PROTECT-ED Care Coordination for Overdose and HIV Prevention

(PROTECT-ED Trial)

This trial explores a new approach to support individuals visiting the emergency department who need help with opioid use disorder or are at risk of HIV. The goal is to enhance overdose and HIV prevention services for those returning to the community after a correctional setting. Participants will receive comprehensive care, including peer support, medications for opioid use disorder, and access to HIV prevention services if needed. Suitable candidates include individuals recently released from a correctional facility who face opioid use issues or are at risk for HIV.

As an unphased trial, this study provides a unique opportunity to contribute to innovative solutions for critical health challenges.

Research has shown that the PROTECT-ED Care Coordination approach, which includes strategies like harm reduction and peer support, is generally safe. Harm reduction methods have reduced the use of nonprescribed opioids and lowered related risks. This suggests that the PROTECT-ED methods are likely safe for participants.

Although controlled studies have not directly proven the safety of the PROTECT-ED approach, its components have succeeded in other settings. For example, programs focusing on harm reduction and connecting people to community care have demonstrated positive results, such as fewer overdoses and better access to healthcare.

Researchers are excited about the PROTECT-ED Care Coordination because it combines several innovative approaches to prevent overdose and HIV. Unlike traditional methods that might focus only on prescribing medications like MOUD (Medications for Opioid Use Disorder) and PrEP (Pre-exposure Prophylaxis) separately, this approach offers a comprehensive package delivered right in the emergency department. It includes peer-delivered prevention services, same-day medication initiation when appropriate, and a strong emphasis on harm reduction and seamless transition to community care. This integrated strategy aims to streamline and enhance the effectiveness of care, addressing multiple health concerns simultaneously and potentially improving patient outcomes dramatically.

Research has shown that combining HIV prevention with care for opioid use disorder (OUD) can help reduce new HIV infections. Evidence indicates that most overdose deaths occur after individuals have started HIV care, highlighting the need for improved prevention services. This trial will evaluate the PROTECT-ED intervention, which includes peer-delivered prevention services and same-day initiation of medication for opioid use disorder (MOUD) and pre-exposure prophylaxis (PrEP) during emergency room visits. Studies suggest that effective strategies can improve outcomes for people with HIV by ensuring they receive appropriate care and support. A coordinated approach in emergency settings, as tested in this trial, could strengthen efforts to prevent both overdoses and HIV.⁶⁷⁸⁹¹⁰