Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Drug Alcohol Depend. 2022 Sep 1;238:109585. doi: 10.1016/j.drugalcdep.2022.109585. Epub 2022 Jul 23.
The intersecting epidemics of opioid misuse, injection drug use, and HIV/HCV have resulted in record overdose deaths and sustained high levels of HIV/HCV transmissions. Literature on social networks suggests opportunities to connect people who use drugs (PWUD) and their peers to HIV/HCV and opioid overdose prevention services. However, little evidence exists on how to design such peer referral interventions in emergency department (ED) settings.
A mixed-method study was conducted to assess the feasibility of an mHealth-facilitated 'patient to peer social network referral program' for PWUD. In-depth interviews (IDIs) and quantitative surveys were conducted with urban ED patients (n = 15), along with 3 focus group discussions (FGDs) (n = 19).
Overall, 34 participants were enrolled (71 % males, 53 % Black). 13/15 IDI participants reported a history of opioid overdose; all had witnessed overdose events; all received HIV/HCV testing. From survey responses, most would invite their peers for HIV/HCV testing and naloxone training; and anticipated peers to accept referrals (HIV: 60 %, HCV: 73 %, naloxone: 93 %). Qualitative data showed PWUD shared health-related information with each other but preferred word of mouth rather than text messages. Participants used smartphones regularly and suggested using Internet advertising for prevention services. Participants expressed enthusiasm for ED-based peer mHealth referral platform to prevention services, as well as referring their peers to proposed services, with monetary incentives.
ED-based peer referral intervention to HIV/HCV testing and naloxone training was viewed favorably by PWUD. Frequent smartphone use among PWUD suggests that the medium could be a promising mode for peer referral.
阿片类药物滥用、注射吸毒和 HIV/HCV 的交叉流行导致了创纪录的过量死亡和持续高的 HIV/HCV 传播。关于社交网络的文献表明，有机会将吸毒者及其同伴与 HIV/HCV 和阿片类药物过量预防服务联系起来。然而，关于如何在急诊室（ED）环境中设计这种同伴转介干预措施，几乎没有证据。
一项混合方法研究评估了 mHealth 促进的“患者到同伴社交网络转介计划”在吸毒者中的可行性。对城市 ED 患者（n=15）进行了深入访谈（IDIs）和定量调查，并进行了 3 次焦点小组讨论（FGD）（n=19）。
共有 34 名参与者被纳入（71%为男性，53%为黑人）。13/15 IDI 参与者报告有阿片类药物过量的病史；所有人都目睹过过量事件；所有人都接受了 HIV/HCV 检测。从调查答复中，大多数人会邀请他们的同伴进行 HIV/HCV 检测和纳洛酮培训；并预计同伴会接受转介（HIV：60%，HCV：73%，纳洛酮：93%）。定性数据显示，吸毒者会互相分享健康相关信息，但更喜欢口口相告而不是短信。参与者经常使用智能手机，并建议使用互联网广告来推广预防服务。参与者对 ED 基于同伴的 mHealth 转介平台对预防服务表示热情，并且愿意通过金钱激励来转介他们的同伴到拟议的服务。
ED 基于同伴的转介干预措施，用于 HIV/HCV 检测和纳洛酮培训，受到吸毒者的好评。吸毒者频繁使用智能手机表明，该媒介可能是一种有前途的同伴转介模式。
