The University of Wisconsin-Madison has been partnering with Vivent Health on research and prevention for many years. Starting in 2018, we conducted a large research study called the Rural Opioid Initiative, or ROI. ROI was one of the first studies in the United
States to examine the growing crisis of opioid and methamphetamine overdose in rural communities.
A note to our study participants: If you have participated in any of the projects below, we want to say thank you. Through the projects below and others that came before them, UW-Madison and Vivent Health continue to learn from people who use drugs about the challenges they face and solutions that could address these challenges. You have made this research possible by generously sharing your time and your experiences. The information you shared will be used to advocate for change and improve the lives of people who use drugs in Wisconsin and beyond.
- The purpose of the Rural Opioid Initiative project in Wisconsin was to examine how common HIV, hepatitis C, and sexually transmitted infections are among people who inject drugs. We also examined whether or not prevention and harm reduction services were available in northern, rural Wisconsin. A total of 991 participants were enrolled out of six Vivent Health offices in Appleton, Eau Claire, Green Bay, La Crosse, Superior, and Wausau, WI to participate in a survey and complete a blood test for HIV and hepatitis C.
- An enormous amount of information was gained from this project. The people who participated in this project indicated that it was hard to access substance use treatment medications, and that it was easier to access condoms, sterile syringes, and hepatitis C and STI treatment. Participants indicated that they were stigmatized by others, and have strong feelings of stigma within themselves.
Wisconsin was 1 of 10 sites in the Rural Opioid Initiative and researchers continue to learn from and use the data to report changes that need to be made to support the community and people who use drugs.You can learn more about the other sites and research findings here: https://ruralopioidinitiative.org/
- The COVID-19 Impact Study was added onto Wisconsin’s Rural Opioid Initiative Project in 2021. The goal was to understand how the COVID-19 pandemic affected the drug supply, access to harm reduction services and supplies, and overdose risk behaviors among people who inject drugs. 240 clients of Vivent Health across all 10 of Vivent Health’s Wisconsin syringe services program offices were recruited to complete an online survey.
- We found that many clients had less social support during the pandemic, and this was correlated with disrupted access to harm reduction services and experiencing an overdose. Disrupted access to harm reduction services was also correlated with being female, reporting feeling pressure to share drugs or equipment, and worrying about withdrawal. It was also correlated with disruptions to the drug supply, such as changes to how and where people got their drugs, the price they paid, the availability, quantity, and purity of drugs, and with whom and where drugs were used.
- In a second phase of the Rural Opioid Initiative, the study team worked with Prevention staff at Vivent Health to design and implement a person-centered service model called Prevention Navigation. The goal of Prevention Navigation was to increase access and linkage to needed health services and treatments among people who inject drugs in Northern Wisconsin.
- Prevention Navigation is a four session program for people who inject drugs, focused on setting goals, identifying barriers/facilitators, making referrals to community resources, and creating individualized harm reduction plans. It is now available as a regular service in some Vivent Health offices.
- More than half of participants in Prevention Navigation said they had challenges with their mental health, having a stable income, and having access to a safe, stable place to sleep, to food, and to transportation and healthcare when they started the program.
- Participants in Prevention Navigation had better access to a safe, stable place to sleep and food for themselves and their families after participating in the program.
- iThrive WI delivered an overdose prevention intervention through a smartphone application to 60 participants on a study-provided phone with an unlimited data plan. Participants chose an overdose prevention goal they wanted to work on each week over the course of 12 weeks and received resources to support achieving their goals.
- Participating in the program was associated with decreases in behaviors that raise risk of overdose, such as using alone and injection drug use.
- Participants also shared how having access to a phone through the study helped them achieve things like gaining employment and housing, re-engaging with their loved ones, accessing substance use treatment, and more.