Combining Social Network Strategies and Routine Substance Use Screening
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Substance use disorder screening, Social network intervention.
- Who it may be relevant to
- Registry conditions: HIV, Substance Use Disorder (SUD). Basic parameters: from 18 years · Male.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Overview
This study aims to improve health care for people who may have HIV or substance use disorders by bringing two services to a large community health center in Chicago. First, the clinic will begin offering routine screening for substance use to all patients. Second, the study will offer a social network-based program that helps people identify friends or partners who may need support and link them to care. The goal is to help more people learn their HIV status, reduce HIV levels in the community, and connect people with substance use treatment when needed. The study will also look at how well these services can be added into everyday clinic practice and what is needed to keep them going over time.
Detailed description
This project will take place in a network of federally qualified health centers that serves communities in Chicago that experience some of the highest rates of new HIV infections. The study has two main parts: Routine Substance Use Screening and a Social Network Intervention (SNI).
Routine screening at the clinics will introduce a consistent, standardized way to ask patients about substance use during regular visits. Patients who screen positive will be offered help, referrals, and follow-up services.
The social network intervention asks patients to think about people in their social networks (such as partners, friends, or peers) who may have untreated HIV, may have fallen out of care, or may have substance use concerns. Participants will receive support and tools to help connect people in their network to HIV testing, care, and treatment or substance use services at these clinics.
Together, these activities aim to:
* Identify people who have HIV but are not in care * Reduce HIV viral load levels in the community * Identify people with substance use disorders and link them to treatment * Improve access to supportive services in the community
The study will also examine how easy or hard it is for clinics to use these two strategies in everyday practice. Researchers will gather feedback from clinic staff and patients to understand what helps or gets in the way of using these services in the long term. The goal is to create a package of tools and processes that other clinics can adopt in the future.
Interventions
- Behavioral Substance use disorder screening
Implement a routine SUD screening at the FQHC. - Behavioral Social network intervention
Social network intervention (SNI) to identify individuals who are viremic, have SUD, or both and link them to harm reduction and HIV continuum of care services. There are three main activities that make up the SNI: 1) recruiting, screening, and interviewing "index participants"; 2) training the index participants to recruit others; 3) screening and interviewing persons who present a valid recruitment voucher given to them by an index participant.
Primary outcome measures
- Rate of Substance Use Disorder (SUD) Detection [Time frame: Baseline through 24 months]
- Number of Individuals Identified as Viremic and/or Having SUD Through the Social Network Intervention (SNI) [Time frame: Baseline through 24 months]
- Linkage to HIV Care or Substance Use Services [Time frame: Baseline through 24 months]
Secondary outcome measures (8)
- Viral Suppression Among Individuals Identified Through Screening or SNI [Time frame: Baseline through 24 months]
- Time to Linkage to HIV Care or Substance Use Services [Time frame: Baseline through 24 months]
- Number of New HIV Diagnoses Identified Through the SNI [Time frame: Baseline through 24 months]
- Substance Use Treatment Initiation [Time frame: Baseline through 24 months]
- Re-engagement in HIV Care [Time frame: Baseline through 24 months]
- Acceptability of SUD Screening and the SNI [Time frame: Measured at Months 6, 12, 18, and 24]
- Feasibility of Implementing the SUD Screener and SNI [Time frame: Baseline through 24 months]
- Sustainability of Screening and SNI Workflows (EPIS: Sustainment Phase) [Time frame: Measured at 24 months]
Eligibility criteria
Inclusion criteria
- Assigned male sex at birth
- Has sex with men
- Speaks English or Spanish
Exclusion criteria
- Institutionalized individuals
- Women
- Non-Hispanic whites
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Non-randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Supportive care
Study locations
United States · 1 center
- Howard Brown Health — Chicago
Publications
- Proctor E, Silmere H, Raghavan R, Hovmand P, Aarons G, Bunger A, Griffey R, Hensley M. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health. 2011 Mar;38(2):65-76. doi: 10.1007/s10488-010-0319-7. PMID 20957426
- Aarons GA, Hurlburt M, Horwitz SM. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Health. 2011 Jan;38(1):4-23. doi: 10.1007/s10488-010-0327-7. PMID 21197565
- Oehler C, Rajagopal A, Songster T, Schmitt J, McNulty M, Schneider J, Pitrak D, Ridgway JP. Partner Notification Services for Patients with Established and New HIV Infection Leads to Diagnosis and Linkage of HIV-Positive Partners. AIDS Behav. 2021 Mar;25(3):809-813. doi: 10.1007/s10461-020-03043-5. Epub 2020 Sep 19. PMID 32949327
- Cummins B, Johnson K, Schneider JA, Del Vecchio N, Moshiri N, Wertheim JO, Goyal R, Skaathun B. Leveraging social networks for identification of people with HIV who are virally unsuppressed. AIDS. 2024 Feb 1;38(2):245-254. doi: 10.1097/QAD.0000000000003767. Epub 2023 Oct 26. PMID 37890471
- Skaathun B, Pho MT, Pollack HA, Friedman SR, McNulty MC, Friedman EE, Schmitt J, Pitrak D, Schneider JA. Comparison of effectiveness and cost for different HIV screening strategies implemented at large urban medical centre in the United States. J Int AIDS Soc. 2020 Oct;23(10):e25554. doi: 10.1002/jia2.25554. PMID 33119195
- Curran GM, Bauer M, Mittman B, Pyne JM, Stetler C. Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Med Care. 2012 Mar;50(3):217-26. doi: 10.1097/MLR.0b013e3182408812. PMID 22310560
- McPherson M, Smith-Lovin L, Cook JM. Birds of a Feather: Homophily in Social Networks. Annual Review of Sociology 2001; 27(1): 415-44.
- Shrader CH, Borquez A, Vasylyeva TI, Chaillon A, Artamanova I, Harvey-Vera A, Vera CF, Rangel G, Strathdee SA, Skaathun B. Network-level HIV risk norms are associated with individual-level HIV risk and harm reduction behaviors among people who inject drugs: a latent profile analysis. AIDS Behav. 2023 Feb;27(2):484-495. doi: 10.1007/s10461-022-03783-6. Epub 2022 Aug 8. PMID 35939177
Identifiers
NCT: NCT07414459 · 813457 · R37DA063274