Linking Infectious and Narcology Care-Part II (LINC-II)
HIV Infection, Drug Use
About this trial
This is an interventional health services research trial for HIV Infection focused on measuring Russia, Substance use, Peer case managers, ART, HIV
Eligibility Criteria
Inclusion Criteria:
- 18 years or older
- HIV infected
- Hospitalized at narcology hospital
- History of injection drug use
- Current diagnosis of opioid use disorder
- Provision of information for 2 contacts to assist with follow-up
- Address within 100 kilometers of St. Petersburg
- Possession of a telephone (home or cell)
- Able and willing to comply with all study protocols and procedures
Exclusion Criteria:
- Not fluent in Russian
- Cognitive impairment
- Pregnancy, planning to become pregnant, or breastfeeding
- ART use in past 30 days prior to hospitalization
- Known hypersensitivity to naltrexone
- Acute severe psychiatric illness (i.e. ,answered yes to any of the following: past three month active hallucinations; mental health symptoms prompting a visit to the ED or hospital; mental health medication changes due to worsening symptoms; presence of suicidal ideations)
- Known history of liver failure
- ALT or AST >5 times the upper limit of normal
- Known severe thrombocytopenia (<50k)
- Known coagulation disorder/taking anticoagulation medications
- Body habitus that precludes intramuscular injection
- Known hypersensitivity to naloxone
- Known history of Raynaud's disease
- Known history of Itsenko-Cushing syndrome
- Known history of generalized mycoses
- Known history of glaucoma
- Known history of osteoporosis.
- Planned surgeries in the next 12 months
Sites / Locations
- First St. Petersburg Pavlov State Medical University
- City Addiction Hospital
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
LINC-II
Standard of Care
LINC-II is a multi-faceted intervention combining pharmacological therapy (i.e., ART and naltrexone for opioid use disorder) and 12 months of strengths-based case management delivered to coordinate care across the narcology and HIV health care systems.
Participants randomized to the control group will receive the narcology hospital's standard of care, which is detoxification with or without stabilization. Prior to discharge, those identified as HIV-infected are given contact details for an HIV clinic, not an appointment. Upon discharge, patients are encouraged to receive outpatient narcology treatment, monthly, for 1 year. For this study, with regard to linkage to HIV medical care, patients will be given printed information about where to obtain HIV medical care and a resource card containing harm reduction information.