Abstract
People experiencing homelessness (PEH) are disproportionately diagnosed with active tuberculosis. While promoting latent tuberculosis infection (LTBI) treatment has been a call to action, PEH engaging in substance use often experience challenges in completing LTBI treatment. In this non-randomized single arm study, we tested an innovative, community-based, nurse-led community health worker (RN-CHW) model, on reducing drug use among 50 PEH, residing in homeless shelters or living on the streets in Los Angeles. Follow-up was at 3- and 6- months. Findings revealed significant and ongoing decrease in any drug use (odds ratio [OR]=0.30; 95% confidence interval [CI]=0.14-0.68);p=.004), amphetamine use (OR=0.14; 95% CI=0.02-0.81;p=.029), cannabis use (OR=0.26; 95% CI=0.12-0.57;p=.001) and methamphetamine use (OR=0.30; 95% CI=0.10-0.90;p=.031) at 6-month follow-up. To our knowledge, this pilot study is the first to evaluate the impact a RN-CHW delivered intervention on reduction in drug use among PEH enrolled in a LTBI intervention. LTBI interventions may serve as an entryway into reduction in drug use among this underserved population.
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