Aligning Efforts to Boost Medications for Opioid Use Disorder and Pre-Exposure Prophylaxis for HIV

Among the many harmful consequences of opioid use disorder (OUD), two outcomes are particularly critical: opioid overdose and HIV infection. Fortunately, two interventions-medications for OUD (MOUD) and pre-exposure prophylaxis (PrEP) for HIV-effectively reduce the risk of opioid overdose and HIV, respectively. Despite the safety and availability of MOUD and PrEP, their uptake remains quite low. Efforts to increase use of MOUD and PrEP have occurred largely independently, yet these interventions integrate well in the setting of office-based treatment of OUD. To develop strategies that promote utilization of both medications, an integrated framework is needed. The OUD care cascade, a model describing treatment stages through which a patient may progress, has been increasingly used to facilitate monitoring and strategically expand MOUD services. Integrating PrEP into this framework could bring increased attention to PrEP utilization and strengthen efforts to enhance uptake of both medications. While real-world challenges exist along the continuum from diagnosis to retention, integrated measurement frameworks such as dashboards can help track progress, identify gaps, and optimize treatment strategies. To accelerate progress in the fight against HIV and opioid overdose, it is time to integrate monitoring and research of MOUD and PrEP.