Bolstering the HIV Surveillance System Through Innovative Methods, Technologic Advances, and Community-Driven Solutions to Inform Intervention Efforts and End the Epidemic.

An accurate and comprehensive HIV surveillance system is critical to understanding the burden of HIV infection. Reliable estimates into the surveillance system serve as the cornerstone for HIV prevention and treatment programs. PURPOSE OF REVIEW: In this article, we review the current structure and function of the HIV surveillance system in the US, identify gaps in reporting, and propose multiple potential interventions to augment the HIV surveillance system.

Prevalence of adults with stimulant misuse and/or stimulant use disorder in Massachusetts, USA, 2014-2021.

Background And Aims: Stimulant-involved overdose deaths are increasing throughout the United States. Because stimulant misuse (i.e.

Association of Involuntary Displacement of People Experiencing Homelessness and Crime in Denver, CO: A Spatiotemporal Analysis.

In 2022, approximately 580,000 people experienced homelessness in the United States. In response, many cities have implemented "camping ban" policies enforced by involuntary displacement of homeless encampments. Displacement has been cited as a strategy to protect public health and safety.

An economic analysis of the cost of mobile units for harm reduction, naloxone distribution, and medications for opioid use disorder.

Background & Objective: Mobile substance use treatment units are effective approaches to increase treatment access and reduce barriers to opioid use disorder (OUD) care. However, little is known about the economic costs of maintaining and operating these units. This study aimed to estimate the economic costs of starting and maintaining mobile units providing harm reduction, overdose education and naloxone distribution (OEND), and medication for opioid use disorder (MOUD).

U.S. trends in methamphetamine-involved psychiatric hospitalizations in the United States, 2015-2019.

Background: In the U.S., overdose deaths and substance treatment admissions related to methamphetamine are rising.

Using decision tree models and comprehensive statewide data to predict opioid overdoses following prison release.

Purpose: Identifying predictors of opioid overdose following release from prison is critical for opioid overdose prevention.

Methods: We leveraged an individually linked, state-wide database from 2015-2020 to predict the risk of opioid overdose within 90 days of release from Massachusetts state prisons. We developed two decision tree modeling schemes: a model fit on all individuals with a single weight for those that experienced an opioid overdose and models stratified by race/ethnicity.

Involuntary displacement and self-reported health in a cross-sectional survey of people experiencing homelessness in Denver, Colorado, 2018-2019.

Background: The number of people experiencing unsheltered homelessness in the U.S. is increasing.

Cost of start-up activities to implement a community-level opioid overdose reduction intervention in the HEALing Communities Study.

Background: Communities That HEAL (CTH) is a novel, data-driven community-engaged intervention designed to reduce opioid overdose deaths by increasing community engagement, adoption of an integrated set of evidence-based practices, and delivering a communications campaign across healthcare, behavioral-health, criminal-legal, and other community-based settings. The implementation of such a complex initiative requires up-front investments of time and other expenditures (i.e.

Intersectional inequities and longitudinal prevalence estimates of opioid use disorder in Massachusetts 2014-2020: a multi-sample capture-recapture analysis.

Background: As overdoses continue to increase worldwide, accurate estimates are needed to understand the size of the population at risk and address health disparities. Capture-recapture methods may be used in place of direct estimation at nearly any geographic level (e.g.

Identifying structural risk factors for overdose following incarceration: a concept mapping study.

Background: Currently, there are more than two million people in prisons or jails, with nearly two-thirds meeting the criteria for a substance use disorder. Following these patterns, overdose is the leading cause of death following release from prison and the third leading cause of death during periods of incarceration in jails. Traditional quantitative methods analyzing the factors associated with overdose following incarceration may fail to capture structural and environmental factors present in specific communities.

Establishing a Protocol for Determining the Costs of an Integrated Set of Evidence-based Practices Aimed at Reducing Opioid Overdose Deaths.

Objectives: In the midst of the opioid overdose crisis, local jurisdictions face a choice of public health interventions. A significant barrier when considering evidence-based practices (EBPs) is the lack of information regarding their implementation cost. This protocol paper provides the methodological foundation for the economic cost evaluations of community-wide strategies on the scale of a national study.

Massachusetts Prevalence of Opioid Use Disorder Estimation Revisited: Comparing a Bayesian Approach to Standard Capture-Recapture Methods.

Background: The National Survey on Drug Use and Health (NSDUH) estimated the prevalence of opioid use disorder (OUD) among the civilian, noninstitutionalized people aged 12 years or older in Massachusetts as 1.2% between 2015 and 2017. Accurate estimation of the prevalence of OUD is critical to the success of treatment and resource planning.

Mortality, incarceration and cost implications of fentanyl felonization laws: A modeling study.

Background: Opioid overdose continues to be a major cause of death in the United States. One effort to control opioid use has been to implement policies that enhance criminalization of opioid possession. Laws to further criminalize possession of fentanyl have been enacted or are under consideration across the country, including at the national level.

Economic Evaluation of Extended-Release Buprenorphine for Persons With Opioid Use Disorder.

Importance: In 2017, the US Food and Drug Administration (FDA) approved a monthly injectable form of buprenorphine, extended-release buprenorphine; published data show that extended-release buprenorphine is effective compared with no treatment, but its current cost is higher and current retention is lower than that of transmucosal buprenorphine. Preliminary research suggests that extended-release buprenorphine may be an important addition to treatment options, but the cost-effectiveness of extended-release buprenorphine compared with transmucosal buprenorphine remains unclear.

Objective: To evaluate the cost-effectiveness of extended-release buprenorphine compared with transmucosal buprenorphine.

Estimated Clinical Outcomes and Cost-effectiveness Associated With Provision of Addiction Treatment in US Primary Care Clinics.

Importance: US primary care practitioners (PCPs) are the largest clinical workforce, but few provide addiction care. Primary care is a practical place to expand addiction services, including buprenorphine and harm reduction kits, yet the clinical outcomes and health care sector costs are unknown.

Objective: To estimate the long-term clinical outcomes, costs, and cost-effectiveness of integrated buprenorphine and harm reduction kits in primary care for people who inject opioids.

Population-Level Health Effects of Involuntary Displacement of People Experiencing Unsheltered Homelessness Who Inject Drugs in US Cities.

Importance: At least 500 000 people in the US experience homelessness nightly. More than 30% of people experiencing homelessness also have a substance use disorder. Involuntary displacement is a common practice in responding to unsheltered people experiencing homelessness.

The prevalence of opioid use disorder in Kentucky's counties: A two-year multi-sample capture-recapture analysis.

Background: Kentucky has one of the highest opioid overdose mortality rates in the United States. Accurate estimates of people with opioid use disorder (OUD) are critical to plan for the scope of interventions required to reduce overdose and opioid misuse. Commonly used household surveys are known to underestimate OUD at the state-level and do not provide county-level estimates.

Beyond Sex: Human Monkeypox Virus is an Emerging Threat to Marginalized Populations.

The human version of the monkeypox virus (MPXV) is establishing itself to various degrees across the globe. While substantial attention has been focused on sexual risk, particularly among men who have sex with men, other populations are vulnerable to this virus. In particular, people experiencing homelessness and those with substance use disorders are vulnerable to MPXV.

A multinational Delphi consensus to end the COVID-19 public health threat.

Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities.

Opioid Use Disorder Among Ohio's Medicaid Population: Prevalence Estimates From 19 Counties Using a Multiplier Method.

The decades-long overdose epidemic in the United States is driven by opioid misuse. Overdoses commonly, although not exclusively, occur in individuals with opioid use disorder (OUD). To allocate adequate resources and develop appropriately scaled public health responses, accurate estimation of the prevalence of OUD is needed.