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HIV InfectionsNCT04601064

Peer Supported Collaborative Care Mental Health and Substance Use Disorder Care

A study testing Collaborative Care Model in people with HIV Infections and Substance Use Disorders, run by Johns Hopkins University at 1 site in United States.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

This is a research study to assess the effectiveness of a peer-led collaborative care model for integrating treatment for substance use and or mental health disorders into HIV care settings. Read more about this study

Who is it for?
Ages 18 to 99 years
What is being tested?
Collaborative Care Model
Could I receive a placebo?
No, everyone receives an active treatment
How many people
405 participants
Where
1 siteUnited States
Study dates
20 Apr 2022to 15 Dec 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 99 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Individuals 18-99 years old
  • accessing HIV care at the Bartlett HIV clinic
  • Screened positive for a Mental health disorder or substance use disorder based on a computerized self-administered screen with Patient Health Questionnaire (PHQ-9)(score>10), General Anxiety Disorder (GAD-7) (score>10), National Institute on Drug Abuse Drug Use Screening Tool: 3 Question Quick Screen (Response of "Yes" to one or more heavy drinking days or "Yes" to use of illegal drugs or prescription drugs for non-medical reasons.
  • Does not currently have a Mental Health or Substance Use Disorder treatment provider and or not receiving any current treatment (psychotherapy or pharmacotherapy) for Mental Health or Substance Use Disorder.
  • English speaking

Who cannot join

  • Individuals lacking the capacity to consent

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Johns Hopkins Hospital

    Baltimore, Maryland, 21287

Other trials in United States

About this study

Official title: Peer Supported Collaborative Care to Increase Engagement in Mental Health and Substance Use Disorder Care in HIV Care Settings

This is a research study to assess the effectiveness of a peer-led collaborative care model for integrating treatment for substance use and or mental health disorders into HIV care settings.

Depending on whether or not participants enroll in this study, participants will be assigned randomly (by chance, like drawing a number from a hat) to one of two groups. In group 1, participants would receive usual clinical care. In group 2, participants would work with a peer-case manager who would help support participants to engage in substance use or mental health disorder care. Regardless of the group participants are in, participants will fill out a survey when first enrolled in the study, and then again 12 months later.

Being tested
Collaborative Care Model
Keywords
Collaborative Care, Peer Support
Medical subject headings
HIV Infections, Substance-Related Disorders, Mental Disorders, Behavior, Addictive

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Collaborative Care ModelBehavioural

    Collaborative care (CC) is an evidence-based model of integrated mental health and substance use disorder care endorsed by the American Psychiatric Association for the integration of mental health and substance use disorder care into primary care settings. CC includes the following components: 1) A collaborative care team of multidisciplinary health care providers consisting of the primary physician, a care manager and a consulting psychiatrist, providing care in a coordinated fashion; 2) A population focus with the team working together to provide care and continuously measure and track health outcomes of a defined population of patients; 3) A measurement-guided approach with systematic use of disease specific patient reported outcome measures, such as symptom rating scales like the PHQ-9 to drive clinical decision making; and 4) Evidence-based practices with the team adapting scientifically proven treatments within an individual clinical context to achieve improved health outcomes.

Study groups in NCT04601064
Study groupRoleWhat they receive
Collaborate Care (CC) ModelExperimentalFor patients randomized to the CC arm, in addition to the provider being alerted to the positive Mental Health and Substance Use Disorder screener, the patient will also be assigned to a peer case manager (P-CM). The P-CM will provide longitudinal care for the patient as part of their care management case load. The collaborative care support team will include the P-CM, a consultant addiction psychiatrist and the patient's HIV provider who will implement a stepped care program consisting of: 1) an initial assessment, determination of and implementation of an individualized care plan to provide; 2) psychosocial and medication adherence support; 3) evidence-based brief intervention incorporating motivational interviewing informed strategies; 4) measurement-based care for Mental Health and Substance Use Disorder provided directly by the HIV primary care provider or in collaboration with specialty Mental Health and Substance Use Disorder services.
Receives: Behavioral: Collaborative Care Model
Usual Care (UC)No interventionFor patients randomized to the UC referral arm, the patient's HIV provider will receive an electronic alert of the patient's positive screen for a Mental Health and Substance Use Disorder. The patient will not be contacted by the P-CM. The provider, at their discretion, will initiate referral to the psychiatry service available onsite. For patients with Substance Use Disorder, providers refer to the in-clinic Substance Use Disorder treatment program that is managed by a nurse practitioner with Substance Use Disorder care experience. Once referred, the patient is seen by the nurse practitioner (separate from the HIV provider) who manages prescription of and assessment of adherence to buprenorphine, including monitoring of urine toxicology results with support from an addiction counselor. The Bartlett Clinic runs 2 substance use groups weekly and has processes for referral to a higher level of Substance Use Disorder care at offsite Substance Use Disorder treatment programs.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The Number of Participants with HIV Virologic Suppression

    This is defined as a viral load < 200 copies/ml

    Measured: Within a 3 month window of the 12 month follow-up (i.e. 3 months before or after the 12 month follow up)

Secondary outcomes (3)
  1. Number of Participants with Retention in HIV Care

    At least 2 medical visit dates, specifically for HIV care, that are at least 90 days apart

    Measured: Within 12 months of patient entrance into the study

  2. Number of Participants Who Obtain Treatment for Mental Health and Substance Use Disorder

    Receipt of evidence-based treatment for Mental Health and Substance Use Disorder, including medication and brief psychotherapy

    Measured: Within 12 month of patient entrance into the study

  3. Number of Participants with Change in Severity of Mental Health and Substance Use Disorder

    The following changes in Mental Health and Substance Use Disorder outcomes from baseline to 12 month follow up: Depression- 50% reduction in PHQ 9, Anxiety- 50% reduction in GAD 7, Bipolar Disorder- 50% reduction in Altman Mania Scores, PTSD- 50% reduction in PTSD Checklist 5, and Substance Use Disorder- 50% reduction in severity of dependence scale score

    Measured: Changes from baseline to 12 month follow up

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Oct 2020
  2. Study start20 Apr 2022
  3. Primary completion15 Dec 2026 (estimated)
  4. Study completion15 Dec 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
405 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04601064
Sponsor's protocol ID
IRB00264580
Other IDs
R01DA052297
Status last verified
Jan 2026
First submitted
19 Oct 2020
Last updated
12 Jan 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Vagenas P, Azar MM, Copenhaver MM, Springer SA, Molina PE, Altice FL. The Impact of Alcohol Use and Related Disorders on the HIV Continuum of Care: a Systematic Review : Alcohol and the HIV Continuum of Care. Curr HIV/AIDS Rep. 2015 Dec;12(4):421-36. doi: 10.1007/s11904-015-0285-5.

    PubMed 26412084
  • Chander G, Himelhoch S, Moore RD. Substance abuse and psychiatric disorders in HIV-positive patients: epidemiology and impact on antiretroviral therapy. Drugs. 2006;66(6):769-89. doi: 10.2165/00003495-200666060-00004.

    PubMed 16706551
  • Azar MM, Springer SA, Meyer JP, Altice FL. A systematic review of the impact of alcohol use disorders on HIV treatment outcomes, adherence to antiretroviral therapy and health care utilization. Drug Alcohol Depend. 2010 Dec 1;112(3):178-93. doi: 10.1016/j.drugalcdep.2010.06.014. Epub 2010 Aug 11.

    PubMed 20705402
  • Rooks-Peck CR, Adegbite AH, Wichser ME, Ramshaw R, Mullins MM, Higa D, Sipe TA; Prevention Research Synthesis Project. Mental health and retention in HIV care: A systematic review and meta-analysis. Health Psychol. 2018 Jun;37(6):574-585. doi: 10.1037/hea0000606.

    PubMed 29781655
  • Chander G, Himelhoch S, Fleishman JA, Hellinger J, Gaist P, Moore RD, Gebo KA. HAART receipt and viral suppression among HIV-infected patients with co-occurring mental illness and illicit drug use. AIDS Care. 2009 May;21(5):655-63. doi: 10.1080/09540120802459762.

    PubMed 19444675
  • Sam TS, Hutton HE, Lau B, McCaul ME, Keruly J, Moore R, Chander G. Antiretroviral Therapy Use, Medication Adherence, and Viral Suppression Among PLWHA with Panic Symptoms. AIDS Behav. 2015 Nov;19(11):2049-56. doi: 10.1007/s10461-015-1064-4.

    PubMed 25903506
  • Monroe AK, Lau B, Mugavero MJ, Mathews WC, Mayer KH, Napravnik S, Hutton HE, Kim HS, Jabour S, Moore RD, McCaul ME, Christopoulos KA, Crane HC, Chander G. Heavy Alcohol Use Is Associated With Worse Retention in HIV Care. J Acquir Immune Defic Syndr. 2016 Dec 1;73(4):419-425. doi: 10.1097/QAI.0000000000001083.

    PubMed 27243904
  • Chander G, Lau B, Moore RD. Hazardous alcohol use: a risk factor for non-adherence and lack of suppression in HIV infection. J Acquir Immune Defic Syndr. 2006 Dec 1;43(4):411-7. doi: 10.1097/01.qai.0000243121.44659.a4.

    PubMed 17099312
  • Falade-Nwulia O, Sutcliffe CG, Mehta SH, Moon J, Chander G, Keruly J, Katzianer J, Thomas DL, Moore RD, Sulkowski MS. Hepatitis C Elimination in People With HIV Is Contingent on Closing Gaps in the HIV Continuum. Open Forum Infect Dis. 2019 Sep 30;6(10):ofz426. doi: 10.1093/ofid/ofz426. eCollection 2019 Oct.

    PubMed 31667200
  • Westergaard RP, Hess T, Astemborski J, Mehta SH, Kirk GD. Longitudinal changes in engagement in care and viral suppression for HIV-infected injection drug users. AIDS. 2013 Oct 23;27(16):2559-66. doi: 10.1097/QAD.0b013e328363bff2.

    PubMed 23770493
  • Campo RE, Alvarez D, Santos G, Latorre J. Antiretroviral treatment considerations in Latino patients. AIDS Patient Care STDS. 2005 Jun;19(6):366-74. doi: 10.1089/apc.2005.19.366.

    PubMed 15989432
  • Giordano TP, Visnegarwala F, White AC Jr, Troisi CL, Frankowski RF, Hartman CM, Grimes RM. Patients referred to an urban HIV clinic frequently fail to establish care: factors predicting failure. AIDS Care. 2005 Aug;17(6):773-83. doi: 10.1080/09540120412331336652.

    PubMed 16036264
  • Lucas GM, Chaudhry A, Hsu J, Woodson T, Lau B, Olsen Y, Keruly JC, Fiellin DA, Finkelstein R, Barditch-Crovo P, Cook K, Moore RD. Clinic-based treatment of opioid-dependent HIV-infected patients versus referral to an opioid treatment program: A randomized trial. Ann Intern Med. 2010 Jun 1;152(11):704-11. doi: 10.7326/0003-4819-152-11-201006010-00003.

    PubMed 20513828
  • Low AJ, Mburu G, Welton NJ, May MT, Davies CF, French C, Turner KM, Looker KJ, Christensen H, McLean S, Rhodes T, Platt L, Hickman M, Guise A, Vickerman P. Impact of Opioid Substitution Therapy on Antiretroviral Therapy Outcomes: A Systematic Review and Meta-Analysis. Clin Infect Dis. 2016 Oct 15;63(8):1094-1104. doi: 10.1093/cid/ciw416. Epub 2016 Jun 25.

    PubMed 27343545
  • Sherer R, Stieglitz K, Narra J, Jasek J, Green L, Moore B, Shott S, Cohen M. HIV multidisciplinary teams work: support services improve access to and retention in HIV primary care. AIDS Care. 2002 Aug;14 Suppl 1:S31-44. doi: 10.1080/09540120220149975.

    PubMed 12204140

Questions about this trial

What is this clinical trial studying?

A study testing Collaborative Care Model in people with HIV Infections and Substance Use Disorders, run by Johns Hopkins University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 12 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The Number of Participants with HIV Virologic Suppression (time frame: Within a 3 month window of the 12 month follow-up (i.e. 3 months before or after the 12 month follow up)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04601064, which also lists 25 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Jan 2026.

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