Promoting HIV Risk Reduction Among People Who Inject Drugs: A Stepped Care Approach Using Contingency Management With PrEP Adherence and Support Services

Who May Qualify: Aims 1 and 2: 1. Receive or willing to receive care at one of the participating study sites 2. Have a recent negative HIV test with no concern for acute HIV 3. Report injection drug use in their lifetime 4. Meet PrEP eligibility criteria by either a) sharing of injection or drug preparation equipment; b) sexual risk behaviors (i.e. condomless sex or STI) in the past 6 months 5. Meet Diagnostic and Statistical Manual of Mental Disorders - 5th edition (DSM5) criteria for opioid use disorder 6. Have a phone or use of a household member's phone 7. Provide written willing to sign a consent form Aim 3: 1. Currently employed at one of the participating study sites 2. Willing to complete a web-based survey Who Should NOT Join This Trial: Aims 1 and 2: 1. Currently prescribed PrEP 2. Self-report or urine test confirming pregnancy, breastfeeding, or trying to conceive 3. Any plans that would preclude study completion (surgery, major medical treatment or conditions, incarceration, travel out of state or country.) 4. Inability to provide at least one collateral contact for a friend or family member. 5. Non-English speaking (for sites without Spanish-speaking staff) 6. Have kidney disease (a contraindication to PrEP) Aim 3: 1\. Non-English speaking Always talk to your doctor about whether this trial is right for you.