This qualitative study focuses on the strategies 70 HIV+ former opioid users employ to maintain wellness. HIV+ former opioid users who must simultaneously deal with HIV seropositivity, including medication management and institutional affiliation, amid an already difficult process of opioid recovery, pose multiple challenges not only for the individuals but also for their families/social networks. This re- submission application is being submitted under PAR-10-021 AIDS Science Track Award for Research Transition (A-START) by an Early Career Investigator. He has a long history of successfully engaging participants in street drug user studies, and will now focus on interviewing this population of HIV+ sustained abstainers who have ceased their opioid misuse for five or more years. The use of non- prescribed and/or abuse of opioids, particularly heroin, (but including a number of pharmaceutical pill forms - Oxycontin, Vicodin, Percocet, morphine, and even more recent syrup forms, i.e. "Lean") are associated with high relapse rates, infectious disease susceptibility, criminal justice involvement, and social disharmony. Qualitative researchers have developed technologies for recruiting and investigating the drug-using careers of active users, but have not often documented patterns of non-use. The data gathered from this exploratory pilot study of HIV seropositive former opioid users who have been able to maintain abstinence will serve as a platform for larger studies examining the intersection of HIV/AIDS, drug abuse, and public health issues. The former users in this study will be from the New York metropolitan area, all with histories of daily heroin and/or other illicit opioid use exceeding one year, greater than five years sustained abstinence from these substances, and HIV seropositive status as measured by self report. The project team will verify HIV status by asking for documentation (for example test results, correspondence from doctors, prescriptions for HIV medication, etc.). The open ended interview is designed to elicit information describing the process of their recovery as well as ascertain the co-occurrence of other physical and emotional issues. The Centers for Disease Control and Prevention suggests substance use, largely opioid use, is increasing as a primary HIV transmission route. This study holds promise for informing future interventions and sketching a roadmap to maintenance of recovery and wellness as demonstrated by HIV+ people with lived experience/s of abstinence from substance use.
HIV+ individuals that have overcome the misuse of opioids, (e.g., heroin and/or prescription opioids such as Oxycontin), are an understudied population. Such misuse is difficult to overcome and is associated with high relapse rates, susceptibility to infectious diseases, criminal justice involvement, and social and familial disruption. An examination of successful strategies and processes undertaken by HIV+ former heroin users/opioid abusers who are now long-term sustained abstainers can provide important insights about how they maintain abstinence while so many others failed. The findings from this pilot study may be used to develop new treatment techniques and primary and secondary intervention strategies and subsequently extend the success such persons have gained to others in similar situations, while significantly influencing substance abuse and HIV treatment policy.