We propose to develop and pilot a single-session, peer-led intervention (PEERLINK) to increase linkage of hospitalized HIV+ substance abusers to HIV primary care and/or drug treatment. We believe this is a timely and important project because (1) a high percentage of individuals hospitalized for HIV-related illnesses have co-morbid substance use disorders; (2) a significant minority are not in care for either condition; (3) without care, both conditions will worsen, leading to declining health, increased hospitalizations, and higher health care costs; and (4) no at the bedside intervention currently exists to enhance care linkage. Motivational interventions have been shown to change substance use and increase participation in drug treatment, while peer interventions have been shown to improve utilization of HIV services. Thus, development of a peer-led motivational intervention to improve linkage to care for individuals with this co-morbidity is warranted. ? ? Specifically, our aims are to: 1) Develop and refine PEERLINK (a single-session, peer- delivered bedside intervention based on Motivational Interviewing) through an iterative process; 2) Train peers to deliver PEERLINK with fidelity (feasibility) and determine its acceptability to both patients and peers (acceptability); 3) Determine the promise of PEERLINK with regard to the following outcomes: (1) acceptance of an HIV and/or substance use treatment referral; (2) time to 1st kept appointment; and (3) evidence of a connection to care (HIV and/or substance abuse) based on number of appointments made/ kept . ? ? Engagement in HIV care can save lives, enhance quality of life, save money, and prevent further transmission of HIV. Effective, inexpensive, brief behavioral interventions targeted to patients in the hospital who are not connected to HIV care and have complex substance use and/or mental health issues may successfully link HIV-positive patients to comprehensive HIV care, thereby gaining improvements in their health outcomes. Patients linked to HIV care have improved quality of life, lengthened life, and reduced viral loads, which decreases the risk of HIV transmission. ? ? ? ?
| Wolfe, Hannah; Haller, Deborah L; Benoit, Ellen et al. (2013) Developing PeerLink to engage out-of-care HIV+ substance users: training peers to deliver a peer-led motivational intervention with fidelity. AIDS Care 25:888-94 |
