Publications by authors named "Tyler S Bartholomew"

Although people who inject drugs (PWID) are at high risk of acquiring HIV, knowledge and uptake of pre-exposure prophylaxis (PrEP) for HIV prevention among this population remain low due to numerous psychosocial and structural barriers. Multiple implementation strategies have been proposed to address this gap, notably providing long-acting injectable (LAI) formulations of PrEP and offering PrEP at syringe services programs (SSPs). This qualitative study explores the acceptability and feasibility of offering LAI-PrEP for PWID at risk for HIV at Florida's first legal SSP.

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Article Synopsis
  • - The study aimed to evaluate the effects of the COVID-19 pandemic on the health of people who inject drugs (PWID) using a collaborative data-sharing model established in 2021, which pooled data from multiple studies across North America.
  • - Researchers analyzed data on various health indicators (like substance use treatment and mental health conditions) over four different time periods: pre-pandemic, early-pandemic, mid-pandemic, and late-pandemic, involving 6,213 PWID participants.
  • - The results showed minimal changes in health indicators throughout the pandemic, suggesting stability possibly due to policy adjustments and resilience in support services for PWID, highlighting the potential of the data-sharing model for better health insights.
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Background: While people with substance use disorders, including people who inject drugs (PWID), experience increased risk for COVID-19 infection and adverse outcomes, COVID-19 vaccination rates among PWID are consistently lower than those observed in the general population. Offering COVID-19 vaccines at syringe services programs (SSPs) has been proposed as a critical strategy to increase vaccine uptake among this population. We explored the experiences of frontline staff at an SSP in Miami, Florida implementing onsite COVID-19 vaccines.

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Background: Buprenorphine is a first-line treatment for opioid use disorder (OUD), essential for reducing opioid overdose mortality and improving treatment retention. Despite federal policies that mandate the acceptance of buprenorphine in recovery residences, individuals in South Florida taking this medication often face significant barriers to admission. This study uses a secret shopper survey to examine whether federal policies regarding prescribed buprenorphine use are being violated in South Florida recovery residences.

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Fifty-five of 62 women who inject drugs (WWID) selected long-acting cabotegravir (CAB-LA) over oral PrEP, and 51/55 received a first injection. More recent injection drug use and number of sexual partners were associated with selecting CAB-LA (P < .05).

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Methadone is an opioid receptor agonist medication used in the treatment of opioid use disorder (OUD). Geographic distance to opioid treatment programs (OTPs) is a major barrier to treatment, given requirements for direct observation of dosing and periodic drug screens, and 'methadone treatment deserts' are defined as a public transit threshold of 30 minutes. The purpose of this study was to examine public transit access to methadone treatment for participants of a syringe services program (SSP) in Miami-Dade County, Florida.

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Background: Xylazine is an increasingly common adulterant in the North American unregulated drug supply that is associated with adverse health outcomes (e.g., skin infections, overdose).

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Interventions for substance use disorders (SUDs) are typically delivered face-to-face or remotely via telehealth. In recent years, there has been a rapid rise in the number of SUD services delivered using telehealth. However, the literature on which mode of service delivery SUD patients and providers prefer is still emerging, particularly with respect to family-based interventions in Opioid Treatment Programs (OTPs).

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Background: Xylazine is an increasingly common adulterant in the North American unregulated drug supply that is associated with adverse health outcomes (e.g., skin infections, overdose).

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Introduction: People who use drugs (PWUD) are at increased risk for HIV infection. HIV self-testing (HIVST) is a promising method for identifying new infections, but optimal distribution strategies remain understudied.

Methods: To characterize PWUD by HIVST distribution strategy (peers vs.

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Introduction: Despite having a high risk of acquiring sexually transmitted infections, people who inject drugs (PWID) often do not receive recommended HPV screenings due to barriers to healthcare. Guideline-based cervical HPV screening and vaccination can prevent cervical cancer. Low-cost, low-barrier methods for cancer screening and prevention are important for vulnerable communities such as PWID.

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Article Synopsis
  • The study focuses on a Comprehensive-TeleHarm Reduction (C-THR) intervention aimed at improving HIV prevention services for people who inject drugs (PWID) through syringe services programs (SSP) in Miami, Florida.
  • The CHARIOT trial will involve 350 PWID participants who will be randomly assigned to receive either C-THR or standard clinic referrals, with the goal of increasing engagement in HIV prevention methods like PrEP and medications for opioid use disorder.
  • The outcomes will be assessed over 12 months, focusing on factors such as engagement, effectiveness, cost-effectiveness, and barriers to implementing the C-THR intervention.
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Article Synopsis
  • - Xylazine, an alpha-2 adrenergic agonist, has become a contaminant in fentanyl and is associated with naloxone-resistant overdoses and unusual wounds in drug users; a unique case in Florida involved a woman with xylazine-induced wounds confirmed through a test strip at a syringe services program.
  • - The woman, 43, presented to a student-run clinic for care of multiple ulcerations on her forearms, and after receiving treatment, she returned seven weeks later with worsening wounds; xylazine was confirmed in her urine during this second visit.
  • - Many people who use drugs (PWUD) struggle to access traditional healthcare due to stigma and lack of insurance, highlighting the urgent need for improved access
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Background: Tele-harm reduction (THR) is a telehealth-enhanced, peer-led, harm reduction intervention delivered within a trusted syringe services program (SSP) venue. The primary goal of THR is to facilitate linkage to care and rapid, enduring virologic suppression among people who inject drugs (PWID) with HIV. An SSP in Miami, Florida, developed THR to circumvent pervasive stigma within the traditional healthcare system.

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Background: People who use drugs (PWUD) experience elevated HIV risk and numerous barriers to facility-based HIV testing. HIV self-testing (HIVST) could circumvent many of those barriers and is acceptable among PWUD, yet HIVST implementation for PWUD is limited. Service providers' perspectives on specific HIVST delivery strategies could help increase availability for PWUD.

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Article Synopsis
  • A study conducted at a student-run clinic in Miami found that 55.9% of patients who inject drugs tested positive for xylazine in their urine samples.
  • The presence of xylazine was linked to factors such as unsheltered homelessness, wounds, and positive tests for hepatitis C, fentanyl, and MDMA.
  • The findings highlight the growing prevalence of xylazine in the Southeastern U.S. and emphasize the need for better screening to address associated risks for people who inject drugs.
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Families Facing the Future (FFF) is an intervention designed specifically for families with a parent in methadone treatment. FFF is unique because it addresses prevention for children and recovery for parents in a single intervention. The primary goals of the program are to prevent parents' relapse, help them cope with relapse if it occurs, and teach parenting skills in order to reduce the likelihood of substance use among their children.

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Background: As injection drug use has increased in the US, so too has the prevalence of receptive syringe sharing. Since the 1980s, Needle and Syringe Programs (NSPs) have been an important source of clean injection equipment and disposal of used syringes. This study reports national syringe coverage and examines the impact of program attributes on organizational-level service uptake, defined as number of syringes distributed per participant contact per year.

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Introduction: The expanded capacity of syringe services programs (SSPs) in the USA to integrate telehealth services was largely related to flexibility of buprenorphine prescription in response to the COVID-19 pandemic. SSPs demonstrated the potential of using telehealth to reach participants with both medical and non-medical services. The present study examines the implementation of medical and non-medical telehealth-based health services in 2020 at SSPs in the USA and organizational characteristics associated with adopting specific telehealth services.

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Objectives: Based on increasing drug overdose deaths and a shortage of healthcare professionals trained in the management of opioid use disorder (OUD), it is imperative to improve health professional education in addiction medicine. This small group learning exercise and patient panel was designed to provide first year medical students with insights into the lives of people with OUD-through a lens of harm reduction-and to connect biomedical knowledge to the core values and professional themes of their doctoring courses.

Methods: Facilitators were assigned to each small group of 8 students for the harm reduction-centered Long and Winding Road small group case exercise.

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Article Synopsis
  • The study explored a telehealth-based intervention for improving access to buprenorphine treatment among people who inject drugs (PWID) with opioid use disorder during the pandemic.
  • A total of 109 participants engaged in the intervention, and the three-month retention rate for buprenorphine was found to be 58.7%.
  • Factors positively influencing retention included telehealth provider visits and receiving increasing doses of buprenorphine, while a history of stimulant use negatively impacted retention rates.
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Background: Naloxone is a medication that can quickly reverse an opioid overdose. Syringe service programs (SSPs) are community-based prevention programs that provide a range of evidence-based interventions in the USA, including naloxone distribution. Attributes of SSPs make them ideal settings for naloxone distribution-they have staff and delivery models that are designed to reach people who use drugs where they are.

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Background: The resurgence of HIV outbreaks and rising prevalence among people who inject drugs (PWID) remain exigent obstacles to Ending the HIV Epidemic in the USA. Adapting a low threshold, comprehensive treatment model for PWID with HIV can leverage syringe services programs (SSPs) to increase availability and accessibility of antiretrovirals (ART), medications for opioid use disorder (MOUD), and hepatitis C cure. We developed Tele-Harm Reduction, a telehealth-enhanced, harm reduction intervention delivered within an SSP venue.

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Background: Hospitalizations for severe injection drug use-related infections (SIRIs) are characterized by high costs, frequent patient-directed discharge, and high readmission rates. Beyond the health system impacts, these admissions can be traumatizing to people who inject drugs (PWID), who often receive inadequate treatment for their substance use disorders (SUD). The Jackson SIRI team was developed as an integrated infectious disease/SUD treatment intervention for patients hospitalized at a public safety-net hospital in Miami, Florida in 2020.

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