Project hope - exploring the role of harm reduction vending machines in reducing the risk of HIV infection and transmission - no known studies have examined a health vending machine program's (project…

This $554,922 Project Grant from the National Institute on Drug Abuse (NIDA) under the Drug Use and Addiction Research Programs (CFDA 93.279) supports a three-year research initiative (September 1, 2025 – August 31, 2028) examining the efficacy and impact of Project HOPE, a health vending machine program designed to improve HIV prevention outcomes among people who use drugs (PWUD). The research will employ a longitudinal mixed-methods approach to evaluate whether the vending machines increase access to HIV self-testing kits, naloxone, and other health promotion supplies. Conducted by California State University, Bakersfield's Auxiliary for Sponsored Programs Administration, the study aims to determine how machine characteristics such as location and operating hours influence utilization patterns among high-risk and low-risk participants.

The project addresses critical gaps in the evidence base regarding low-barrier, accessible health interventions during the opioid epidemic. The research will generate findings on whether Project HOPE participation affects HIV screening behaviors, reduces drug and sexual risk behaviors, improves naloxone cascade outcomes, and facilitates peer network diffusion of innovation. Products delivered will include data characterizing vending machine users, impact assessment reports on behavioral and health screening outcomes, and recommendations for expanding evidence-based health vending machine programs as sustainable alternatives to traditional health service delivery models for underserved populations facing complex health challenges.

Project hope - exploring the role of harm reduction vending machines in reducing the risk of HIV infection and transmission - no known studies have examined a health vending machine program's (project hope) efficacy, mechanisms, and impact on the social environment through a longitudinal mixed methods approach. The long-term goal is to determine if project hope provides a sustainable approach to accessing HIV self-testing and health promotion supplies and information among people who use drugs (pwuds) facing complex health challenges. The objectives of this proposal are three-fold: 1) determine the effects of participation on project hope on HIV screening behaviors, 2) assess whether project hope improves access to HIV self-testing kits and health-related supplies, and 3) examine how health vending machine characteristics (e.g. location, operating hours) influence utilization patterns. The central hypothesis is that people identified as high-risk for overdose and HIV infection will utilize more health promotion supplies, including HIV self-testing and naloxone kits, than low-risk program participants, resulting in increased HIV screening, reduced risk behaviors, improvements to the naloxone cascade, and diffusion of innovation within peer networks. The rationale is that amid the fourth wave of the opioid epidemic, pwuds are experiencing an acceleration of drug-related morbidity and mortality outcomes, including HIV infection, yet encounter a multitude of barriers to accessing health promotion and HIV self-testing resources. The proposed work aims to inform the expansion of evidence-based, accessible, low-threshold, and low-barrier health vending machine programs, which include HIV self-testing kits. The central hypothesis will be tested by pursuing three specific aims: 1) to examine the characteristics of people who utilize project hope; 2) to describe the impact of the program on drug and sexual risk behaviors, HIV screening behaviors, naloxone cascade outcomes, and diffusion of innovation; and 3) to examine the longitudinal utilization patterns in relation to project hope health vending machine features. We will pursue these aims by conducting a mixed methods study, including 300 brief cross-sectional surveys with people registered to use project hope, quarterly interviews with 75 participants recruited into the high-risk cohort, and periodic qualitative interviews with a subset of 12 high-risk cohort participants. The proposed research is significant, because IT is the first study to include a network of health vending machines with varying characteristics and to employ a longitudinal mixed methods approach to study the efficacy of the health vending machine model in improving engagement with the "seek, test, treat, and retain" model of care; health promotion supplies; and the naloxone cascade.