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Nurse-led intervention to decrease drug use among LTBI positive homeless adults.

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Area of Science:

  • Public Health
  • Infectious Diseases
  • Addiction Medicine

Background:

  • People experiencing homelessness (PEH) have higher rates of active tuberculosis.
  • Latent tuberculosis infection (LTBI) treatment is crucial, but substance use complicates completion for PEH.
  • Innovative interventions are needed to support LTBI treatment adherence and address co-occurring substance use in PEH.

Purpose of the Study:

  • To evaluate a novel community-based, nurse-led community health worker (RN-CHW) intervention.
  • To assess the intervention's impact on reducing drug use among PEH in Los Angeles.
  • To explore the potential of LTBI interventions as a pathway to substance use reduction.

Main Methods:

  • A non-randomized, single-arm study involving 50 PEH in Los Angeles.
  • Participants resided in homeless shelters or on the streets.
  • Intervention involved a RN-CHW model with 3- and 6-month follow-ups.

Main Results:

  • Significant reduction in any drug use at 6 months (OR=0.30, p=0.004).
  • Significant decreases in amphetamine (OR=0.14, p=0.029), cannabis (OR=0.26, p=0.001), and methamphetamine use (OR=0.30, p=0.031).
  • Ongoing drug use reduction observed at the 6-month follow-up.

Conclusions:

  • This pilot study is the first to assess a RN-CHW intervention for drug use reduction in PEH undergoing LTBI treatment.
  • The RN-CHW model effectively reduced drug use in this population.
  • LTBI interventions can serve as a critical entry point for substance use disorder treatment among underserved PEH.