Evidence map›Paper›PMID 42322177›Full record

ArticleDrug and alcohol review2026

Perceptions of Buprenorphine With Naloxone Treatment and the Fear of Precipitated Withdrawal: A Qualitative Exploration With HIV Prevention Trials Network 094 INTEGRA Participants and Staff.

Rose A Schmidt, Amaya Perez-Brumer, Peter Davidson, Steve Shoptaw, Nabila El-Bassel, Philip Andrew, Jayla Harris, Omar Nieto, Sydney Bornstein, Rashaunna Redd and 8 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Drug and alcohol review, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Rose A SchmidtDalla Lana School of Public Health, University of Toronto, Toronto, Canada.ORCID 0000-0002-0307-8482
Amaya Perez-BrumerDalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Peter DavidsonSchool of Medicine, University of California San Diego, La Jolla, California, USA.
Steve ShoptawDepartment of Family Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
Nabila El-BasselSchool of Social Work, Columbia University, New York, New York, USA.
Philip AndrewHIV Prevention Trials Network, Durham, North Carolina, USA.
Jayla HarrisHIV Prevention Trials Network, Durham, North Carolina, USA.
Omar NietoDepartment of Family Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
Sydney BornsteinMilken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
Rashaunna ReddColumbia University, ICAP/BPC, New York, New York, USA.
Jessica YeagerMcGovern School of Medicine, UTHealth Houston, Houston, Texas, USA.
David Goodman-MezaDivision of Infectious Diseases, University of California Los Angeles, Los Angeles, California, USA.
Albert L HassonDepartment of Family Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
Marc SeigelMilken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA.
Cecile DenisDepartment of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0002-0903-6080
Renee El-KrabSchool of Medicine, University of California San Diego, La Jolla, California, USA.
Laramie R SmithSchool of Medicine, University of California San Diego, La Jolla, California, USA.ORCID 0000-0002-5371-3229
HPTN 094 Team

Funding

SDMC: HPTN 084 Pregnancy SupplementUM1AI068617 · NIAID · FRED HUTCHINSON CANCER RESEARCH CENTER · PI Elizabeth Renata Brown, Deborah J Donnell · 2011 to 2026
$204.9M
UCLA AIDS Prevention and Treatment Clinical Trials UnitUM1AI069424 · NIAID · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Judith S. Currier, RAPHAEL J LANDOVITZ · 2012 to 2026
$51.8M
ICAP Clinical Trials UnitUM1AI154468 · NIAID · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI WAFAA M. EL-SADR, JESSICA E. JUSTMAN · 2021 to 2026
$13.0M
The District of Columbia Clinical Trials Unit (DC CTU)UM1AI154466 · NIAID · GEORGE WASHINGTON UNIVERSITY · PI Sarah Henn, Manya Magnus · 2021 to 2026
$12.5M
Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentNational Institute of Allergy and Infectious Diseases UM1AI068613National Institute of Allergy and Infectious Diseases UM1AI068617National Institute of Allergy and Infectious Diseases UM1AI068619NIAID NIH HHS UM1 AI068617NIAID NIH HHS UM1 AI069424NIAID NIH HHS UM1 AI154466NIAID NIH HHS UM1 AI154468NIDA NIH HHSNIH HHSNIH Office of the DirectorNIMH NIH HHS
6 · The paper itself

Abstract

introductionUptake of evidence-based medication for opioid use disorder (MOUD), including buprenorphine-naloxone, remains low despite the expanding US opioid crisis. This study examined participants' and staff perceptions of adopting and delivering buprenorphine-naloxone on a mobile unit providing integrated MOUD and HIV services for people with opioid use disorder who inject drugs in the HPTN 094 INTEGRA trial.

methodsWe conducted semi-structured interviews with people with opioid use disorder who inject drugs in the intervention or control arm (n = 77) and mobile unit staff (n = 38) of HPTN 094 as part of an embedded qualitative implementation science evaluation across five US cities: Houston, Los Angeles, New York City, Philadelphia and Washington, DC. Interviews were transcribed and analysed using a pragmatic inductive and deductive thematic approach.

resultsFear of precipitated withdrawal was a primary factor shaping perceptions of buprenorphine and other MOUD formulations. This fear was heightened by the widespread presence of fentanyl in the unregulated drug supply. Participants' MOUD preferences were influenced by their treatment goals and by misperceptions of the role of naloxone in buprenorphine and the risk of precipitated withdrawal. Additional barriers included stigma towards MOUD and infrastructure constraints that complicated buprenorphine-naloxone inductions on a mobile unit. DISCUSSION AND

conclusionsEven with facilitated access, perceptions of evidence-based MOUD were strongly shaped by fear of precipitated withdrawal. Aligning MOUD formulations with the treatment goals of people who inject drugs, along with expanding flexibility in MOUD access, delivery and induction practices across formulations, may improve uptake of these life-saving treatments.

Indexed as

BuprenorphineBuprenorphine, Naloxone Drug CombinationFearHIV InfectionsOpioid-Related DisordersSubstance Withdrawal SyndromeAdultAttitude of Health PersonnelFemaleHumansMaleMiddle AgedMobile Health UnitsNaloxoneNarcotic AntagonistsOpiate Substitution TreatmentBuprenorphineBuprenorphine, Naloxone Drug CombinationNaloxoneNarcotic AntagonistsbuprenorphineHIVmobile health unitsnaloxone drug combinationopiate substitution treatmentopioid‐related disorders

Identifiers

PMID42322177
PMCPMC13282718

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.