NOT-DA-21-019 Notice of Special Interest (NOSI): Telehealth Strategies for Individuals with HIV and Substance Use Disorders

The National Institute on Drug Abuse (NIDA) is issuing this Notice of Special Interest (NOSI) inviting research applications to explore and develop telehealth methods and strategies for diagnosis, prevention, treatment, and population analysis in individuals living with HIV and Substance Use Disorder (SUD).

Background: More than 1.2 million individuals in the United States are living with HIV. SUD is a significant factor in the propagation and persistence of the HIV/AIDS epidemic in the nation, and the perpetuation of HIV leading to increased morbidity, mortality, and transmissibility. SUDs impact multiple stages of the HIV continuum-of-care cascade, including transmission, diagnosis, illness trajectories, and treatment. Integrating medical care for individuals with HIV and SUDs has been extremely challenging. Medical approaches for the diagnosis and treatment of individuals with HIV and SUD’s are usually conventional, dependent on in-person clinical visits as an essential setting for establishing relationship, accurate diagnosis, treatment, and monitoring. This traditional in-person approach has major limitations: (1) It requires patients’ time, effort and resources to attend appointments; (2) It presents major challenges in rural areas and in certain populations due to difficulties in access to care, availability of trained providers, cultural differences, language barriers, etc. The COVID-19 pandemic has put into evidence the fragility of the in-person approach, opening the horizon for the consideration and use of telehealth strategies in the management of HIV with co-existing SUDs.

Rationale: There is a need for scientific studies that demonstrate the feasibility, implementation, efficacy, effectiveness, acceptance, and utilization of telehealth in individuals with HIV and SUDs. Most methods are generally still in the early stages of development, and existing studies generally lack the scope required to inform dissemination into clinical practice. Thus, new telehealth-delivered strategies and implementation of those already proven are needed.

Research Areas:

  • Evaluation and development of remote screening strategies, utilizing telehealth platforms, for individuals with HIV and SUDs in the context of the COVID-19 pandemic.
  • Evaluation and development of remote screening strategies, utilizing telehealth platforms with multiple languages, for individuals with HIV and SUDs in rural, urban and suburban locations, in the criminal justice system, in the Native-American population, in disenfranchised minorities, in the Northern and Southern border locations of the US, in schools and colleges, etc.
  • Optimization of existing, and development of novel remote-delivery therapeutic strategies, including but not limited to E-prescribe, Pro-Active Messages, Time-Life Follow Back, Cotinine monitoring, Counseling, Gender-Oriented, etc.
  • Remote, telehealth-mediated implementation of therapeutic strategies for HIV and SUDs.
  • Methods to promote or improve the systematic uptake of telehealth and other remote strategies in individuals with HIV and SUDs.
  • Evaluation of efficacy, effectiveness, utilization, sustainability and cost-effectiveness of these strategies for individuals living with HIV and SUDs.