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Research Article: 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

Date Published: 2023-06-30

Abstract:
Introduction People who inject drugs (PWID) have remained a contributor to the consistent HIV incidence rates in the US for decades. Pre-exposure prophylaxis (PrEP) is a promising biomedical intervention for HIV prevention among individuals at risk for HIV infection, including PWID. However, PWID report the lowest rates of PrEP uptake and adherence among at-risk groups. Tailored HIV prevention interventions must include strategies that compensate for cognitive dysfunction among PWID. Methods and analysis Using the multiphase optimisation strategy, we will be conducting a 16-condition factorial experiment to investigate the effects of four different accommodation strategy components to compensate for cognitive dysfunction among 256 PWID on medication for opioid use disorder. This innovative approach will inform optimisation of a highly effective intervention to enhance PWID’s ability to process and utilise HIV prevention content to improve PrEP adherence and HIV risk reduction in a drug treatment setting. Ethics and dissemination The institutional review board at the University of Connecticut approved this protocol (H22-0122) with an institutional reliance agreement with APT Foundation Inc. All participants are required to sign an informed consent form prior to engaging in any study protocols. The results of this study will be disseminated on national and international platforms through presentations at major conferences and journals. Trial registration number NCT05669534 .

Introduction:
HIV incidence in the US has remained largely stagnant for the past 15 years, 1 as people who inject drugs (PWID) have consistently contributed to 10% of new infections each year. 1 Pre-exposure prophylaxis (PrEP) can provide primary HIV prevention to persons at-risk for HIV. HIV prevention interventions involving PrEP should appropriately target the highest-risk groups, rather than applying a one-size-fits-all approach. PrEP uptake and adherence among PWID, however, have remained alarmingly low, despite increased…

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