New York researchers are testing whether the addiction teams hospitals built during the opioid crisis can also serve as a delivery system for HIV prevention drugs, targeting a population that remains at alarming risk despite decades of progress against the epidemic.

The effort is funded by a $756,000 federal grant from the National Institute on Drug Abuse and focuses on a drug called PrEP (pre-exposure prophylaxis), a daily pill or injectable that prevents HIV infection. FDA-approved since 2012, PrEP has transformed HIV prevention for many Americans. But among people who use substances, uptake remains in the single digits, even though the CDC designates this population as an HIV priority group.

New York sits at the center of both crises. The state recorded more than 4,800 opioid overdose deaths in 2023, and New York City alone accounts for roughly one in ten people living with HIV in the entire country. A 2022-2023 HIV cluster in the South Bronx, linked to injection use of fentanyl and xylazine, served as a stark reminder that substance use-driven transmission is still an active threat, not a relic of the 1980s epidemic.

The core idea behind the study is straightforward: people who rarely walk into a clinic do end up in hospitals. When they arrive, addiction consult services, the multidisciplinary teams that expanded rapidly across the Northeast during the opioid crisis to connect patients with treatment, are often already at the bedside starting medications like buprenorphine. Researchers want to know whether that same visit can also be used to assess HIV risk and get patients started on PrEP.

Despite the logic being apparent, almost no research has actually examined how to make that work in practice. This pilot is designed to fill that gap. Researchers will first interview 20 hospitalized patients with substance use disorders and 20 clinicians about the barriers and opportunities they see, then convene a taskforce including patients and hospital partners to develop a practical approach. The final phase is a 12-month test of that approach across hospital sites.

The study is explicitly designed as groundwork for a larger trial. If the pilot shows the approach is workable, the team plans to seek a full NIH grant to test its effectiveness at scale. Similar early-stage addiction research has unfolded in states like Ohio, where researchers are testing whether training rural doctors can close treatment gaps, reflecting a broader federal push to reach patients who fall outside traditional care systems.

The 12-month pilot phase is expected to wrap up before the team submits its follow-on funding application, meaning results are still a few years away from informing practice more broadly.