreatment challengesRisk populationsPatientsHIVIntegrated 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 populationsInterest 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 trialHIVTrialsInterventionOutcomesIntent 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 ResearchMeSH KeywordsAdultDrug UsersHIV InfectionsHumansIntentionMaleMental Status and Dementia TestsMiddle AgedNeurocognitive DisordersPre-Exposure ProphylaxisRisk Reduction BehaviorSubstance Abuse, IntravenousConceptsHIV 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 callsTreatment 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 ResearchMeSH KeywordsAdultAnti-HIV AgentsCognitive DysfunctionDrug UsersFemaleHIV InfectionsHumansMaleMedication AdherenceMethadoneMiddle AgedSubstance Abuse, IntravenousTreatment Outcome