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Murphy M, Rogers BG, Ames E, Galipeau D, Uber J, Napoleon S, Brinkley-Rubinstein L, Toma E, Byrne S, Teitelman AM, Berk J, Chan PA, Ramsey S. Implementing Preexposure Prophylaxis for HIV Prevention in a Statewide Correctional System in the United States. Public Health Rep 2024; 139:174-179. [PMID: 37476929 PMCID: PMC10851896 DOI: 10.1177/00333549231186576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
HIV disproportionately affects populations experiencing incarceration. Preexposure prophylaxis (PrEP) is an effective approach to preventing HIV acquisition among populations at increased risk of acquiring HIV. Yet few, if any, efforts have been made to offer PrEP in correctional settings. Beginning in November 2019, the Rhode Island Department of Corrections (RIDOC) implemented a systemwide PrEP initiation program with linkage to PrEP care in the community upon reentry. Incarcerated individuals identified as being potentially at increased risk of HIV acquisition during standard clinical screenings and medical care were referred to a PrEP care provider for potential PrEP initiation. Of the 309 people who met with a PrEP care provider, 35% (n = 109; 88 men, 21 women) agreed to initiate PrEP while incarcerated. Clinical testing and evaluation were completed for 82% (n = 89; 69 men, 20 women) of those who agreed to initiate PrEP. Of those, 54% (n = 48; 29 men, 19 women) completed the necessary clinical evaluation to initiate PrEP, were determined to be appropriate candidates for PrEP use, and had the medication delivered to a RIDOC facility for initiation. Only 8 people (4 men, 4 women) were successfully linked to a PrEP care provider in the community after release. The RIDOC experience demonstrates notable levels of PrEP interest and moderate levels of PrEP uptake among this population. However, PrEP engagement in care after release and persistence in taking PrEP when in the community were relatively poor, indicating a need to better understand approaches to overcoming barriers to PrEP care in this unique setting.
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Affiliation(s)
- Matthew Murphy
- Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Brown University School of Public Health, Providence, RI, USA
- Rhode Island Hospital, Providence, RI, USA
- The Rhode Island Department of Corrections, Cranston, RI, USA
| | - Brooke G. Rogers
- Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Brown University School of Public Health, Providence, RI, USA
- The Miriam Hospital, Providence, RI, USA
| | - Evan Ames
- Rhode Island Hospital, Providence, RI, USA
| | | | - Julia Uber
- Rhode Island Hospital, Providence, RI, USA
| | - Siena Napoleon
- Brown University School of Public Health, Providence, RI, USA
| | | | - Emily Toma
- Brown University School of Public Health, Providence, RI, USA
- The Miriam Hospital, Providence, RI, USA
| | | | | | - Justin Berk
- Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Rhode Island Hospital, Providence, RI, USA
- The Rhode Island Department of Corrections, Cranston, RI, USA
| | - Philip A. Chan
- Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Brown University School of Public Health, Providence, RI, USA
- The Miriam Hospital, Providence, RI, USA
| | - Susan Ramsey
- Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Rhode Island Hospital, Providence, RI, USA
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2
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Spaulding AC. The power of peers at prison exit. Lancet HIV 2024; 11:e2-e3. [PMID: 38071993 DOI: 10.1016/s2352-3018(23)00330-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 12/25/2023]
Affiliation(s)
- Anne C Spaulding
- Departments of Epidemiology and Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
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3
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Stokes ML, Abram KM, Aaby DA, Welty LJ, Meyerson NS, Zawitz CJ, Teplin LA. Substance Use Disorders and HIV/AIDS Risk Behaviors in Youth After Juvenile Detention: A 16-Year Longitudinal Study. J Adolesc Health 2023; 73:640-649. [PMID: 37716716 PMCID: PMC10513729 DOI: 10.1016/j.jadohealth.2023.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/27/2023] [Accepted: 05/10/2023] [Indexed: 09/18/2023]
Abstract
PURPOSE To examine the association between substance use disorders (SUDs) and HIV/AIDS risk behaviors in detained youth as they age. METHODS Prospective longitudinal study of a stratified random sample of 1,829 youth aged 10 to 18 years at baseline, sampled between November 1995 and June 1998 from the Cook County Juvenile Temporary Detention Center, Chicago, Illinois, and reinterviewed up to 13 times (to median age 32); 17,766 interviews overall. RESULTS Youth had greater odds of engaging in every risk behavior when they had an SUD compared with when they did not have an SUD. For example, SUD was associated with condomless vaginal sex with a high-risk partner (OR: 2.28, 95% CI: 1.84-2.82). SUD was also associated with multiple partners, although the strength varied by time and sex (e.g., 16 years after baseline, OR: 3.58, 95% CI: 2.46-5.23 females; OR: 2.07, 95% CI: 1.48-2.88 males). Types of SUD-alcohol, comorbid alcohol and marijuana, drugs other than marijuana-were also associated with HIV/AIDS risk behaviors. DISCUSSION SUDs and HIV/AIDS risk behaviors are linked among youth in the juvenile justice system and as they age. There is a longstanding need for targeted and integrated HIV and SUD services, but this need remains unmet.
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Affiliation(s)
- Marquita L Stokes
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Karen M Abram
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
| | - David A Aaby
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Leah J Welty
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Nicholas S Meyerson
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Chad J Zawitz
- Cermak Health Services, Cook County Department of Corrections, Chicago, Illinois; Division of Infectious Diseases, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Linda A Teplin
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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4
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Chimoyi L, Charalambous S. The case for pre-exposure prophylaxis in prison settings. Lancet HIV 2023; 10:e3-e4. [PMID: 36243017 DOI: 10.1016/s2352-3018(22)00258-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 09/06/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Lucy Chimoyi
- The Aurum Institute, Parktown, Johannesburg, South Africa 2193; School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Salome Charalambous
- The Aurum Institute, Parktown, Johannesburg, South Africa 2193; School of Public Health, University of the Witwatersrand, Johannesburg, South Africa; Yale School of Public Health, Division of Epidemiology of Microbial Diseases, New Haven, CT, USA.
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5
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Dauria E, Skipalska H, Gopalakrishnan L, Savenko O, Sabadash L, Tolou-Shams M, Flanigan T, Navario P, Castillo TP. Exploratory qualitative study examining acceptability of strategies to improve access to substance use treatment and HIV prevention services for young adults on probation in Ukraine. BMJ Open 2022; 12:e061909. [PMID: 36418138 PMCID: PMC9685251 DOI: 10.1136/bmjopen-2022-061909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 11/04/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Adults <30 years' of age experience elevated HIV-rates in Ukraine. Young adults (YA) involved in the criminal justice system (CJS) are at an increased HIV-risk given elevated rates of substance use, engagement in high-risk sexual behaviour and insufficient healthcare access. The objective of this exploratory study was to investigate the acceptability of strategies to refer and link CJS-involved YA to HIV-prevention and substance use treatment services from CJS settings. DESIGN We conducted qualitative individual interviews with CJS-involved YA (18-24 years), and CJS stakeholders. Interviews were guided by the Social Ecological Model. Interviews with YA explored substance use and sexual behaviour, and acceptability of strategies to link YA to HIV-prevention and substance use treatment services from CJS. Stakeholder interviews explored system practices addressing HIV-prevention and substance use and addiction. Data were analysed using Inductive Thematic Analysis. SETTING Data were collected in three locales, prior to the 2022 Russian-Ukrainian conflict. PARTICIPANTS Thirty YA and 20 stakeholders. RESULTS Most YA were men, reported recent injection drug use and were M age=23 years. YA were receptive to linkage to HIV-prevention services from CJS; this was shaped by self-perceived HIV-risk and lack of access to HIV-prevention services. YA were less receptive to being referred to substance use treatment services, citing a lack of self-perceived need and mistrust in treatment efficacy. Stakeholders identified multilevel contextual factors shaping acceptability of HIV-prevention and substance use treatment from CJS (eg, stigma). CONCLUSIONS Findings should be reviewed as a historical record of the pre-conflict context. In that context, we identified strategies that may have been used to help curtail the transmission of HIV in a population most-at-risk, including CJS-involved YA. This study demonstrates that improving access to substance use treatment and HIV-prevention services via CJS linkage were acceptable if provided in the right conditions (eg, low or no-cost, confidential).
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Affiliation(s)
- Emily Dauria
- Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Lakshmi Gopalakrishnan
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California, USA
| | | | | | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California, USA
| | | | - Peter Navario
- School of Public Health, New York University, New York, New York, USA
- HealthRight International, New York, New York, USA
| | - Theresa P Castillo
- School of Public Health, New York University, New York, New York, USA
- HealthRight International, New York, New York, USA
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6
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Wilson K, Przybyla S, Bleasdale J, Gabriel S, Leblanc N, St Vil N. Factors correlated with pre-exposure prophylaxis (PrEP) awareness and use among black adults in the United States: implications for improving HIV prevention. AIDS Care 2022; 34:1481-1488. [PMID: 35981242 DOI: 10.1080/09540121.2022.2113027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
HIV remains a significant public health concern for Black adults (BA) in the United States. Pre-exposure prophylaxis (PrEP) is a highly effective prevention tool prescribed to protect the health of HIV-uninfected individuals. Yet, low rates of PrEP awareness and utilization persist among BA. Less is understood about the pathways that may promote PrEP uptake. The present study explored factors associated with PrEP awareness and use among BA. Using a cross-sectional sample of 666 BA, we employed multivariable logistic regression models to examine the relationship between PrEP and several covariates. Most participants were unaware of PrEP (71%). Reporting history of incarceration and lifetime sexually transmitted infection testing [aOR 1.76 (1.19, 2.59), p < 0.05] had greater odds of PrEP awareness. Only 6% of respondents had ever taken PrEP. Reports of incarceration history [aOR 9.96 (2.82, 35.14), p < 0.05], concurrent sexual partners [aOR 1.09 (1.00, 1.18), p < 0.05], and substance use during sex [aOR 4.23 (1.02, 17.48), p < 0.05] had greater odds of PrEP use. Interventions aiming to improve PrEP uptake among BA must consider the individual, social, and structural contexts associated with its awareness and use. Enhanced efforts by healthcare providers and institutions may better facilitate access to PrEP for HIV prevention and control transmission.
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Affiliation(s)
- Kennethea Wilson
- Department of Community Health and Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Sarahmona Przybyla
- Department of Community Health and Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Jacob Bleasdale
- Department of Community Health and Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Steven Gabriel
- Department of Community Health and Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Natalie Leblanc
- School of Nursing, University of Rochester, Rochester, NY, USA
| | - Noelle St Vil
- School of Social Work, University at Buffalo, Buffalo, NY, USA
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7
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Murphy MJ, Rogers BG, Chambers LC, Zanowick-Marr A, Galipeau D, Noh M, Scott T, Napoleon SC, Rose J, Chan PA. Characterization of Risk Factors Among Individuals with a History of Incarceration Presenting to a Sexually Transmitted Infections Clinic: Implications for HIV and STI Prevention and Care. AIDS Patient Care STDS 2022; 36:291-299. [PMID: 35951448 PMCID: PMC9419926 DOI: 10.1089/apc.2022.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
More than 2 million people are incarcerated in the United States with many millions more processed through correctional facilities annually. Communities impacted by incarceration are also disproportionately impacted by the HIV and sexually transmitted infection (STI) epidemics. However, relatively little is known about the behaviors that place individuals with a history of incarceration at risk for HIV/STI acquisition. We utilized clinical data from patients presenting to an STI clinic located in Providence, Rhode Island. A latent class analysis was conducted on reported HIV acquisition risk behavior and STI testing results on a total of 1129 encounters where a history of incarceration was reported. A total of three classes were identified. Class 1 (N = 187, 11%), more frequently reported 10+ sexual partners (45%), an STI diagnosis (48%) and sex while intoxicated (86%) in the past year as well as identifying as a man who has sex with other men (60%). Class 2 (N = 57, 5%) was more likely to report giving (53%) and receiving (44%) money/drugs for sex in the past year as well as a history of injecting drugs (61%) and using methamphetamine (60%). Class 3 (N = 885, 78%) most frequently reported 0-2 sexual partners (48%), identified as Black (27%), Hispanic/Latino (69%) and a man who only has sex with women (80%). Class 1 had significantly higher odds ratio (1.8, 95% confidence interval = 1.3-2.5) of testing HIV/STI positive. The results provide important insights into risk subgroups for those with a history of incarceration at risk of HIV/STI acquisition.
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Affiliation(s)
- Matthew J Murphy
- School of Public Health, Brown University, Providence, Rhode Island, USA.,Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Rhode Island Department of Corrections, Brown University, Providence, Rhode Island, USA
| | - Brooke G Rogers
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,The Miriam Hospital Department of Medicine, Division of Infectious Diseases, Providence, Rhode Island, USA
| | - Laura C Chambers
- School of Public Health, Brown University, Providence, Rhode Island, USA.,The Miriam Hospital Department of Medicine, Division of Infectious Diseases, Providence, Rhode Island, USA
| | - Alexandra Zanowick-Marr
- The Miriam Hospital Department of Medicine, Division of Infectious Diseases, Providence, Rhode Island, USA
| | - Drew Galipeau
- The Miriam Hospital Department of Medicine, Division of Infectious Diseases, Providence, Rhode Island, USA
| | - Madeline Noh
- School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Ty Scott
- School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Siena C Napoleon
- School of Public Health, Brown University, Providence, Rhode Island, USA.,The Miriam Hospital Department of Medicine, Division of Infectious Diseases, Providence, Rhode Island, USA
| | - Jennifer Rose
- Wesleyan University Quantitative Analysis Center, Brown University, Providence, Rhode Island, USA
| | - Philip A Chan
- School of Public Health, Brown University, Providence, Rhode Island, USA.,Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,The Miriam Hospital Department of Medicine, Division of Infectious Diseases, Providence, Rhode Island, USA
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8
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Murphy M, Sosnowy C, Rogers B, Napoleon S, Galipeau D, Scott T, Tao J, Berk J, Clarke J, Nunn A, Chan PA. Defining the Pre-exposure Prophylaxis Care Continuum Among Recently Incarcerated Men at High Risk for HIV Infection: Protocol for a Prospective Cohort Study. JMIR Res Protoc 2022; 11:e31928. [PMID: 35142633 PMCID: PMC8874820 DOI: 10.2196/31928] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND HIV disproportionately impacts criminal justice-involved individuals, including men who experience incarceration. Men make up the vast majority of those experiencing incarceration as well as those newly diagnosed with HIV infection. Pre-exposure prophylaxis (PrEP) is a highly effective biomedical intervention that significantly reduces the risk of HIV acquisition. However, implementation in criminal justice systems is limited. Little is known about effective PrEP implementation and use in this unique public health context. OBJECTIVE The aim of this study is to characterize the experience of implementing PrEP clinical care in a criminal justice setting for men vulnerable to HIV acquisition. METHODS This article describes a PrEP care continuum for men experiencing incarceration who are at increased risk of HIV acquisition, which can help conceptualize approaches to evaluating PrEP implementation. RESULTS The outlined study will enroll 100 men experiencing incarceration at high risk for HIV acquisition prior to release into the community. The goal is to initiate PrEP prior to release and link individuals to PrEP providers in the community, capturing barriers and facilitators to PrEP use during this uniquely vulnerable time period for HIV acquisition. CONCLUSIONS Based on the proposed care continuum and what is known about HIV risk and prevention efforts in the criminal justice context, we outline key future research efforts to better understand effective approaches to preventing HIV infection among this vulnerable population. The described approach presents a powerful public health opportunity to help end the HIV epidemic. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/31928.
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Affiliation(s)
| | | | | | | | | | - Ty Scott
- Brown University, Providence, RI, United States
| | - Jun Tao
- Brown University, Providence, RI, United States
| | - Justin Berk
- Brown University, Providence, RI, United States
| | | | - Amy Nunn
- Brown University, Providence, RI, United States
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9
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Hoff E, Rutledge R, Gibson BA, Price CR, Gallagher C, Maurer K, Meyer JP. Preexposure Prophylaxis for Women Across the Criminal Justice System: Implications for Policy and Practice. JOURNAL OF CORRECTIONAL HEALTH CARE 2022; 28:22-31. [PMID: 34762498 PMCID: PMC8825570 DOI: 10.1089/jchc.19.11.0082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Data that inform preexposure prophylaxis (PrEP) implementation for women involved in criminal justice (WICJ) systems are scarce. In a survey of PrEP attitudes, acceptability, and barriers across the criminal justice system, incarcerated women (n = 48) were more likely than WICJ on probation (n = 125) to be eligible for PrEP (29% vs. 15%; p = .04) and willing to take PrEP if offered (94% vs. 78%; p = .01). In multivariate models, PrEP eligibility directly correlated with being incarcerated (adjusted odds ratio [aOR] 4.81, 95% confidence interval [CI] 1.76-13.1) and inversely correlated with Hispanic/Latina ethnicity (aOR 0.31; 95% CI 0.10-0.96). Recent partner violence exposure was associated with PrEP eligibility (aOR 3.29; 95% CI 1.54-7.02) and discordant risk perception (aOR 2.36; 95% CI 1.18-4.70). Findings demonstrate high potential for PrEP for all WICJ, though implementation efforts will need to address partner violence.
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Affiliation(s)
- Emily Hoff
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Internal Medicine, University of Texas Southwestern, Dallas, Texas, USA
| | - Ronnye Rutledge
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Britton A. Gibson
- Frank H. Netter MD School of Medicine, Quinnipiac University, Hamden, Connecticut, USA
| | | | - Colleen Gallagher
- Health and Addiction Services Quality Improvement Program, Connecticut Department of Correction, Wethersfield, Connecticut, USA
| | - Kathleen Maurer
- Health and Addiction Services Quality Improvement Program, Connecticut Department of Correction, Wethersfield, Connecticut, USA
| | - Jaimie P. Meyer
- AIDS Program, Yale School of Medicine, New Haven, Connecticut, USA.,*Address correspondence to: Jaimie P. Meyer, MD, AIDS Program, Yale School of Medicine, 135 College Street, Suite 323 New Haven, CT 06510, USA.
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10
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Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep 2021; 70:1-187. [PMID: 34292926 PMCID: PMC8344968 DOI: 10.15585/mmwr.rr7004a1] [Citation(s) in RCA: 829] [Impact Index Per Article: 276.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
These guidelines for the treatment of persons who have or are at risk for sexually transmitted infections (STIs) were updated by CDC after consultation with professionals knowledgeable in the field of STIs who met in Atlanta, Georgia, June 11-14, 2019. The information in this report updates the 2015 guidelines. These guidelines discuss 1) updated recommendations for treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis; 2) addition of metronidazole to the recommended treatment regimen for pelvic inflammatory disease; 3) alternative treatment options for bacterial vaginosis; 4) management of Mycoplasma genitalium; 5) human papillomavirus vaccine recommendations and counseling messages; 6) expanded risk factors for syphilis testing among pregnant women; 7) one-time testing for hepatitis C infection; 8) evaluation of men who have sex with men after sexual assault; and 9) two-step testing for serologic diagnosis of genital herpes simplex virus. Physicians and other health care providers can use these guidelines to assist in prevention and treatment of STIs.
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11
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Ramsey SE, Ames EG, Uber J, Habib S, Hunt L, Brinkley-Rubinstein L, Teitelman AM, Clarke J, Kaplan C, Phillips NJ, Murphy M. Linking Women Experiencing Incarceration to Community-Based HIV Pre-Exposure Prophylaxis Care: A Qualitative Study. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2021; 33:216-233. [PMID: 34014108 PMCID: PMC8189628 DOI: 10.1521/aeap.2021.33.3.216] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Women experiencing incarceration (WEI) in the United States are disproportionately impacted by HIV, yet HIV pre-exposure prophylaxis (PrEP) is underutilized by women in the United States. In order to inform an intervention to promote PrEP initiation during incarceration and facilitate linkage to PrEP care following release from incarceration, we conducted individual, semistructured qualitative interviews with WEI (N = 21) and key stakeholders (N = 14). While WEI had little or no previous knowledge about PrEP, they viewed it as something that would benefit women involved in the criminal justice system. Participants stated that HIV-related stigma and underestimation of HIV risk might serve as barriers to PrEP initiation during incarceration. Participants reported that competing priorities, difficulty scheduling an appointment, and lack of motivation could interfere with linkage to PrEP care in the community. Further, cost, substance use, and difficulty remembering to take the medication were cited most commonly as likely barriers to adherence.
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Affiliation(s)
- Susan E Ramsey
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Rhode Island Hospital, Providence, Rhode Island
| | - Evan G Ames
- Rhode Island Hospital, Providence, Rhode Island
| | - Julia Uber
- Rhode Island Hospital, Providence, Rhode Island
| | - Samia Habib
- Rhode Island Hospital, Providence, Rhode Island
| | - Laura Hunt
- Rhode Island Hospital, Providence, Rhode Island
| | | | - Anne M Teitelman
- University of Pennsylvania School of Nursing, Philadelphia, Pennnsylvania
| | - Jennifer Clarke
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Rhode Island Department of Corrections, Cranston, Rhode Island
| | - Clair Kaplan
- University of Pennsylvania School of Nursing, Philadelphia, Pennnsylvania
| | - Nicole J Phillips
- University of Pennsylvania School of Nursing, Philadelphia, Pennnsylvania
| | - Matthew Murphy
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Rhode Island Department of Corrections, Cranston, Rhode Island
- Rhode Island Hospital, Providence, Rhode Island
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12
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Knittel AK, Shook-Sa BE, Rudolph JE, Edmonds A, Ramirez C, Cohen MH, Adedimeji A, Taylor TN, Michel KG, Milam J, Cohen J, Donohue JD, Foster A, Fischl M, Konkle-Parker D, Adimora AA. Incidence and Prevalence of Incarceration in a Longitudinal Cohort of Women at Risk for Human Immunodeficiency Virus in the United States, 2007-2017. J Womens Health (Larchmt) 2021; 30:694-704. [PMID: 33544023 PMCID: PMC8112715 DOI: 10.1089/jwh.2020.8417] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: To estimate the incidence, prevalence, frequency, and duration of incarceration and to identify risk factors for incarceration among women at risk for human immunodeficiency virus (HIV) in the United States. Methods: During semiannual study visits in a multicenter cohort study, 970 HIV sero-negative participants at risk for HIV were asked about their own incarceration (10/2007-09/2017) and incarceration of sexual partners (10/2013-09/2017). We used descriptive statistics and multivariable log-binomial regression to identify baseline predictors of incident incarceration. Results: Median follow-up time across the 970 participants was 5.5 years (IQR 3.5-9.5). Nearly half (n = 453, 46.7%) of participants were incarcerated during or before the study, and the incarceration rate was 5.5 per 100 person-years. In multivariable models, incident incarceration was associated with prior incarceration (RR 5.20, 95% CI: 3.23-8.41) and noninjection drug use (RR 1.57, 95% CI: 1.10-2.25). Conclusions: Incarceration is common for women at risk for HIV. Prevention interventions that address the complex interplay of drug use, sex exchange, and housing instability for women who have experienced incarceration have the potential to reach an important group of U.S. women at risk of HIV infection.
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Affiliation(s)
- Andrea K. Knittel
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Bonnie E. Shook-Sa
- Department of Biostatistics and University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Jacqueline E. Rudolph
- Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Andrew Edmonds
- Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Catalina Ramirez
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | | | - Adebola Adedimeji
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Brooklyn, New York, USA
| | - Tonya N. Taylor
- Division of Infectious Disease, SUNY Downstate Medical Center, College of Medicine, Brooklyn, New York, USA
| | - Katherine G. Michel
- Department of Infectious Diseases, Georgetown University, Washington, District of Columbia, USA
| | - Joel Milam
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Jennifer Cohen
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Jessica D. Donohue
- WIHS Data Management and Analysis Center, Johns Hopkins University, Baltimore, Maryland, USA
| | - Antonina Foster
- Division of Infectious Disease, Department of Medicine, Emory University, Atlanta, Georgia, USA
| | - Margaret Fischl
- Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Deborah Konkle-Parker
- Division of Infectious Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Adaora A. Adimora
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
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13
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Meyer JP. Women's Intersectional Risks for HIV and Incarceration and Implications for Interventions. J Womens Health (Larchmt) 2021; 30:630-631. [PMID: 33124955 PMCID: PMC8085140 DOI: 10.1089/jwh.2020.8841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jaimie P Meyer
- AIDS Program, Yale School of Medicine, New Haven, Connecticut, USA
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14
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Harvey TD, Keene DE, Pachankis JE. Minority stress, psychosocial health, and survival among gay and bisexual men before, during, and after incarceration. Soc Sci Med 2021; 272:113735. [DOI: 10.1016/j.socscimed.2021.113735] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/08/2020] [Accepted: 01/27/2021] [Indexed: 12/28/2022]
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15
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Adams JW, Khan MR, Bessey S, Friedman SR, McMahon JM, Lurie MN, Galea S, Marshall BD. Preexposure prophylaxis strategies for African-American women affected by mass incarceration. AIDS 2021; 35:453-462. [PMID: 33170818 PMCID: PMC7855567 DOI: 10.1097/qad.0000000000002749] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/14/2020] [Accepted: 10/12/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We aimed to determine the effectiveness of various preexposure prophylaxis (PrEP) prescription strategies for African-American women impacted by mass incarceration within an urban setting. DESIGN An agent-based model was utilized to evaluate prevention strategies in an efficient, ethical manner. By defining agents, their characteristics and relationships, we assessed population-level effects of PrEP on HIV incidence. METHODS We tested hypothetical PrEP prescription strategies within a simulation representing the African-American population of Philadelphia, Pennsylvania. Four strategies were evaluated: PrEP for women meeting CDC indicators regarding partner characteristics, PrEP for women with a recently incarcerated male partner, PrEP for women with a recently released male partner and couples-based PrEP at time of release. Interventions occurred alongside scale-up of HAART. We evaluated reductions in HIV transmissions, the number of persons on PrEP needed to avert one HIV transmission (NNT) and the resulting proportions of people on PrEP. RESULTS Scenarios prescribing PrEP based on criminal justice system involvement reduced HIV transmissions. The NNT ranged from 147 (couples-based scenario) to 300 (recently released scenario). The percentage of the female population covered by PrEP at any one time ranged from 0.14% (couples-based) to 10.8% (CDC-based). CDC-guideline scenarios were consistently less efficient compared to the justice-involved interventions. CONCLUSION Expanding PrEP for African-American women and their male partners affected by incarceration should be considered in national HIV prevention goals and correctional facilities leveraged as intervention sites. Partner characteristics in the current CDC indications may be more effective and efficient if guidelines considered criminal justice involvement.
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Affiliation(s)
- Joëlla W. Adams
- Brown University School of Public Health, Providence, Rhode Island
| | - Maria R. Khan
- Division of Comparative Effectiveness and Decision Science, Department of Population Health, New York University
| | - S.E. Bessey
- Brown University School of Public Health, Providence, Rhode Island
| | | | | | - Mark N. Lurie
- Brown University School of Public Health, Providence, Rhode Island
| | - Sandro Galea
- Boston University School of Public Health, Boston, Massachusetts, USA
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16
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Uzoeghelu U, Bogart LM, Mahoney T, Ghebremichael MS, Kerr J, Ojikutu BO. HIV Risk-Related Behaviors and Willingness to Use Pre-Exposure Prophylaxis Among Black Americans with an Arrest History. J Racial Ethn Health Disparities 2021; 9:498-504. [PMID: 33544327 DOI: 10.1007/s40615-021-00980-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/18/2021] [Accepted: 01/27/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Black individuals in the USA are arrested and incarcerated at a significantly higher rate than White individuals, and incarceration is associated with increased HIV vulnerability. Pre-exposure prophylaxis (PrEP) reduces the risk for HIV transmission, but little is known about the relationship between HIV risk behavior and willingness to use PrEP among Black individuals with an arrest history. METHOD A total of 868 individuals completed a nationally representative survey and provided baseline data on sexual risk. Participants were grouped as those with a history of arrest (N = 226) and those with no history of arrest (N=619) based on self-reported arrest history. Our study examined HIV risk behaviors associated with willingness to use PrEP between those with arrest history and those without arrest history. RESULTS Participants with an arrest history were more likely to have a lifetime history of anal sex (p<0.0001) and sexually transmitted diseases (p=0.0007). A history of multiple sexual partners in the past 3 months was associated with PrEP willingness in individuals with an arrest history [aPR 2.61 (1.77, 3.85), p<0.0001], adjusting for other covariates in the model. CONCLUSIONS Differences in risk behavior and willingness to use PrEP exist by arrest history. Understanding these risk behaviors are necessary to increase access to PrEP. PrEP uptake and adherence interventions, when recommended and made available for individuals at substantive risk of HIV infection at the time of arrest and during incarceration, are essential to reducing the spread of HIV in correctional facilities and in communities to which they return.
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Affiliation(s)
- Ugochukwu Uzoeghelu
- Department of Postgraduate Education, Harvard Medical School, 25 Shattuck St, Boston, MA, 02215, USA.
| | | | - Taylor Mahoney
- Boston University School of Public Health, Boston, MA, USA
| | | | - Jelani Kerr
- University of Louisville, Louisville, KY, USA
| | - Bisola O Ojikutu
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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17
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Yang C, Zaller N, Clyde C, Tobin K, Latkin C. Association between Recent Criminal Justice Involvement and Transactional Sex among African American Men Who Have Sex with Men in Baltimore. J Urban Health 2020; 97:635-641. [PMID: 30815776 PMCID: PMC7560689 DOI: 10.1007/s11524-019-00350-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Non-Hispanic Black/African American men who have sex with men (AAMSM) have been disproportionately affected by criminal justice (CJ) involvement and HIV. One potential pathway between CJ involvement and high HIV prevalence and incidence among AAMSM is through risky sexual behavior. The goal of this study was to explore the association between recent CJ involvement, i.e., having been arrested and/or in prison/jail in the past 6 months, and transactional sex in a sample of AAMSM in Baltimore. We analyzed the baseline data of 396 AAMSM from a pilot behavioral HIV intervention conducted in Baltimore, MD, between October 2012 and November 2015. A multivariate logistic regression model was conducted to explore the association between recent CJ involvement and transactional sex. A total of 65 (16%) participants reported recent CJ involvement, and 116 (29%) reported transactional sex in the past 90 days. After adjusting for age, education, employment, sexual identity, HIV status, and drug use, recent CJ involvement was significantly associated with transactional sex (AOR 3.31; 95% CI 1.72; 5.70). Being 24-40 years (AOR 2.73; 95% CI 1.17, 6.33) or over 40 years older (AOR 3.80; 95% CI 1.61, 8.98) vs. younger and using drugs (AOR 4.47; 95% CI 2.43, 8.23) also remained independently associated with recent transactional sex. Findings of the current study contribute to the literature on the association between recent history of CJ involvement and transactional sex among AAMSM. More evidence-based HIV prevention interventions for people involved in the CJ system who are at high risk for contracting HIV, particularly racial and sexual minorities such as AAMSM, are urgently needed.
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Affiliation(s)
- Cui Yang
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Nick Zaller
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Catie Clyde
- Clinical and Translational Science Center, University of California-Davis, Davis, CA, USA
| | - Karin Tobin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Carl Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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18
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Springer SA, Barocas JA, Wurcel A, Nijhawan A, Thakarar K, Lynfield R, Hurley H, Snowden J, Thornton A, del Rio C. Federal and State Action Needed to End the Infectious Complications of Illicit Drug Use in the United States: IDSA and HIVMA's Advocacy Agenda. J Infect Dis 2020; 222:S230-S238. [PMID: 32877568 PMCID: PMC7467230 DOI: 10.1093/infdis/jiz673] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
In response to the opioid crisis, IDSA and HIVMA established a working group to drive an evidence- and human rights-based response to illicit drug use and associated infectious diseases. Infectious diseases and HIV physicians have an opportunity to intervene, addressing both conditions. IDSA and HIVMA have developed a policy agenda highlighting evidence-based practices that need further dissemination. This paper reviews (1) programs most relevant to infectious diseases in the 2018 SUPPORT Act; (2) opportunities offered by the "End the HIV Epidemic" initiative; and (3) policy changes necessary to affect the trajectory of the opioid epidemic and associated infections. Issues addressed include leveraging harm reduction tools and improving integrated prevention and treatment services for the infectious diseases and substance use disorder care continuum. By strengthening collaborations between infectious diseases and addiction specialists, including increasing training in substance use disorder treatment among infectious diseases and addiction specialists, we can decrease morbidity and mortality associated with these overlapping epidemics.
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Affiliation(s)
| | | | | | - Ank Nijhawan
- UT Southwestern Medical Center, Dallas, Texas, USA
| | - Kinna Thakarar
- Maine Medical Center, Portland, ME, USA
- Tufts University School Of Medicine, Boston, Massachusetts, USA
| | - Ruth Lynfield
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | | | - Jessica Snowden
- University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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19
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Sosnowy C, Tao J, Nunez H, Montgomery MC, Ndoye CD, Biello K, Mimiaga MJ, Raifman J, Murphy M, Nunn A, Maynard M, Chan PA. Awareness and use of HIV pre-exposure prophylaxis among people who engage in sex work presenting to a sexually transmitted infection clinic. Int J STD AIDS 2020; 31:1055-1062. [PMID: 32753003 DOI: 10.1177/0956462420943702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Collette Sosnowy
- Department of Medicine, Brown University Alpert Medical School, Providence, RI, USA
| | - Jun Tao
- Department of Medicine, Brown University Alpert Medical School, Providence, RI, USA
| | - Hector Nunez
- Department of Medicine, Brown University Alpert Medical School, Providence, RI, USA
| | | | | | - Katie Biello
- Center for Health Equity Research, Brown University School of Public Health, Providence, RI, USA.,Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI, USA.,The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Matthew J Mimiaga
- Center for Health Equity Research, Brown University School of Public Health, Providence, RI, USA.,Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI, USA.,The Fenway Institute, Fenway Health, Boston, MA, USA.,Department of Psychiatry and Human Behavior, Brown University Alpert Medical School, Providence, RI, USA
| | - Julia Raifman
- Department of Health Law, Policy and Management, Boston University, Boston, MA, USA
| | - Matthew Murphy
- Department of Medicine, Brown University Alpert Medical School, Providence, RI, USA
| | - Amy Nunn
- Department of Medicine, Brown University Alpert Medical School, Providence, RI, USA.,Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Michaela Maynard
- Department of Medicine, Brown University Alpert Medical School, Providence, RI, USA
| | - Philip A Chan
- Department of Medicine, Brown University Alpert Medical School, Providence, RI, USA.,Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI, USA
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20
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Abstract
PURPOSE OF REVIEW People with HIV and HCV are concentrated within criminal justice settings globally, primarily related to criminalization of drug use. This review examines updated prevention and treatment strategies for HIV and HCV within prison with a focus on people who inject drugs and the challenges associated with the provision of these services within prisons and other closed settings and transition to the community. RECENT FINDINGS The prevalence of HIV and HCV are several-fold higher in the criminal justice system than within the broader community particularly in regions with high prevalence of injecting drug use, such as Asia, Eastern Europe and North America and where drug use is criminalized. Strategies to optimize management for these infections include routine screening linked to treatment within these settings and medication-assisted treatments for opioid dependence and access to syringe services programs. We build upon the 2016 WHO Consolidated Guidelines through the lens of the key populations of prisoners. Linkage to treatment postrelease, has been universally dismal, but is improved when linked to medication-assisted therapies like methadone, buprenorphine and overdose management. In many prisons, particularly in low-income and middle-income settings, provision of even basic healthcare including mental healthcare and basic HIV prevention tools remain suboptimal. SUMMARY In order to address HIV and HCV prevention and treatment within criminal justice settings, substantial improvement in the delivery of basic healthcare is needed in many prisons worldwide together with effective screening, treatment and linkage of treatment and prevention services to medication-assisted therapies within prison and linkage to care after release.
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Affiliation(s)
- Adeeba Kamarulzaman
- Centre of Excellence on Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
- Section of Infectious Diseases, Yale University School of Medicine and School of Public Health, New Haven, Connecticut, USA
| | | | - Frederick L. Altice
- Centre of Excellence on Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
- Section of Infectious Diseases, Yale University School of Medicine and School of Public Health, New Haven, Connecticut, USA
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21
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Brinkley-Rubinstein L, Cloud D, Drucker E, Zaller N. Opioid Use Among Those Who Have Criminal Justice Experience: Harm Reduction Strategies to Lessen HIV Risk. Curr HIV/AIDS Rep 2019; 15:255-258. [PMID: 29752698 DOI: 10.1007/s11904-018-0394-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE OF REVIEW We reviewed the HIV and opioid literature relevant to harm reduction strategies for those with criminal justice experience. RECENT FINDINGS Opioid use in the United States has risen at an alarming rate recently. This has led to increased numbers of people who inject drugs, placing new populations at risk for HIV, including those who have criminal justice experience. In recent years, there has been a gradual decrease in the number of individuals under the supervision of the criminal justice system. However, concurrently, there has been a rise in the number of individuals incarcerated in jails in rural counties that are at the center of the current opioid epidemic. We provide a number of harm reduction strategies that could be implemented in correctional settings such as access and linkage to medication-assisted treatment, connection to syringe exchange programs and safe injection facilities (where available), and the repackaging of pre-exposure prophylaxis as a harm reduction tool.
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Affiliation(s)
- Lauren Brinkley-Rubinstein
- Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA.
- Center for Health Equity Research, University of North Carolina, Chapel Hill, NC, USA.
| | - David Cloud
- Vera Institute of Justice, New York, NY, USA
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA, USA
| | - Ernest Drucker
- College of Public Health, New York University, New York, NY, USA
| | - Nickolas Zaller
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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22
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Brinkley-Rubinstein L, Peterson M, Zaller ND, Wohl DA. Best practices for identifying men who have sex with men for corrections-based pre-exposure prophylaxis provision. HEALTH & JUSTICE 2019; 7:7. [PMID: 30982117 PMCID: PMC6717965 DOI: 10.1186/s40352-019-0088-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 04/04/2019] [Indexed: 05/27/2023]
Abstract
PURPOSE Men who have sex with men (MSM) who are incarcerated are at increased risk for HIV acquisition, yet there are challenges associated with disclosing sexual identity/orientation among people who are incarcerated. METHODS The current study used semi-structured, qualitative interviews to explore attitudes and awareness of pre-exposure prophylaxis (PrEP) among 26 MSM who were incarcerated at the Rhode Island Department of Corrections. RESULTS Participants noted variable levels of willingness to disclose sexual identity/orientation. CONCLUSIONS CJ institutions should consider involving medical staff and outside agencies when using the CDC PrEP guidelines or consider a WHO-based, rather than behavior-based, approach to determining candidacy for PrEP.
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Affiliation(s)
- Lauren Brinkley-Rubinstein
- Department of Social Medicine, Center for Health Equity, University of North Carolina at Chapel Hill, 333 S. Columbia St., 341B MacNider Hall, Chapel Hill, NC 27599 USA
- Center for Health Equity Research, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
| | | | - Nickolas D. Zaller
- College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - David A. Wohl
- Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
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23
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Ramsey SE, Ames EG, Brinkley-Rubinstein L, Teitelman AM, Clarke J, Kaplan C. Linking women experiencing incarceration to community-based HIV pre-exposure prophylaxis care: protocol of a pilot trial. Addict Sci Clin Pract 2019; 14:8. [PMID: 30832717 PMCID: PMC6398222 DOI: 10.1186/s13722-019-0137-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 02/16/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Women experiencing incarceration (WEI) engage in high rates of sex- and drug-related behavior that places them at risk for HIV. Pre-exposure prophylaxis (PrEP) is an efficacious means of reducing HIV acquisition. There is a general lack of knowledge regarding PrEP among women at elevated risk, and only a small percentage of at-risk women are currently engaged in PrEP care. The period of incarceration represents an opportunity to identify at-risk women, initiate PrEP during incarceration, and establish linkage to community-based PrEP care upon release from incarceration. Further, post-release is a time period that is particularly risky, and there are numerous barriers, including substance use, that may impede linkage to community-based care in the absence of intervention. The current protocol describes plans for the development and pilot randomized controlled trial (RCT) of an intervention to promote PrEP uptake during incarceration and facilitate linkage to community-based PrEP care post-release. METHODS/DESIGN The motivational interviewing-navigation (MI-NAV) study intervention is being developed, refined, and tested over three phases within the framework of the social ecological model. All phases of the study are being conducted at a women's correctional facility and community-based PrEP provider located in the Northeastern region of the United States. Phase 1 consists of individual qualitative interviews to be conducted with key stakeholders (n = 6-10) from the community-based PrEP care site and (n = 6-10) from the women's correctional facility, as well as with (n = 18-30) WEI. Recruitment for Phase 1 was initiated in November 2017. In Phase 2, MI-NAV will be piloted with a small cohort (n = 8-12) of WEI and will be refined based upon participant feedback. During Phase 3, a pilot RCT of MI-NAV and a standard of care condition will be conducted with 80 WEI. RCT participants will complete baseline and follow-up assessments 1, 3, and 6 months post-release. The primary study outcome is linkage to community-based PrEP care, verified via medical records. DISCUSSION This study will develop and evaluate a psychosocial intervention (MI-NAV) to promote PrEP uptake and facilitate linkage to community-based PrEP care among women at-risk for HIV. It is expected that, as a result of this project, the feasibility, acceptability, and preliminary efficacy of MI-NAV will be determined. If found to be efficacious, this intervention has the potential to reduce HIV acquisition in a high-need, underserved community. Clinical trial registration NCT03281343.
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Affiliation(s)
- Susan E. Ramsey
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI USA
- Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, RI USA
- Rhode Island Hospital, Providence, RI USA
| | | | - Lauren Brinkley-Rubinstein
- Department of Social Medicine, University of North Carolina, Chapel Hill, NC USA
- Center for Health Equity Research, University of North Carolina, Chapel Hill, NC USA
| | | | - Jennifer Clarke
- Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, RI USA
- Rhode Island Department of Corrections, Cranston, RI USA
- Department of Obstetrics and Gynecology, The Warren Alpert Medical School of Brown University, Providence, RI USA
| | - Clair Kaplan
- Planned Parenthood of Southern New England, Providence, RI USA
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