Houston Daily

The University of Houston is participating in a $21.2 million statewide initiative to address the opioid crisis, with a focus on examining opioid use disorder among people living with HIV in Harris County. The Texas Opioid Abatement Fund Council (OAFC) has distributed 109 grants through the Short-term Community-based Opioid Recovery Effort, funded by settlements from opioid lawsuits.

The OAFC was established by the Texas Legislature in 2021 to ensure that funds recovered from statewide opioid settlement agreements are allocated and used efficiently to mitigate the effects of the opioid epidemic across Texas.

Dipali Rinker, research associate professor at the UH College of Pharmacy and member of the Prescription Drug Misuse Education and Research (PREMIER) Center, will lead a project supported by a $250,000 grant—the maximum amount for individual awards—to investigate the overlap between HIV and opioid use disorder in Harris County. This region has higher rates of drug poisoning deaths from prescription opiates, heroin, fentanyl, and other synthetic opioids than any other public health region in Texas.

In Houston/Harris County, as of mid-2024, about 27,674 individuals are living with HIV. The area reports more than 1,000 new HIV diagnoses each year—rates that surpass both state and national averages. Studies show that people living with HIV are nearly twice as likely to misuse opioids compared to those without HIV.

“There are shared risk factors in both disease states with a high likelihood of pain among people living with HIV leading to opioid prescriptions,” said Rinker. “Then in seeking treatment for opioid use disorder, people living with HIV are more likely to experience stigma, social marginalization and discrimination due to their dual diagnosis.”

Rinker's project will assess how Screening, Brief Intervention, and Referral to Treatment (SBIRT)—a healthcare approach aimed at identifying and addressing substance misuse before it becomes severe—is implemented among patients receiving care at five Ryan White-funded clinics in Houston/Harris County. These clinics receive federal support through the Ryan White HIV/AIDS Program administered by the Health Resources and Services Administration (HRSA).

“SBIRT is an empirically supported framework for reducing substance misuse, but to date, there are no strategic initiatives in Houston/Harris County among people living with HIV engaged in care to better integrate SBIRT for opioid use disorder,” said Rinker. “We hope to develop a community of practice - a group of people who come together to create stronger academic-community partnerships to better screen, provide a brief intervention, and refer a person living with HIV to treatment for opioid use disorder.”

Rinker will work alongside co-investigator Shital Patel from Baylor College of Medicine. They plan to collect data through patient records as well as interviews and surveys involving both patients and providers.

“We need to understand both what prevents and enables them and their providers to seek treatment,” said Rinker. She added that integrating effective treatment for opioid use disorder is crucial not only for reducing harm related to substance use but also for improving outcomes related to HIV care.

“The intersection of HIV and OUD can also worsen adherence to antiretroviral therapy. It is expected that at the end of this project we will have a comprehensive assessment of barriers and facilitators to implement SBIRT in HIV care,” she said.