Key Takeaways
- The University of Houston is part of a $21.2 million Texas effort to tackle the opioid epidemic by examining opioid use disorder among people living with HIV in Harris County and integrating prevention.
- Harris County has higher numbers of drug poisoning-related deaths due to commonly prescribed opiates, heroin, fentanyl and other synthetic opioids than any other public health region in the state.
- Of the approximately 1.2 million people living with HIV in the U.S., nearly twice as many are likely to misuse opioids as people not living with HIV.
Continuing its national leadership in stemming the opioid crisis, the University of Houston is part of a $21.2 million effort across Texas fighting this public health emergency. The Texas Opioid Abatement Fund Council awarded 109 grants to entities that are working on solutions to the epidemic. These funds were made available through the Short-term Community-based Opioid Recovery Effort grant opportunity.
In fact, the money comes from opioid lawsuits.
The Texas Legislature formed the OAFC in 2021 to ensure money recovered through the joint efforts of the state and its political subdivisions from statewide opioid settlement agreements is allocated fairly and spent to remediate the opioid crisis using efficient, cost-effective methods.
HIV and opioid use disorder in Harris County
At the UH College of Pharmacy Dipali Rinker, research associate professor and member of the Prescription Drug Misuse Education and Research (PREMIER) Center, will use a $250,000 grant (the maximum individual grant award) to investigate HIV and opioid use disorder in Harris County, which includes the city of Houston.
The county has higher numbers of drug poisoning-related deaths due to commonly prescribed opiates, heroin, fentanyl and other synthetic opioids than any other public health region in the state. As of mid-2024, in Houston/Harris County, approximately 27,674 individuals are living with HIV, with over 1000 new HIV diagnoses annually, which is higher than both the state and national averages.
Researchers understand why people with HIV are more likely to have opioid use disorder.
“There are shared risk factors in both disease states with a high likelihood of pain among people living with HIV leading to opioid prescriptions,” said Rinker. “Then in seeking treatment for opioid use disorder, people living with HIV are more likely to experience stigma, social marginalization and discrimination due to their dual diagnosis.”
Intervention and prevention
Rinker will seek to determine the extent to which Screening, Brief Intervention, and Referral to Treatment (SBIRT) is implemented into the treatment of people living with HIV and opioid use disorder among patients engaged in treatment at one of five Ryan White-funded clinics in Houston/Harris County. Ryan White–funded clinics are health care providers and organizations that receive federal funding through the Ryan White HIV/AIDS Program, a U.S. federal initiative administered by the Health Resources and Services Administration (HRSA). SBIRT is a healthcare approach used to identify and help people who may be prone to drug or alcohol use before their problems become severe.
“SBIRT is an empirically supported framework for reducing substance misuse, but to date, there are no strategic initiatives in Houston/Harris County among people living with HIV engaged in care to better integrate SBIRT for opioid use disorder,” said Rinker. “We hope to develop a community of practice - a group of people who come together to create stronger academic-community partnerships to better screen, provide a brief intervention, and refer a person living with HIV to treatment for opioid use disorder.”
To do this, Rinker and co-investigator Shital Patel, MD, from Baylor College of Medicine, will collect data from patient records as well as from patients and providers through interviews and surveys.
“We need to understand both what prevents and enables them and their providers to seek treatment,” said Rinker, who added that integrating effective treatment for OUD is paramount for not only reducing harm related to substance use, but to improve HIV-related outcomes.
“The intersection of HIV and OUD can also worsen adherence to antiretroviral therapy. It is expected that at the end of this project we will have a comprehensive assessment of barriers and facilitators to implement SBIRT in HIV care,” she said.