Perceptions of People Who Inject Drugs About Long-acting Medications for Opioid Use Disorder, Preexposure...

Long-acting injectable (LAI) forms of preexposure prophylaxis and antiretroviral therapy and extended-release medications for opioid use disorder (OUD) may reduce HIV and OUD treatment attrition, but community interest among people who inject drugs remains underexplored.

From September to December 2023, we conducted a cross-sectional survey of adults with OUD and a history of injection drug use who were attending a New Jersey syringe exchange program to assess their experiences with HIV and OUD care and their knowledge, attitudes, and preferences about LAI.

Of 193 participants, 15 were persons with HIV (PWH), 72 were high risk for HIV (HRH), and 91 were low risk for HIV (LRH). Many participants had previously taken medications for OUD (60%), but knowledge of extended-release medications for OUD was low (40% PWH, 45.8% HRH, 41.6% LRH, P = .85). Participant interest in extended-release naltrexone (33.3% PWH, 27.8% HRH, 26.7% LRH, P = .91) and extended-release buprenorphine (33.3% PWH, 18.3% HRH, 20.9% LRH, P = .45) was also low. Preexposure prophylaxis knowledge was high (59.1% HRH, 63.9% LRH, P = .54), but prior usage (11.1% HRH, 6.7% LRH, P = .32) and interest (18.1% HRH, 21.1% LRH P = .63) in LAI preexposure prophylaxis were low. PWH had high awareness (66.7%) and interest (66.7%) in receiving LAI antiretroviral therapy. Interest in integrated care was greater for PWH (69.2%) than for those at HRH (29.8%) or LRH (33.9%; P = .03), and preferred treatment locations varied among the groups.

Targeted education and outreach are particularly needed for extended-release medications for OUD and LAI preexposure prophylaxis. A differentiated care model may better address the needs of people who inject drugs with OUD, whether at risk for or with HIV. Addressing barriers to LAI treatment remains essential.