Notre: optimizing long-acting pre-exposure prophylaxis and medications for opioid use disorder interventions in carceral settings - CO-occurring substance use and HIV risk among individuals in…

Notre: optimizing long-acting pre-exposure prophylaxis and medications for opioid use disorder interventions in carceral settings - CO-occurring substance use and HIV risk among individuals in correctional settings presents a significant public health challenge. Approximately 17% of incarcerated individuals have an opioid use disorder (OUD), and HIV prevalence is notably higher than in the general population. Evidence-based medical interventions-such as pre-exposure prophylaxis (prep) and medications for opioid use disorder (moud), including buprenorphine-are available but remain underutilized in these environments. Long-acting injectable (LAI) formulations of both prep and buprenorphine, recently approved by the FDA, offer new opportunities for improving treatment continuity and outcomes. This project proposes a hybrid implementation-effectiveness type 2 study to evaluate a CO-packaged LAI prep + buprenorphine (XR-b) intervention in correctional and post-release settings in maryland and washington, DC. Specific objectives include: (1) developing a protocol for LAI prep + XR-b delivery; (2) evaluating implementation facilitation strategies; and (3) comparing the effectiveness of LAI prep + XR-b to oral prep + sublingual buprenorphine (SL-b). The long-term goal is to inform scalable, evidence-based practices for improving health outcomes in high-need populations.