Bringing Care Closer: NIH-Funded Clinical Trial of Integrated Health Services Through Mobile Medical Units Helped Reduce Deaths Among People Who Inject Drugs and Are at Risk for HIV

University Professor Nabila El-Bassel co-led the HPTN 094 randomized controlled trial, which evaluated integrated HIV-prevention and addiction care for people who inject drugs in five U.S. cities: New York City, Houston, Los Angeles, Philadelphia, and Washington, D.C.

The study was funded by the National Institutes of Health (NIH) and evaluated integrated HIV-prevention and addiction care for people who inject drugs. The study shows that delivering integrated HIV and substance use disorder (SUD) services using peer navigation in mobile medical units reduced all-cause deaths by 71% at 52 weeks compared to participants who received peer navigation to community-based services alone. The results are published in JAMA Psychiatry (DOI: 10.1001/jamapsychiatry.2026.3644).

University Professor Nabila El-Bassel co-led the study with Steven Shoptaw of the University of California, Los Angeles (UCLA).

“People who inject drugs often face fragmented systems, unstable housing, stigma, and other barriers that make sustained care difficult. HPTN 094 shows why we must continue developing low-threshold models that meet people where they are and connect HIV prevention, addiction treatment, and supportive care in ways that are accessible and responsive to their lives,” said El-Bassel.

“Our findings show that bringing integrated care for HIV prevention and opioid use disorder to people who inject drugs who live in our cities and who are out of treatment helps many to start and to remain in care after six months. When that integrated care is delivered using peer navigation on mobile units, there is a suggestion that all-cause mortality is reduced one year later compared to peer navigation alone to available community services,” said Shoptaw.

The trial found that 26 weeks of integrated HIV-prevention, addiction, and peer navigation services delivered through mobile units did not significantly increase use of daily, oral HIV pre-exposure prophylaxis (PrEP) or medications for opioid use disorder (MOUD) compared with peer navigation to community-based services.

About the Study

The analysis included 409 adults without HIV who injected drugs, had opioid use disorder, were not taking MOUD at enrollment, and were willing to consider MOUD. Participants were recruited in Houston, Los Angeles, New York City, Philadelphia, and Washington, D.C. Participants were assigned to one of two groups:

  • Intervention group: 26 weeks of peer navigation plus integrated PrEP, MOUD, and limited clinical and supportive services delivered through a mobile unit.
  • Active comparison group: 26 weeks of peer navigation linking participants to available community services.


Peer navigation helps participants connect with care and overcome barriers to accessing services.

Study Leadership

Nabila El-Bassel, PhD, is University Professor and the Willma and Albert Musher Professor of Social Work at Columbia University. She directs Columbia’s Social Intervention Group and Global Health Research Center of Central Asia. She served as HPTN 094 Protocol Co-Chair.

Steven Shoptaw, PhD, is Professor Emeritus of Family Medicine and Psychiatry and Biobehavioral Sciences, George F. Kneller Endowed Chair in Family Medicine, and Vice Chair for Research in the UCLA Department of Family Medicine. He served as HPTN 094 Protocol Chair.

Study Support

The HPTN 094 protocol identifies the Division of AIDS within the National Institute of Allergy and Infectious Diseases as the study sponsor and the National Institute on Drug Abuse as the funder. The manuscript acknowledges support from the National Institute of Allergy and Infectious Diseases under award numbers UM1AI068619, UM1AI068617, and UM1AI068613. The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Article Information

  • Manuscript title: HPTN 094 Randomized Trial Outcomes of Mobile Units for Integrated Addiction and HIV Prevention Services for People Who Inject Drugs
  • Journal: JAMA Psychiatry, DOI: 10.1001/jamapsychiatry.2026.3644
  • ClinicalTrials.gov registration: NCT04804072

 

November 05, 2026
JAMA Psychiatry