Slowing the Emerging Opioid Epidemic in Southern California: Responding to Increases in Opioid, Prescription, and Injection Drug Use Meeting Report

The UCLA CFAR-sponsored “Slowing the Emerging Opioid Epidemic in Southern California: Responding to Increases in Opioid, Prescription, and Injection Drug Use” was held on November 16, 2018.  This meeting was hosted by Drs. Pamina Gorbach and Steve Shoptaw of UCLA and Ricky Bluthenthal of USC in November 2018 and  explored why the opioid epidemic has not exploded in California and how researchers can contribute to prevention efforts.

We engaged leading HIV/AIDS research to address the impacts of opioids in the populations too often marginalized and especially vulnerable to the effects of HIV (e.g., men who have sex with men, racial/ethnic minorities, and injection drug users).  The report details our findings and articulates both policy and research recommendations for the field. 

You can download the full meeting report here:  Slowing the Emerging Opioid Epidemic in Southern California: Responding to Increases in Opioid, Prescription, and Injection Drug Use Meeting Report

This event was made possible with the generous support of the UCLA Center for AIDS Research (AI028697) and the UCLA AIDS Institute. Additional funds were provided by the Center for HIV Identification, Prevention, and Treatment Services (MH058107).

Shortened Time to ART Initiation in MSM Reduces Risk of HIV-1 Sexual Transmission

Presented at HIVR4P 2018 – (P16.02) Shortened Time to ART Initiation in MSM Reduces Risk of HIV-1 Sexual Transmission

Juan Berenguer, Javier Parrondo, Raphael J Landovitz

Background: In a previous mathematical model, we found that initial treatment with DTG and RAL-based regimens provide advantages over both EFV- and DRVr-based ART for the reduction of HIV-1 transmission risk from anal intercourse in HIV-infected MSM. This analysis aims to analyze the effect of time to initiation of first ART after diagnosis on the probability of HIV-1 transmission events (HIV-TE) in HIV-1-infected MSM by mathematical modeling.

Methods: We used discrete event simulation modeling to estimate the probability of HIV-TE in the first 8W after ART initiation; we varied ART initiation from D0 to D28 after simulated “diagnosis”. The model inputs used sexual behavior parameters from the MSM population of the START trial, and transmission rates per-sex act and HIV-1 RNA level from recent meta-analyses. HIV-1 RNA decay curves(W0 to W8)were modeled by fractional polynomial regressionof repeated measurements of HIV-1 RNA from the databases of the Single, Spring-2, and Flamingo trials. ART starts at D0 through D28, compared with D28 initiation by ART type were modeled with 106theoretical patients for each comparison.

Results: The number of simulated HIV-TE per patient in the first 8 weeks after ART initiation in the INSTI, EFV, and DRVr arms increased linearly from 0.03, 0.08, and 0.14 for ART initiation on D0 to 0.26, 0.31, and 0.33 for ART initiation on D28. The percent reduction in the number of simulated HIV-TE in the first 8 weeks, compared to initiation of ART on D28 in the INSTI, EFV, and DRVr arms, decreased linearly from 87%, 74%, and 59% for ART initiation on D0 to 2%, 1%, and 1% for ART initiation on D28.

Conclusions: These results support the notion that ART initiation rapidly after diagnosis of HIV for MSM has the potential to maximally impact HIV-1 horizontal transmission when compared to waiting one month, as is current practice. Statistically significant advantages of INSTI over EFV and DRVr were also noted supporting evolving guidelines recommendations for INSTI-based initial therapy.

Methods Seminar – Scott Comulada, Dr.PH on Perceived mHealth Barriers and Benefits in Resource-poor Settings: Qualitative findings from health officials, community health workers, and persons living with HIV in South Africa

W. Scott Comulada, Dr.P.H.
Associate Professor-in-Residence,
UCLA Department of Psychiatry & Biobehavioral Sciences Co-Director,

CHIPTS Methods Core Project Lead, ATN CARES Analytic Core

Tuesday, February 13, 2pm – 3pm

Center for Community Health, UCLA Wilshire Center
10920 Wilshire Blvd., Suite 350, Room 350-46 (Conference Room)

mHealth solutions have been proposed to address healthcare system inefficiencies in resource-poor settings, especially for home-based HIV testing and counseling (HTC) programs. The transfer of rapid diagnostic testing and health information from the field to the clinic is crucial for the success of home-based HTC programs; mHealth solutions have been pilot-tested. Yet wide-scale mHealth adoption has not occurred. Even as infrastructure barriers decrease, a need to better understand perceived adoption barriers by stakeholders remains. We conducted focus group discussions (FGD) in South Africa in 2016 with 10 field staff from a home-based HTC program, 12 community health workers (CHWs) and 10 persons living with HIV. Key informant (KI) interviews were conducted with five health officials. Perceptions about current home-based HTC practices, future mHealth systems and the use of biometrics for patient identification were discussed and will be presented during the seminar. In addition, I will discuss how qualitative findings are being used to inform the development of future mHealth systems.

The CHIPTS’ Methods Core hosts a monthly seminar series, which are one-hour workshops on research and statistical methods.  The seminars are open to HIV researchers, faculty, students, and community. To see previous seminars, check out the Methods Seminar tag or you can find seminar videos on our Youtube Channel! This series is hosted by the Center for HIV Identification, Prevention, and Treatment Services (CHIPTS) and made possible by funds from the National Institute of Mental Health (MH058107).