Inclusion criteria | Exclusion criteria |
---|---|
Age 18Â years or older | Not fluent in Russian |
HIV-positive | Cognitive impairment precluding informed consent |
Hospitalized at narcology hospital | Breastfeeding or being pregnant |
History of injection drug use | ART use in the past 30Â days prior to hospitalization |
Provision of two contacts to assist with follow-up | Acute severe psychiatric illness (i.e., answered yes to any of the following: past three month active hallucinations; mental health symptoms prompting a visit to the emergency room or hospital; mental health medication changes due to worsening symptoms; presence of suicidal ideations) |
Address within St. Petersburg or districts within 100Â km of St. Petersburg | Known history of liver failure |
Possession of a home or mobile phone | Known hypersensitivity to naltrexone |
Ability and willingness to comply with all study protocols and procedures | Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) greater than 5 times the upper limit of normal |
Severe thrombocytopenia | |
Known coagulation disorder/taking anticoagulation medications | |
Body habitus that precludes intramuscular injection (e.g., BMI < 17 or > 45) | |
Known history of Raynaud’s disease, Itsenko-Cushing syndrome, generalized mycoses, glaucoma, or osteoporosis | |
Planned surgeries in the next 12Â months |