HIV prevention and substance use treatment for people with drug use-associated wounds

The National Institute on Drug Abuse awarded The Miriam Hospital $186,895 on May 1, 2026, under the Drug Use and Addiction Research Programs (CFDA 93.279) to conduct research evaluating optimal settings for integrated wound care, pre-exposure prophylaxis (PrEP), and medications for opioid use disorder (MOUD) among people who use drugs.

The project runs through April 30, 2031, with place of performance in Providence, Rhode Island. The research combines qualitative and quantitative methods to examine how wound care delivered through mobile clinics influences patient-provider relationships, logistical access, and uptake of prevention and treatment services. The study leverages an existing cohort of people who use drugs and explores how interpersonal interactions during wound care affect care experiences and preferences among patients and providers, with particular attention to complications from drug supply additives such as xylazine.

The award is a K01 career development grant, providing the principal investigator with training to advance research at the intersection of substance use and infectious diseases while addressing infectious disease complications facing people who use drugs in the context of the ongoing overdose crisis.

Abstract

This timely K01 award focuses on identifying optimal treatment approaches in an evolving drug use landscape, while providing the PI with the necessary training to advance her long-term goal of leading impactful research at the intersection of substance use and infectious diseases. Alongside an unprecedented overdose crisis, people who use drugs are facing an increase in infectious disease complications, including bacterial infections and wounds complicated by drug supply additives like xylazine. When people receive healthcare for these infections, this interaction serves as an important opportunity to provide other key prevention and treatment services that might otherwise be missed, like pre-exposure prophylaxis (prep) and medications for opioid use disorder (moud). However, several challenges prevent many from seeking care in traditional settings like clinics and hospitals. In contrast, new models of care provided through mobile clinics show promise in improving care quality and effectiveness. The research objective of this K01 is to comprehensively evaluate and identify optimal settings to improve moud, prep, and wound care outcomes for people who use drugs within the changing context of the drug supply. Our central hypothesis is that wound care offered through mobile clinics is associated with improved patient-provider relationships and logistical access, thus leading to improved uptake of prevention and treatment services. To study this, we will qualitatively explore how interpersonal interactions during wound care influence care experiences and preferences among people who use drugs and their providers. Next, we will quantitatively examine the influence of individual and interpersonal factors on preferences in integrated wound care, prep, and moud by leveraging an existing cohort study of people who use drugs. Finally, we will conduct a mixed methods analysis to assess individual and organizational determinants of moud and prep utilization within different models of wound care (mobile settings versus brick-and-mortar sites) through an existing network of innovative substance use services. Through this K01 award, the PI will expand upon her background in epidemiology and applied research by gaining complementary training in qualitative and mixed methods research, measurement of interpersonal dynamics influencing treatment delivery, and implementation science research. Training will be guided by an exceptional team of leading experts in substance use treatment and infectious disease care who have outstanding track records of mentorship and impactful research. Through these research aims, the PI will obtain preliminary data to inform subsequent studies focused on comprehensively evaluating novel models of care among people who use drugs. Ultimately, this K01 award will support the PI as she progresses into an independent research career focused on identifying and assessing new approaches in substance use and infectious disease care as IT adapts to the changing drug use environment.