Mobile medical units reduce deaths among people who inject drugs

Researchers in five major United States cities conducted a clinical trial to test how mobile medical units affect mortality rates among people who inject drugs.

The study, known as the HIV Prevention Trials Network Study 094 (HPTN 094), enrolled 409 adults without HIV who had opioid use disorder and were willing to consider medication for opioid use disorder (MOUD). The trial took place in Houston, Los Angeles, New York City, Philadelphia, and Washington, D.C.

Participants were split into two groups for 26 weeks. One group received peer navigation combined with integrated HIV preexposure prophylaxis (PrEP), MOUD, and supportive services delivered directly via a mobile unit. The second group received peer navigation that linked them to existing community-based services rather than a mobile unit. The researchers found that the mobile unit approach reduced all-cause deaths by 71% compared to the group using community-based services.

While both groups showed low levels of verified PrEP use, 14% of participants in the study used MOUD at both the 26 and 52 week marks. The study co-chairs noted that these results highlight the need for models that meet people where they are to overcome barriers like stigma and unstable housing. The researchers observed that low uptake of oral PrEP suggests that this specific medication faces challenges with acceptance among people who inject drugs.

They suggested that future efforts should evaluate long-acting PrEP formulations for this population.