Grant: Doctoral Research Award - Priority Announcement - HIV/AIDS and/or STBBI

Opioid use disorder (OUD) is a chronic condition where people continuously use opioids like heroin or fentanyl. Over 50% of people with OUD also have a mental health disorder (MHD) and this combination puts them at high risk of overdose or other causes of death. Unfortunately, few receive treatment for both conditions. Opioid agonist therapy (OAT) is a safe and effective treatment for OUD, reducing cravings and overdose deaths. It may also improve MHD symptoms, but research on OAT's impact on MHD management is limited. This is especially important for people living with HIV (PLWH). Despite progress in HIV care, having both OUD and MHD are lowering the chances of living longer in PLWH. This study wants to understand whether periods of engagement and disengagement in OAT affect MHD management in PLWH. We will look at two aspects of MHD management: giving out MHD medications (dispensation) and ensuring individuals take them regularly as prescribed (adherence). We will examine mood and anxiety disorders and psychotic disorders, along with the medicines used to manage these conditions (antidepressants, antipsychotics, and anxiolytics). We think that people on OAT may need fewer MHD medications as OAT can improve some MHD symptoms, and their adherence may be better during OAT engagement. We will analyze anonymized healthcare records of PLWH with OUD and MHD in British Columbia (BC) between 2012 and 2020, during BC's overdose and mental health crises escalation. Our analysis plan includes using a mix of traditional statistical methods and artificial intelligence techniques. This research could inform personalized MHD management and appropriate prescribing practices during OAT by identifying specific MHD medicines people adhere to. Consequently, it could reduce negative events like overdose deaths. Among PLWH, proper management of MHD during OAT can improve their mental health, leading to better HIV and OUD end results.