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Ojeda VD, Groneman A, Hiller-Venegas S, Moreno M, Schuler B, Barksdale J, Berliant E, Romero N, Edwards TM, Lister Z, Gilmer T, Gaines T, Bazzi A. A randomized clinical trial testing a health literacy intervention to reduce disparities in access to care among Justice-Impacted Adults (JIA). HEALTH & JUSTICE 2024; 12:34. [PMID: 39083138 PMCID: PMC11290280 DOI: 10.1186/s40352-024-00284-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 06/20/2024] [Indexed: 08/03/2024]
Abstract
BACKGROUND Low health literacy is costly and observed among justice-impacted adults (JIA), a group that often faces numerous barriers in accessing healthcare and a disproportionate burden of illness. Health literacy interventions for JIA are critically needed to improve healthcare access and related outcomes. METHODS This manuscript describes the protocol for a longitudinal mixed-methods randomized clinical trial that assesses the effectiveness of a coach-guided health literacy intervention on JIA's healthcare access. The intervention was previously piloted with justice impacted adults. We will recruit 300 JIA ages 18 + in San Diego, California. Participants will be randomized 1:1 to the Treatment Group (i.e., coach-guided intervention providing 12 sessions of individualized health coaching and service navigation over 6 months) or the Control Group (i.e., self-study of the health coaching program, and brief service navigation support). We will quantitatively assess JIA's healthcare access defined as: use of healthcare, health insurance status, and regular source of care at 6-months as the primary outcomes. Participants will also be surveyed at 12-months. Statistical analyses will incorporate the intent-to-treat (ITT) principle and we will estimate mixed-effects logistic regression for the primary outcomes. We will also conduct qualitative interviews at 6 and 12-months with 40 purposively sampled participants, stratified by study arm, who reported healthcare access barriers at baseline. Interviews will explore participants' satisfaction with the intervention, healthcare attitudes, self-efficacy for and barriers to healthcare access over time, perceived contribution of the intervention to health and well-being, and diffusion of intervention-related information within participants' social networks. We will conduct deductive thematic analyses of qualitative data. DISCUSSION Low health literacy among JIA is a foundational challenge requiring tailored intervention strategies. Findings from this trial may inform policies and the structure of service delivery models to build health literacy among JIA in institutional and community settings throughout the United States and elsewhere. TRIAL REGISTRATION This study is registered with the United States' ClinicalTrials.gov registry under protocol # 161,903.
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Affiliation(s)
- Victoria D Ojeda
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA.
| | - Arthur Groneman
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Sarah Hiller-Venegas
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Melissa Moreno
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Briana Schuler
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Jerrica Barksdale
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Emily Berliant
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Natalie Romero
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Todd M Edwards
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Zephon Lister
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Todd Gilmer
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Tommi Gaines
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Angela Bazzi
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
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Creasy SL, Sweet S, Myers JJ, Shumway M, Tolou-Shams M, McCaffrey N, Dauria EF. eHealth-Enhanced Peer Navigation for Substance Use Treatment and HIV Prevention Service Linkage for Young Adults Surveilled by the Criminal Legal System: Protocol for a Pilot Randomized Trial Study. JMIR Res Protoc 2024; 13:e54815. [PMID: 38530335 PMCID: PMC11005443 DOI: 10.2196/54815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/02/2024] [Accepted: 02/22/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND In the United States, the proportion of criminal legal-involved (CLI) adults with a substance use disorder reaches 72%, and ~150,000 persons with HIV pass through a carceral setting annually, which represents 16% of the HIV-infected population nationally. Despite the high need for substance use treatment and HIV prevention services, few carceral settings successfully link CLI individuals to treatment upon release. Young adults represent 41.9% of the adults incarcerated in the United States and have the highest HIV incidence rates nationally. Peer patient navigation has successfully increased community-based care linkage for people living with HIV leaving jail; yet, peer-led navigation for HIV prevention among HIV-negative CLI populations is undeveloped and untested. eHealth approaches to substance use and HIV prevention services hold promise because they improve access to effective intervention services, particularly for younger people. OBJECTIVE This paper describes a protocol for a pilot randomized controlled trial that aims to improve linkage to substance use treatment and HIV prevention services using peer navigation and a codeveloped eHealth technology adjunct. METHODS The three aims of this study are to (1) adapt an existing evidence-based navigator model and incorporate codeveloped eHealth technology to refer and link young adults (18 to 29 years) surveilled by the criminal legal system to substance use and pre-exposure prophylaxis (PrEP) services; (2) refine and test the intervention with criminal legal-involved young adults (CLI-YAs); and (3) assess the feasibility, acceptability, and impact of the intervention. Data to inform the intervention will be collected via system partner interviews (n=4) and focus groups with CLI-YAs (n=24). Next, an open trial (n=10) will be conducted. The intervention will be refined via interviews with participants and facilitators, and a randomized pilot trial (n=75) will be conducted to assess the feasibility, acceptability, and preliminary impact of the eHealth-enhanced navigation on substance use and PrEP services linkage. Exit interviews conducted with a subsample of intervention participants (n=10), the navigator (n=1), and system partners (n=4) will assess intervention acceptability and suggestions for improvement. A community of practice, a group of system partners with an interest in working toward solutions to common problems, will inform each phase of the study. RESULTS The project is currently ongoing. The project was funded in September 2022. Internal review board approval was received on March 21, 2022. The first results from early study aims are expected to be published in 2025. CONCLUSIONS This study provides an opportunity to reduce HIV acquisition and improve access to substance use treatment in a systemically marginalized group: young CLI-YAs. The results will contribute to the development and testing of a future multilevel randomized controlled trial. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54815.
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Affiliation(s)
- Stephanie L Creasy
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Sheridan Sweet
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Janet J Myers
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, CA, United States
| | - Martha Shumway
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, CA, United States
| | - Marina Tolou-Shams
- Department of Psychiatry, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, CA, United States
| | - Nicole McCaffrey
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Emily F Dauria
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
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Rogers BG, Murphy M, Zanowick-Marr A, Chambers L, Maynard M, Galipeau D, Toma E, Almonte A, Napoleon S, Chan PA. Characterizing HIV Syndemics and the Role of Incarceration Among Men Who have Sex with Men Presenting for Care at a Sexually Transmitted Infections Clinic. AIDS Behav 2023; 27:2513-2522. [PMID: 36633764 PMCID: PMC10336172 DOI: 10.1007/s10461-023-03978-5] [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] [Accepted: 01/01/2023] [Indexed: 01/13/2023]
Abstract
Men who have sex with men (MSM) with a history of incarceration experience unique risk factors for HIV acquisition. The current study examined unique risk factors for HIV among MSM with a history of incarceration presenting to a sexually transmitted infections (STI) clinic. We analyzed self-reported behavioral data from clinical encounters among patients attending the clinic between January 2012 and April 2021. There were 17,221 unique visits, of which 5988 were MSM. Of these, 4.34% (N = 206) were MSM with a history of incarceration. MSM with a history of incarceration were significantly more likely to report a range of behavioral risk factors for HIV, yet also were significantly less likely to perceive themselves at risk for HIV. Future research and practice should develop culturally tailored biobehavioral HIV prevention services and consider embedding these programs within criminal justice settings to better reach this at-risk group.
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Affiliation(s)
- Brooke G Rogers
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA.
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, 02903, USA.
| | - Matthew Murphy
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
- The Rhode Island Public Health Institute, Providence, RI, USA
| | - Alexandra Zanowick-Marr
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
| | - Laura Chambers
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, 02903, USA
| | - Michaela Maynard
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
| | - Drew Galipeau
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
| | - Emily Toma
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
| | - Alexi Almonte
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
| | - Siena Napoleon
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
| | - Philip A Chan
- Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, 02903, USA
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Cloud DH, Garcia-Grossman IR, Armstrong A, Williams B. Public Health and Prisons: Priorities in the Age of Mass Incarceration. Annu Rev Public Health 2023; 44:407-428. [PMID: 36542770 PMCID: PMC10128126 DOI: 10.1146/annurev-publhealth-071521-034016] [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: 12/24/2022]
Abstract
Mass incarceration is a sociostructural driver of profound health inequalities in the United States. The political and economic forces underpinning mass incarceration are deeply rooted in centuries of the enslavement of people of African descent and the genocide and displacement of Indigenous people and is inextricably connected to labor exploitation, racial discrimination, the criminalization of immigration, and behavioral health problems such as mental illness and substance use disorders. This article focuses on major public health crises and advances in state and federal prisons and discusses a range of practical strategies for health scholars, practitioners, and activists to promote the health and dignity of incarcerated people. It begins by summarizing the historical and sociostructural factors that have led to mass incarceration in the United States. It then describes the ways in which prison conditions create or worsen chronic, communicable, and behavioral health conditions, while highlighting priority areas for public health research and intervention to improve the health of incarcerated people, including decarceral solutions that can profoundly minimize-and perhaps one day help abolish-the use of prisons.
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Affiliation(s)
- David H Cloud
- Center for Vulnerable Populations, San Francisco School of Medicine, University of California, San Francisco, California, USA;
- Rollins School of Public Health, Department of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, Georgia, USA
| | - Ilana R Garcia-Grossman
- Center for Vulnerable Populations, San Francisco School of Medicine, University of California, San Francisco, California, USA;
| | - Andrea Armstrong
- College of Law, Loyola University New Orleans, New Orleans, Louisiana, USA
| | - Brie Williams
- Center for Vulnerable Populations, San Francisco School of Medicine, University of California, San Francisco, California, USA;
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Georgieva E, Benkova K, Vlaeva N, Karamalakova Y, Miteva R, Abrashev H, Nikolova G. Is Illicit Substance Use Gender-Specific? The Basic Points of Mental and Health Disorders. TOXICS 2022; 10:toxics10070344. [PMID: 35878250 PMCID: PMC9323370 DOI: 10.3390/toxics10070344] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 12/20/2022]
Abstract
Among the groups of users of illicit substances, a high percentage are persons deprived of their liberty; at the same time, each social and age group is also affected, to one degree or another. The purpose of this study is to provide general data on the relationship between different psychostimulants, clinical and socio-demographic studies, and gender, both among the general population and in one of the most at-risk groups. This review identifies the use of illicit substances as gender-specific in the general population. A detailed study of the causal relationship between the use of illicit substances and gender was carried out. Electronic databases Academic Search Complete, PubMed, HealthCare, Web of Science, and Google Scholar were searched for relevant studies up to 2022 associated with drug abuse and mental and health disorders. The analysis indicated that the human population showed significant differences between the sex of the consumer as to the type of drug consumers, development of addiction, and relapse. We focus on the pathological changes caused by drug use, the personal and physiological individual traits that influence drug choice, and the extent of use in one of the most affected groups of individuals. The study may provide some guidance in developing gender-specific treatment and prevention, including response to some pharmacological and behavioral therapies. The review is intended for a wide audience of social workers, toxicologists, and pharmacologists.
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Affiliation(s)
- Ekaterina Georgieva
- Department of General and Clinical Pathology, Forensic Medicine, Deontology and Dermatovenerology, Faculty of Medicine, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria; (E.G.); (R.M.)
- Department of Medical Psychology, Social Activities and Foreign Languages, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria; (K.B.); (N.V.)
- Department of Chemistry and Biochemistry, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria;
| | - Krasimira Benkova
- Department of Medical Psychology, Social Activities and Foreign Languages, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria; (K.B.); (N.V.)
| | - Nadya Vlaeva
- Department of Medical Psychology, Social Activities and Foreign Languages, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria; (K.B.); (N.V.)
| | - Yanka Karamalakova
- Department of Chemistry and Biochemistry, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria;
| | - Radostina Miteva
- Department of General and Clinical Pathology, Forensic Medicine, Deontology and Dermatovenerology, Faculty of Medicine, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria; (E.G.); (R.M.)
| | - Hristo Abrashev
- Department of Vascular Surgery, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria;
| | - Galina Nikolova
- Department of Chemistry and Biochemistry, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria;
- Correspondence: ; Tel.: +359-897-771-301
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Wu K, Tie Y, Dasgupta S, Beer L, Marcus R. Injection and Non-Injection Drug Use Among Adults with Diagnosed HIV in the United States, 2015-2018. AIDS Behav 2022; 26:1026-1038. [PMID: 34536178 DOI: 10.1007/s10461-021-03457-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2021] [Indexed: 10/20/2022]
Abstract
Understanding behavioral characteristics and health outcomes of people with HIV (PWH) who inject drugs and PWH who use drugs, but do not inject, can help inform public health interventions and improve HIV clinical outcomes. However, recent, nationally representative estimates are lacking. We used 2015-2018 Medical Monitoring Project data to examine health outcome differences among adults with diagnosed HIV who injected drugs or who only used non-injection drugs in the past year. Data were obtained from participant interviews and medical record abstraction. We reported weighted percentages and prevalence ratios with predicted marginal means to assess differences between groups (P < 0.05). PWH who injected drugs were more likely to engage in high-risk sex; experience depression and anxiety symptoms, homelessness, and incarceration; and have lower levels of care retention, antiretroviral therapy adherence, and viral suppression. Tailored, comprehensive interventions are critical for improving outcomes among PWH who use drugs, particularly among those who inject drugs.
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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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Hutchinson AB, MacGowan RJ, Margolis AD, Adee MG, Wen W, Bowden CJ, Spaulding AC. Costs and Consequences of Eliminating a Routine, Point-Of-Care HIV Screening Program in a High-Prevalence Jail. Am J Prev Med 2021; 61:S32-S38. [PMID: 34686288 DOI: 10.1016/j.amepre.2021.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION This study aims to assess the public health impact of eliminating a longstanding routine HIV screening program and replacing it with targeted testing. In addition, costs, outcomes, and cost effectiveness of routine screening are compared with those of targeted testing in the Fulton County Jail, Atlanta, Georgia. METHODS A published mathematical model was used to assess the cost effectiveness and public health impact of routine screening (March 2013-February 2014) compared with those of targeted testing (January 2018-December 2018) from a health system perspective. Costs, outcomes, and other model inputs were derived from the testing programs and the published literature, and the cost effectiveness analysis was conducted from 2019 to 2020. RESULTS Routine screening identified 74 more new HIV infections over 1 year than targeted testing, resulting in an estimated 10 HIV transmissions averted and 45 quality-adjusted life-years saved, and was cost saving. The missed opportunity to diagnose infections because routine screening was eliminated resulted in an estimated 8.4 additional HIV transmissions and $3.7 million in additional costs to the healthcare system. CONCLUSIONS Routine HIV screening in high-prevalence jails is cost effective and has a larger impact on public health than targeted testing. Prioritizing sustained funding for routine, jail-based HIV screening programs in high-prevalence areas may be important to realizing the national HIV prevention goals.
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Affiliation(s)
- Angela B Hutchinson
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Robin J MacGowan
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Andrew D Margolis
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Madeline G Adee
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Wendy Wen
- Georgia Department of Public Health, Atlanta, Georgia
| | - Chava J Bowden
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Anne C Spaulding
- Rollins School of Public Health, Emory University, Atlanta, Georgia
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Kuester LB, Freestone MC. Time away is time out: narratives of intentional reimprisonment amongst inmates living with HIV in a US setting. CRITICAL PUBLIC HEALTH 2021. [DOI: 10.1080/09581596.2020.1737645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Landon B. Kuester
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Mark C. Freestone
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
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Dauria EF, Levine A, Hill SV, Tolou-Shams M, Christopoulos K. Multilevel Factors Shaping Awareness of and Attitudes Toward Pre-exposure Prophylaxis for HIV Prevention among Criminal Justice-Involved Women. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:1743-1754. [PMID: 33236275 PMCID: PMC8276158 DOI: 10.1007/s10508-020-01834-4] [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] [Received: 03/21/2020] [Revised: 08/26/2020] [Accepted: 09/03/2020] [Indexed: 05/14/2023]
Abstract
Although pre-exposure prophylaxis (PrEP) is a key tool in HIV prevention efforts, little is known about PrEP as a prevention strategy for criminal justice-involved (CJI) women. The purpose of this study was to examine multilevel factors shaping PrEP awareness and acceptability among CJI women. Between January 2017 and December 2017, we conducted 52 interviews with CJI women at high risk for HIV and stakeholders from the criminal justice (CJ) and public health (PH) systems. Interviews explored awareness of PrEP and the multilevel factors shaping PrEP acceptability. Data were analyzed using inductive thematic analysis and executive summaries. Atlas.ti facilitated analyses. The majority of CJI women (n = 27) were, on average, 41.3 years, from racial and ethnic minority groups (56% Black/African-American; 19% Latinx) and reported engaging in recent high-risk behavior (nearly 60% engaged in transactional sex, 22% reported ≥ 4 sexual partners, and 37% reported injection drug use). Of system stakeholders (n = 25), 52% represented the CJ sector. Although CJI women were generally unaware of PrEP, attitudes toward PrEP were enthusiastic. Barriers to PrEP acceptability included medication side effects (individual level); distrust in HIV prevention mechanisms (community level); lack of local HIV prevention efforts among high-risk women (public policy/HIV epidemic stage level). Factors promoting PrEP included perceived HIV risk (individual level); PrEP being an HIV prevention method that women can control without partner negotiation (social and sexual network level); and availability of public health insurance (community level). Despite low awareness of PrEP, CJI women expressed positive attitudes toward PrEP. To improve PrEP access for CJI women, implementation efforts should address barriers and leverage facilitators across multiple levels to be maximally effective.
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Affiliation(s)
- Emily F Dauria
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 1001 Potrero Ave., Bldg. 5, San Francisco, CA, 94110, USA.
| | - Andrew Levine
- Department of Sociology, New York University, New York, NY, USA
| | - Samantha V Hill
- Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 1001 Potrero Ave., Bldg. 5, San Francisco, CA, 94110, USA
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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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12
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Mitchell MM, Kelly SM, O'Grady KE, Jaffe JH, Mitchell SG, Schwartz RP. HIV-Risk Behavior Among Adults with Opioid Use Disorder During 12 Months Following Pre-trial Detention: Results from a Randomized Trial of Methadone Treatment. AIDS Behav 2021; 25:1247-1256. [PMID: 33196937 PMCID: PMC7979478 DOI: 10.1007/s10461-020-03090-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2020] [Indexed: 11/26/2022]
Abstract
This was a three group randomized clinical trial of interim methadone and patient navigation involving 225 pre-trial detainees with opioid use disorder in Baltimore. The HIV Risk Assessment Battery (RAB) was administered at baseline (in jail), and at 6 and 12 months post-release. Generalized linear mixed model analyses indicated the condition × time interaction effect failed to reach significance (ps > .05) for both the drug risk and sex risk subscale scores. Therefore, findings suggest that there were no intervention effects on drug or sex risk behaviors. However, increased use of cocaine at baseline was associated with increases in drug- (b = .04, SE = .02) and sex-risk (b = .01, SE = .003) behaviors. These results suggest that interventions targeting cocaine use among pre-trial detainees may serve as a means of reducing HIV risk associated with drug- and sex-risk behaviors.Clinical Trials Registration: Clinicaltrials.gov NCT02334215.
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Affiliation(s)
- M M Mitchell
- Friends Research Institute, 1040 Park Avenue, Suite 103, Baltimore, MD, 21201, USA.
| | - S M Kelly
- Friends Research Institute, 1040 Park Avenue, Suite 103, Baltimore, MD, 21201, USA
| | - K E O'Grady
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - J H Jaffe
- Friends Research Institute, 1040 Park Avenue, Suite 103, Baltimore, MD, 21201, USA
| | - S G Mitchell
- Friends Research Institute, 1040 Park Avenue, Suite 103, Baltimore, MD, 21201, USA
| | - R P Schwartz
- Friends Research Institute, 1040 Park Avenue, Suite 103, Baltimore, MD, 21201, USA
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13
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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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14
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Huang S, Gardner S, Piper KN, Coleman AS, Becan JE, Robertson AA, Elkington KS. Bridging Systems to Implement HIV/STI Programming Within the Juvenile Justice System: Strengths and Challenges of a Local Change Team Approach. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2020; 32:432-453. [PMID: 33112673 DOI: 10.1521/aeap.2020.32.5.432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Justice-involved youth are at risk for HIV/STIs but do not access services. The complex challenges of improving the delivery of health-related services within juvenile justice (JJ) settings warrant exploration of strategies to close this service gap. This study describes the successes and challenges of utilizing a local change team (LCT) strategy comprising JJ and health agency staff to implement HIV/STI programming in JJ settings, across six counties in six states in the U.S. Five focus groups comprising n = 28 JJ and health agency staff who served as LCT members were conducted. Results demonstrated the structured nature of the collaborative process and strength of commitment among LCT members were necessary for successful implementation of HIV/STI programming. The use of LCTs comprising membership of JJ and (behavioral) health systems has broader applicability to other health and behavioral health issues faced by youth on probation that JJ staff may feel ill equipped to address.
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Affiliation(s)
- Sofia Huang
- Columbia University and New York State Psychiatric Institute, New York, New York
| | - Sheena Gardner
- Social Science Research Center, Mississippi State University, Starkville, Mississippi
| | - Kaitlin N Piper
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Ashley S Coleman
- Social Science Research Center, Mississippi State University, Starkville, Mississippi
| | | | - Angela A Robertson
- Social Science Research Center, Mississippi State University, Starkville, Mississippi
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15
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The perfect storm: COVID-19, mass incarceration and the opioid epidemic. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 83:102819. [PMID: 32560975 PMCID: PMC7287479 DOI: 10.1016/j.drugpo.2020.102819] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/29/2020] [Accepted: 06/01/2020] [Indexed: 11/20/2022]
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16
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Fuge TG, Tsourtos G, Miller ER. A systematic review and meta-analyses on initiation, adherence and outcomes of antiretroviral therapy in incarcerated people. PLoS One 2020; 15:e0233355. [PMID: 32421754 PMCID: PMC7233580 DOI: 10.1371/journal.pone.0233355] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 05/04/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Incarcerated people are at increased risk of human immunodeficiency virus (HIV) infection relative to the general population. Despite a high burden of infection, HIV care use among prison populations is often suboptimal and varies among settings, and little evidence exists explaining the discrepancy. Therefore, this review assessed barriers to optimal use of HIV care cascade in incarcerated people. METHODS Quantitative and qualitative studies investigating factors affecting linkage to care, ART (antiretroviral therapy) initiation, adherence and/or outcomes among inmates were systematically searched across seven databases. Studies published in English language and indexed up to 26 October 2018 were reviewed. We performed a narrative review for both quantitative and qualitative studies, and meta-analyses on selected quantitative studies. All retrieved quantitative studies were assessed for risk of bias. Meta-analyses were conducted using RevMan-5 software and pooled odds ratios were calculated using Mantel-Haenszel statistics with 95% confidence interval at a p<0.05. The review protocol has been published at the International Prospective Register of Systematic Reviews (PROSPERO; Number: CRD42019135502). RESULTS Of forty-two studies included in the narrative review, eight were qualitative studies. Sixteen of the quantitative studies were eligible for meta-analyses. The narrative synthesis revealed structural factors such as: a lack of access to community standard of HIV care, particularly in resource limited countries; loss of privacy; and history of incarceration and re-incarceration as risk factors for poor HIV care use in prison populations. Among social and personal characteristics, lack of social support, stigma, discrimination, substance use, having limited knowledge about, and negative perception towards ART were the main determinants of suboptimal use of care in incarcerated people. In the meta-analyses, lower odds of ART initiation was noticed among inmates with higher baseline CD4 count (CD4 ≥500celss/mm3) (OR = 0.37, 95%CI: 0.14-0.97, I2 = 43%), new HIV diagnosis (OR = 0.07, 95%CI: 0.05-0.10, I2 = 68%), and in those who lacked belief in ART safety (OR = 0.32, 95%CI: 0.18-0.56, I2 = 0%) and efficacy (OR = 0.31, 95%CI: 0.17-0.57, I2 = 0%). Non-adherence was high among inmates who lacked social support (OR = 3.36, 95%CI: 2.03-5.56, I2 = 35%), had low self-efficiency score (OR = 2.50, 95%CI: 1.64,-3.80, I2 = 22%) and those with depressive symptoms (OR = 2.02, 95%CI: 1.34-3.02, I2 = 0%). Lower odds of viral suppression was associated with history of incarceration (OR = 0.40, 95%CI: 0.35-0.46, I2 = 0%), re-incarceration (OR = 0.09, 95%CI: 0.06-0.13, I2 = 64%) and male gender (OR = 0.55, 95%CI: 0.42-0.72, I2 = 0%). Higher odds of CD4 count <200cells/mm3 (OR = 2.01, 95%CI: 1.62, 2.50, I2 = 44%) and lower odds of viral suppression (OR = 0.20, 95%CI: 0.17-0.22, I2 = 0%) were observed during prison entry compared to those noticed during release. CONCLUSION Given the high HIV risk in prison populations and rapid movements of these people between prison and community, correctional facilities have the potential to substantially contribute to the use of HIV treatment as a prevention strategy. Thus, there is an urgent need for reviewing context specific interventions and ensuring standard of HIV care in prisons, particularly in resource limited countries.
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Affiliation(s)
- Terefe G. Fuge
- Medicine and Public Health, Flinders University, Adelaide, Australia
| | - George Tsourtos
- Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Emma R. Miller
- Medicine and Public Health, Flinders University, Adelaide, Australia
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17
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Uhrig Castonguay BJ, Cressman AE, Kuo I, Patrick R, Trezza C, Cates A, Olsen H, Peterson J, Kurth A, Bazerman LB, Beckwith CG. The Implementation of a Text Messaging Intervention to Improve HIV Continuum of Care Outcomes Among Persons Recently Released From Correctional Facilities: Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e16220. [PMID: 32053119 PMCID: PMC7055782 DOI: 10.2196/16220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/19/2019] [Accepted: 10/20/2019] [Indexed: 01/19/2023] Open
Abstract
Background Previously incarcerated individuals have suboptimal linkage and engagement in community HIV care. Mobile health (mHealth) interventions have been shown to be effective in addressing these gaps. In Washington, District of Columbia (DC), we conducted a randomized trial of an SMS text messaging–based mHealth intervention (CARE+ Corrections) to increase linkage to community HIV care and antiretroviral treatment adherence among HIV-infected persons involved in the criminal justice system. Objective This study aimed to describe the SMS text messaging–based intervention, participant use of the intervention, and barriers and facilitators of implementation. Methods From August 2013 to April 2015, HIV-positive incarcerated individuals were recruited within the DC Department of Corrections, and persons released in the past 6 months were recruited within the community via street-based recruitment, community partnerships, and referrals. Participants were followed for 6 months and received weekly or daily SMS text messages. Formative research resulted in the development of the content of the messages in 4 categories: HIV Appointment Reminders, Medication Adherence, Prevention Reminders, and Barriers to Care following release from jail. Participants could customize the timing, frequency, and message content throughout the study period. Results Of the 112 participants enrolled, 57 (50.9%) were randomized to the intervention group and 55 (49.1%) to the control group; 2 control participants did not complete the baseline visit, and were dropped from the study, leaving a total of 110 participants who contributed to the analyses. Study retention was similar across both study arms. Median age was 42 years (IQR 30-50), 86% (49/57) were black or African American, 58% (33/57) were male, 25% (14/57) were female, and 18% (10/57) were transgender. Median length of last incarceration was 4 months (IQR 1.7-9.0), and median lifetime number of times incarcerated was 6.5 (IQR 3.5-14.0). Most participants (32/54, 59%) had a baseline viral load of <200 copies/mL. Nearly all participants (52/57, 91%) chose to use a cell phone provided by the study. The most preferred Appointment Reminder message was Hey how you feeling? Don’t forget to give a call and make your appointment (19/57, 33%). The most preferred Medication Adherence message was Don’t forget your skittles! (31/57, 54%), and 63% (36/57) of participants chose to receive daily (vs weekly) messages from this category at baseline. The most preferred Prevention Reminder message was Stay strong. Stay clean (18/57, 32%). The most preferred Barriers to Care message was Holla at your case manager, they’re here to help (12/57, 22%). Minor message preference differences were observed among participants enrolled in the jail versus those from the community. Conclusions Participants’ ability to customize their SMS text message plan proved helpful. Further large-scale research on mHealth platforms is needed to assess its efficacy among HIV-infected persons with a history of incarceration. Trial Registration ClinicalTrials.gov NCT01721226; https://clinicaltrials.gov/ct2/show/NCT01721226
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Affiliation(s)
- Breana J Uhrig Castonguay
- University of North Carolina Center for AIDS Research, Lineberger Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Andrew E Cressman
- The Center for Prisoner Health and Human Rights, Providence, RI, United States.,Brown University School of Public Health, Providence, RI, United States
| | - Irene Kuo
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States.,District of Columbia Center for AIDS Research, Washington, DC, United States
| | - Rudy Patrick
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Claudia Trezza
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Alice Cates
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Halli Olsen
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - James Peterson
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States.,District of Columbia Center for AIDS Research, Washington, DC, United States
| | - Ann Kurth
- Yale University School of Nursing, New Haven, CT, United States
| | | | - Curt G Beckwith
- The Miriam Hospital, Providence, RI, United States.,Division of Infectious Diseases, Alpert Medical School of Brown University, Providence, RI, United States
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18
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Wimberly AS, Gross R, Layde M. Effect of Yoga on Antiretroviral Adherence Postincarceration in HIV+ Individuals. JOURNAL OF CORRECTIONAL HEALTH CARE 2020; 26:83-94. [PMID: 32089078 PMCID: PMC7733694 DOI: 10.1177/1078345819897924] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The negative impacts of stress on antiretroviral therapy (ART) adherence and the many stressors faced by people returning from incarceration support the need for stress reduction interventions for this population. We hypothesized that 37 returning citizens living with HIV and substance use problems randomized to a 12-session weekly yoga intervention would experience improved ART adherence, lower viral loads, and lower heart rate and blood pressure as compared to 36 people randomized to treatment as usual (TAU). We found that ART adherence increased for yoga participants and decreased for TAU participants. There were no significant changes for viral load, heart rate, or blood pressure. The lack of statistically significant effects may be due to a small sample size and enrollment of people largely in HIV treatment. Studies with larger sample sizes and participants exhibiting low ART adherence are warranted to better understand yoga's impact.
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Affiliation(s)
| | - Robert Gross
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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19
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Brinkley-Rubinstein L, Dauria E, Tolou-Shams M, Christopoulos K, Chan PA, Beckwith CG, Parker S, Meyer J. The Path to Implementation of HIV Pre-exposure Prophylaxis for People Involved in Criminal Justice Systems. Curr HIV/AIDS Rep 2019. [PMID: 29516265 DOI: 10.1007/s11904-018-0389-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Lauren Brinkley-Rubinstein
- Department of Social Medicine, University of North Carolina, Chapel Hill, USA.
- Center for Health Equity Research, University of North Carolina, Chapel Hill, USA.
| | - Emily Dauria
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, USA
| | - Marina Tolou-Shams
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, USA
| | | | - Philip A Chan
- Department of Medicine, Brown University, Providence, USA
| | | | - Sharon Parker
- Department of Social Work and Sociology, North Carolina Agricultural and Technical University, Greensboro, USA
| | - Jaimie Meyer
- AIDS Program, Yale School of Medicine, New Haven, USA
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20
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Francis-Graham S, Ekeke NA, Nelson CA, Lee TY, Haj SE, Rhodes T, Vindrola C, Colbourn T, Rosenberg W. Understanding how, why, for whom, and under what circumstances opt-out blood-borne virus testing programmes work to increase test engagement and uptake within prison: a rapid-realist review. BMC Health Serv Res 2019; 19:152. [PMID: 30849986 PMCID: PMC6408812 DOI: 10.1186/s12913-019-3970-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 02/21/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Prisons represent a unique opportunity to diagnose blood-borne viruses. Opt-out testing is receiving increasing interest, as a result of mounting evidence to suggest that the manner in which a test offer is delivered, affects test uptake. Although the effectiveness of opt-out testing within the prison setting has been established, robust explanations are required for the variation in outcomes reported. METHODS Rapid-realist review methodology was used to synthesise the literature on prison-based opt-out testing. The review was carried out in three phases. Phase one: An expert panel provided literature relevant to the implementation of opt-out testing within the English prison estate. Unstructured searches were also conducted to identify other social programmes where "opt-out" had been used to increase uptake. Phase two: a systematic search of six peer-review and five grey literature databases was carried out to identify empirical data on opt-out testing within the prison setting. Phase three: Additional non-exhaustive searches were carried out to identify literature that reinforced emergent concepts. The development of programme theory took place with each iteration and was validated in consultation with stakeholders. RESULTS Programme theory was constructed for two outcomes: the proportion of intake offered a test and the proportion offered that accepted testing. The proportion of intake offered testing was influenced by the timing of the test offer, which was often delayed due to barriers to prisoner access. The decision to accept testing was influenced by concerns about confidentiality, fear of a positive diagnosis, a prisoner's personal interpretation of risk, discomfort with invasive procedures, trust in healthcare, and the fidelity of the opt-out offer. CONCLUSIONS This review identified important implementation considerations that moderate the effectiveness of opt-out testing programmes. It also highlighted a lack of appreciation for the theoretical underpinnings of opt-out programmes and tension around how to implement testing in a manner that adheres to both default theory and informed consent. It is anticipated that results will be used to inform the design and implementation of subsequent versions of these programmes, as well as catalyse further in-depth analysis into their operation within the unique context of prison. REVIEW REGISTRATION CRD42017068342 .
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Affiliation(s)
- Seth Francis-Graham
- The National Institute for Health Research: Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections, University College London, London, UK
- The Institute for Global Health, University College London, London, UK
- The Institute for Liver and Digestive Health, Division of Medicine, University College London, London, UK
| | | | | | - Tin Yan Lee
- The Chinese University of Hong Kong, Hong Kong, China
| | | | - Tim Rhodes
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections, the London School of Hygiene and Tropical Medicine, London, UK
| | - Cecilia Vindrola
- The Institute of Epidemiology & Health, University College London, London, UK
| | - Tim Colbourn
- The Institute for Global Health, University College London, London, UK
| | - William Rosenberg
- The National Institute for Health Research: Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections, University College London, London, UK
- Royal Free London NHS Foundation Trust, London, UK
- The Institute for Liver and Digestive Health, Division of Medicine, University College London, London, UK
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21
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Jones AA, Gerke T, Striley CW, Osborne V, Whitehead N, Cottler LB. A Longitudinal Analysis of the Substance Abuse, Violence, and HIV/AIDS (SAVA) Syndemic among Women in the Criminal Justice System. J Psychoactive Drugs 2019; 51:58-67. [PMID: 30626264 PMCID: PMC6386603 DOI: 10.1080/02791072.2018.1562132] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 10/23/2018] [Indexed: 10/27/2022]
Abstract
Using data from a randomized controlled trial of 319 women mainly recruited from a Municipal Drug Court System in St. Louis, MO, this study evaluates substance use, victimization, and HIV/AIDS risk behaviors over time. The results indicated that, for all participants, the likelihood of victimization, using drugs, and meeting the criteria for HIV/AIDS risk decreased by 46% by the eight-month follow-up; however, results did not differ significantly by intervention group. Women who were sexually abused as a child, had 4+ arrests, or believed they had sexual and drug-using behaviors that need changing at baseline were more likely to experience these issues over time.
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Affiliation(s)
- Abenaa Acheampong Jones
- Postdoctoral Fellow, Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Travis Gerke
- Assistant Member, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Vicki Osborne
- Department of Epidemiology, University of Florida, Gainesville, FL, US
| | - Nicole Whitehead
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Linda B. Cottler
- Department of Epidemiology, University of Florida, Gainesville, FL, US
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22
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Johnson K, Gilbert L, Hunt T, Wu E, Metsch L, Goddard-Eckrich D, Richards S, Tibbetts R, Rowe JC, Wainberg ML, El-Bassel N. The effectiveness of a group-based computerized HIV/STI prevention intervention for black women who use drugs in the criminal justice system: study protocol for E-WORTH (Empowering African-American Women on the Road to Health), a Hybrid Type 1 randomized controlled trial. Trials 2018; 19:486. [PMID: 30201039 PMCID: PMC6131955 DOI: 10.1186/s13063-018-2792-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 07/06/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This paper describes the study protocol of a hybrid type I randomized controlled trial that evaluates the effectiveness and cost-effectiveness of implementing Empowering African-American Women on the Road to Health (E-WORTH), an Afrocentric, group-based, computerized human immunodeficiency virus (HIV)/sexually transmitted infection (STI) prevention intervention for controlled substance-using black women in community corrections settings in New York City. METHODS/DESIGN We provide an overview of E-WORTH's hybrid type I design, which is guided by the Consolidated Framework for Implementation Research (CFIR). E-WORTH combines HIV/STI and intimate partner violence (IPV) prevention components and tests the comparative effectiveness of E-WORTH and streamlined HIV testing versus streamlined HIV testing alone in decreasing biologically confirmed HIV and STI incidence, sexual risk, and IPV, as well as in improving access to HIV and STI prevention services and care. DISCUSSION This paper provides an overview of E-WORTH's intervention protocol and serves as a framework for using hybrid type I designs, guided by the CFIR conceptual framework, to evaluate HIV/STI and IPV prevention interventions in community corrections settings. We discuss how E-WORTH's hybrid type I design advances implementation science through its effectiveness and cost-effectiveness aims as well as through a mixed-methods study that evaluates multilevel theory-driven factors (structural, organizational, staffing, and client) guided by the CFIR that influences the implementation of E-WORTH in a criminal justice setting. This study also addresses the novel challenges and opportunities of implementing an intervention that targets specific racial subgroup(s) in a community corrections setting that services all populations, implementing a group-based intervention with technological components in such settings, and employing community-based participatory research strategies to guide recruitment and retention efforts. TRIAL REGISTRATION ClinicalTrials.gov, NCT02391233 . Registered on 17 March 2015.
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Affiliation(s)
- Karen Johnson
- University of Alabama School of Social Work, Little Hall, 670 Bonner Drive, Tuscaloosa, AL 35401 USA
- Columbia University School of Social Work, Social Intervention Group, 1255 Amsterdam Avenue, New York, NY 10027 USA
| | - Louisa Gilbert
- University of Alabama School of Social Work, Little Hall, 670 Bonner Drive, Tuscaloosa, AL 35401 USA
| | - Timothy Hunt
- University of Alabama School of Social Work, Little Hall, 670 Bonner Drive, Tuscaloosa, AL 35401 USA
| | - Elwin Wu
- University of Alabama School of Social Work, Little Hall, 670 Bonner Drive, Tuscaloosa, AL 35401 USA
| | - Lisa Metsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032 USA
| | - Dawn Goddard-Eckrich
- University of Alabama School of Social Work, Little Hall, 670 Bonner Drive, Tuscaloosa, AL 35401 USA
- Social Intervention Group, Columbia University Teacher’s College, 1255 Amsterdam Avenue, New York, NY 10027 USA
| | - Stanley Richards
- The Fortune Society, 625 West 140th Street, New York, NY 10031 USA
| | - Rick Tibbetts
- New York City Department of Probation, 210 Joralemon Street, Brooklyn, NY 11201 USA
| | - Jessica C. Rowe
- Center for Teaching and Learning, Columbia University, Lewisohn Hall, 2970 Broadway #603, New York, NY 10027 USA
| | - Milton L. Wainberg
- Columbia University / New York State Psychiatric Institute, 1051 Riverside Drive, #24, New York, NY 10032 USA
| | - Nabila El-Bassel
- University of Alabama School of Social Work, Little Hall, 670 Bonner Drive, Tuscaloosa, AL 35401 USA
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Ojikutu BO, Srinivasan S, Bogart LM, Subramanian SV, Mayer KH. Mass incarceration and the impact of prison release on HIV diagnoses in the US South. PLoS One 2018; 13:e0198258. [PMID: 29889837 PMCID: PMC5995372 DOI: 10.1371/journal.pone.0198258] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 05/16/2018] [Indexed: 11/29/2022] Open
Abstract
Background The purpose of this study was to determine the impact of prison release on HIV incidence in the southern region of the United States, the region with the highest rates of both incarceration and new HIV diagnoses nationwide. Methods 5-year HIV diagnoses rates were calculated at the ZIP code level for nine cities and metropolitan statistical areas in the US South (ZIP codes, N = 600). Multilevel regression models were constructed and adjusted rate ratios (ARRs) were estimated for overall, male and female HIV diagnoses rates. Results Across the nine cities, in multilevel, multivariate analysis, controlling for income inequality (GINI coefficient), percent living in poverty and percent Non-Hispanic Black population, the ZIP code level overall HIV diagnosis rate was significantly associated with prison release [ARR 1.004 (95%CI 1.0007, 1.006), p<0.01]. A 10-person increase in prison release rate would result in a 4% increase in overall 5-year HIV diagnosis rate—approximately 9.4 additional cases per 100,000 population. In gender-stratified models, prison release rate was significantly associated with the ZIP code level HIV diagnosis rate for males [ARR 1.004 (95%CI 1.0004, 1.007), p<0.01], but not for females. Conclusions In the southern region of the US, prison release is significantly associated with HIV incidence. HIV prevention interventions should promote timely linkage to ongoing treatment for released inmates living with HIV.
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Affiliation(s)
- Bisola O. Ojikutu
- Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- * E-mail:
| | | | - Laura M. Bogart
- RAND Corporation, Santa Monica, California, United States of America
| | - S. V. Subramanian
- Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Kenneth H. Mayer
- The Fenway Institute, Boston, Massachusetts, United States of America
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Golin CE, Barkley BG, Biddell C, Wohl DA, Rosen DL. Great Expectations: HIV Risk Behaviors and Misperceptions of Low HIV Risk among Incarcerated Men. AIDS Behav 2018; 22:1835-1848. [PMID: 28361452 DOI: 10.1007/s10461-017-1748-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Incarcerated populations have relatively high HIV prevalence but little has been reported about their aggregate HIV risk behaviors or perceptions of risk. A random selection of HIV-negative men (n = 855) entering a US state prison system were surveyed to assess five risk behaviors and his self-perceived HIV risk. Using multivariate logistic regression, we identified factors associated with having elevated actual but low perceived risk (EALPR). Of the 826 men with complete data, 88% were at elevated risk. While 64% of the sample had risk perceptions concordant with their actual risk, 14% had EALPR (with the remainder at low actual but high perceived risk). EALPR rates were lower in those with a pre-incarceration HIV test but higher for those with a negative prison entry HIV test. HIV testing counseling should assess for discordance between actual and perceived risk and communicate the continued risk of HIV despite a negative result.
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Affiliation(s)
- C E Golin
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, 725 MLK Blvd, CB 7590, Chapel Hill, NC, 27599-7590, USA.
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Cecil G. Sheps Center for Health Services Research, UNC-Chapel Hill, Chapel Hill, NC, USA.
| | - B G Barkley
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - C Biddell
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, 725 MLK Blvd, CB 7590, Chapel Hill, NC, 27599-7590, USA
| | - D A Wohl
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, 725 MLK Blvd, CB 7590, Chapel Hill, NC, 27599-7590, USA
| | - D L Rosen
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, 725 MLK Blvd, CB 7590, Chapel Hill, NC, 27599-7590, USA
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Elkington KS, Jaiswal J, Spector AY, Reukauf H, Tesoriero JM, Nash D, Remien RH. Can TasP Approaches Be Implemented in Correctional Settings?: A review of HIV testing and linkage to community HIV treatment programs. J Health Care Poor Underserved 2018; 27:71-100. [PMID: 27133513 DOI: 10.1353/hpu.2016.0047] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
High rates of HIV in correctional populations makes evaluation of programs that increase HIV testing in correctional settings and linkage to HIV treatment upon release, and understanding key implementation issues of these programs, essential to reducing new HIV infection. We conducted a systematic search for studies of outcomes or implementation issues of programs that promote HIV testing or that promote linkage to community HIV treatment post-release. Thirty-five articles met inclusion criteria: nine HIV testing initiatives and four linkage programs. HIV testing uptake rates were between 22% and 98% and rates of linkage to community treatment were between 79% and 84%. Findings suggest that some programs may be effective at reducing HIV transmission within the communities to which inmates return. However, attention to implementation factors, such as organizational culture and staff collaborations, appears critical to the success of these programs. Future research using rigorous design and adequate comparison groups is needed.
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Kral AH, Lambdin BH, Comfort M, Powers C, Cheng H, Lopez AM, Murdoch RO, Neilands TB, Lorvick J. A Strengths-Based Case Management Intervention to Reduce HIV Viral Load Among People Who Use Drugs. AIDS Behav 2018; 22:146-153. [PMID: 28916898 DOI: 10.1007/s10461-017-1903-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Engaging highly marginalized HIV positive people in sustained medical care is vital for optimized health and prevention efforts. Prior studies have found that strengths-based case management helps link people who use drugs to HIV care. We conducted a pilot to assess whether a strengths-based case management intervention may help people who use injection drugs (PWID) or smoke crack cocaine (PWSC) achieve undetectable HIV viral load. PWID and PWSC were recruited in Oakland, California using targeted sampling methods and referral from jails and were tested for HIV. HIV positive participants not receiving HIV care (n = 19) were enrolled in a pilot strengths-based case management intervention and HIV positive participants already in HIV care (n = 29) were followed as comparison participants. The intervention was conducted by a social worker and an HIV physician. Special attention was given to coordinating care as participants cycled through jail and community settings. Surveys and HIV viral load tests were conducted quarterly for up to 11 visits. HIV viral load became undetectable for significantly more participants in the intervention than in the comparison group by their last follow-up (intervention participants: 32% at baseline and 74% at last follow-up; comparison participants: 45% at baseline and 34% at last follow-up; p = 0.008). In repeated measures analysis, PBO intervention participants had higher odds of achieving undetectable viral load over time than comparison participants (p = 0.033). Strengths-based case management may help this highly vulnerable group achieve undetectable HIV viral load over time.
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Abstract
The criminal justice (CJ) system can be leveraged to access women for HIV prevention and treatment programs. Research is lacking on effective implementation strategies tailored to the specific needs of CJ-involved women. We conducted a scoping review of published studies in English from the United States that described HIV interventions, involved women or girls, and used the CJ system as an access point for sampling or intervention delivery. We identified 350 studies and synthesized data from 42 unique interventions, based in closed (n = 26), community (n = 7), or multiple/other CJ settings (n = 9). A minority of reviewed programs incorporated women-specific content or conducted gender-stratified analyses. CJ systems are comprised of diverse access points, each with unique strengths and challenges for implementing HIV treatment and prevention programs for women. Further study is warranted to develop women-specific and trauma-informed content and evaluate program effectiveness.
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Malik M, Kumari S, Manalai P, Hipolito M. Illustrating and analyzing the processes of multi-institutional collaboration: Lessons learnt at Howard University Hospital. ACTA ACUST UNITED AC 2017; 3. [PMID: 28966991 DOI: 10.18103/imr.v3i5.462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Multi-institutional collaboration offers a promising approach to the dissemination of resources for capacity building and the improvement of the training of new investigators and residents, especially in areas of novel curricular content. Physicians should keep pace with the rapid growth of curricular content in an era of restricted resources. Such collaborations, in which educational entities work together and share resources and infrastructure, have been employed in health care to improve quality of care, capacity building, disparity reduction, and resident training. This paper examines a federally funded multi-institutional collaboration for the project STRIDE (Seek, Treat, Reach to Identify Pretrial Defendants Enhancement) between Yale University, George Mason University (GMU), and Howard University, a Historically Black University. The STRIDE study collaboration focused on mental health, opioid addiction, and infectious disease/HIV among Africans Americans involved in CJS (Criminal Justice System). We discuss some of the challenges and benefits of collaborative research projects conducted at Historically Black Colleges and University (HBCUs) and highlight the educational opportunities created by such collaborations for residents and other trainees, leading to the development of independent investigators through multi-institutional, structured collaborative research. We identify some unique challenges such as substance use, race, stigma, incarceration among participants, and the cultural and power difference between participating institutions, and thereby address these issues and how it impacted the course of the multi-institutional collaborative effort.
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Affiliation(s)
- Mansoor Malik
- Howard University Hospital Dept. of Psychiatry and Behavioral Health Sciences Washington DC
| | - Suneeta Kumari
- Howard University Hospital Dept. of Psychiatry and Behavioral Health Sciences Washington DC
| | - Partam Manalai
- Howard University Hospital Dept. of Psychiatry and Behavioral Health Sciences Washington DC
| | - Maria Hipolito
- Howard University Hospital Dept. of Psychiatry and Behavioral Health Sciences Washington DC
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Fischer B, Butler A, Russell C. Commentary on Fazel et al. (2017): High levels of substance use disorders among correctional inmates-some implications for interventions of the review data from Fazel et al. Addiction 2017; 112:1740-1741. [PMID: 28891149 DOI: 10.1111/add.13969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 07/25/2017] [Accepted: 08/01/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Benedikt Fischer
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada.,Institute of Medical Science (IMS), University of Toronto, Toronto, Canada.,Centre for Criminology and Sociolegal Studies, University of Toronto, Toronto, Canada.,Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada.,Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Amanda Butler
- Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Cayley Russell
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
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Parks MJ. Sexual Attitudes and Behaviors Among US Adults With and Without Jail Experience: Implications for Health Promotion. Behav Med 2017; 43:296-306. [PMID: 27128140 DOI: 10.1080/08964289.2016.1165172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Contact with correctional facilities adversely affects midlife health status and contributes to health disparities in the United States. Sexual health of correctional populations has become a focus for public health research and health promotion programs. Relying on the Health Belief Model, most research has focused almost exclusively on case studies of inmates' disease risk, perceptions of disease susceptibility, and condom use. There is a dearth of research on attitudes and behaviors beyond disease risk perceptions and condom use, particularly within a nationally representative sample of adults. Utilizing social cognitive theory, theory of reasoned action, and related theories, this study examines four alternative sexual attitudes and behaviors among a nationally representative sample of adults with and without jail experience. Results show that jail experience is associated with attitudes concerning sexual exclusivity and intimacy, as well as group sex participation and number of partners. Results also demonstrate that alcohol consumption is strongly associated with jail experience and all four outcomes. Findings offer implications for health promotion within correctional populations. Community-based programs focused on correctional populations could be a fruitful line of public health practice, and programs should take into account social contexts, broad attitudes, and risk factors such as substance abuse.
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Sprague C, Scanlon ML, Radhakrishnan B, Pantalone DW. The HIV Prison Paradox: Agency and HIV-Positive Women's Experiences in Jail and Prison in Alabama. QUALITATIVE HEALTH RESEARCH 2017; 27:1427-1444. [PMID: 27742766 DOI: 10.1177/1049732316672640] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Incarcerated women face significant barriers to achieve continuous HIV care. We employed a descriptive, exploratory design using qualitative methods and the theoretical construct of agency to investigate participants' self-reported experiences accessing HIV services in jail, in prison, and post-release in two Alabama cities. During January 2014, we conducted in-depth interviews with 25 formerly incarcerated HIV-positive women. Two researchers completed independent coding, producing preliminary codes from transcripts using content analysis. Themes were developed iteratively, verified, and refined. They encompassed (a) special rules for HIV-positive women: isolation, segregation, insults, food rationing, and forced disclosure; (b) absence of counseling following initial HIV diagnosis; and (c) HIV treatment impediments: delays, interruption, and denial. Participants deployed agentic strategies of accommodation, resistance, and care-seeking to navigate the social world of prison and HIV services. Findings illuminate the "HIV prison paradox": the chief opportunities that remain unexploited to engage and re-engage justice-involved women in the HIV care continuum.
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Affiliation(s)
- Courtenay Sprague
- 1 University of Massachusetts Boston, Boston, Massachusetts, USA
- 2 University of the Witwatersrand, Johannesburg, South Africa
| | | | | | - David W Pantalone
- 1 University of Massachusetts Boston, Boston, Massachusetts, USA
- 3 Fenway Health, Boston, Massachusetts, USA
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Randomized Controlled Trial of an Intervention to Maintain Suppression of HIV Viremia After Prison Release: The imPACT Trial. J Acquir Immune Defic Syndr 2017; 75:81-90. [PMID: 28277487 DOI: 10.1097/qai.0000000000001337] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND HIV-infected individuals transitioning from incarceration to the community are at risk for loss of viral suppression. We compared the effects of imPACT, a multidimensional intervention to promote care engagement after release, to standard care on sustaining viral suppression after community re-entry. METHODS This trial randomized 405 HIV-infected inmates being released from prisons in Texas and North Carolina with HIV-1 RNA levels <400 copies/mL to imPACT versus standard care. The imPACT arm received motivational interviewing prerelease and postrelease, referral to care within 5 days of release, and a cellphone for medication text reminders. The standard care arm received routine discharge planning and a cellphone for study staff contact. The primary outcome was the difference between arms in week 24 postrelease viral suppression (HIV-1 RNA <50 copies/mL) using intention-to-treat analysis with multiple imputation of missing data. RESULTS The proportion with 24-week HIV-1 RNA <50 copies/mL was 60% and 61% in the imPACT and standard care arms, respectively [odds ratio for suppression 0.95 (95% confidence interval: 0.59 to 1.53)]. By week 6 postrelease, 86% in the imPACT arm versus 75% in the standard care arm attended at least 1 nonemergency clinic visit (P = 0.02). At week 24, 62% in both arms reported not missing any antiretroviral doses in the past 30 days (P > 0.99). CONCLUSIONS Higher rates of HIV suppression and medical care engagement than expected based on previous literature were observed among HIV-infected patients with suppressed viremia released from prison. Randomization to a comprehensive intervention to motivate and facilitate HIV care access after prison release did not prevent loss of viral suppression. A better understanding of the factors influencing prison releasees' linkage to community care, medication adherence, and maintenance of viral suppression is needed to inform policy and other strategic approaches to HIV prevention and treatment.
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Associations of criminal justice and substance use treatment involvement with HIV/HCV testing and the HIV treatment cascade among people who use drugs in Oakland, California. Addict Sci Clin Pract 2017; 12:13. [PMID: 28610602 PMCID: PMC5470222 DOI: 10.1186/s13722-017-0078-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 04/18/2017] [Indexed: 11/10/2022] Open
Abstract
Background People who smoke crack cocaine and people who inject drugs are at-risk for criminal justice involvement as well as HIV and HCV infection. Compared to criminal justice involvement, substance use treatment (SUT) can be cost-effective in reducing drug use and its associated health and social costs. We conducted a cross-sectional study of people who smoke crack cocaine and people who inject drugs to examine the association between incarceration, community supervision and substance use treatment with HIV/HCV testing, components of the HIV treatment cascade, social and physical vulnerability and risk behavior. Methods Targeted sampling methods were used to recruit people who smoke crack cocaine and people who inject drugs (N = 2072) in Oakland, California from 2011 to 2013. Poisson regression models were used to estimate adjusted prevalence ratios between study exposures and outcomes. Results The overall HIV prevalence was 3.3% (95% CI 2.6–4.1). People previously experiencing incarceration were 21% (p < 0.001) and 32% (p = 0.001), respectively, more likely to report HIV and HCV testing; and were not more likely to report receiving HIV care or initiating ART. People previously experiencing community supervision were 17% (p = 0.001) and 15% (p = 0.009), respectively, more likely to report HIV and HCV testing; and were not more likely to report receiving HIV care or initiating ART. People with a history of SUT were 15% (p < 0.001) and 23% (p < 0.001), respectively, more likely to report receiving HIV and HCV testing, 67% (p = 0.016) more likely to report HIV care, and 92% (p = 0.012) more likely to report HIV treatment initiation. People previously experiencing incarceration or community supervision were also more likely to report homelessness, trouble meeting basic needs and risk behavior. Conclusions People with a history of substance use treatment reported higher levels of HCV and HIV testing and greater access to HIV care and treatment among HIV-positive individuals. People with a history of incarceration or community supervision reported higher levels of HCV and HIV testing, but not greater access to HIV care or treatment among HIV-positive individuals., Substance use treatment programs that are integrated with other services for HIV and HCV will be critical to simultaneously address the underlying reasons drug-involved people engage in drug-related offenses and improve access to essential medical services.
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Powers C, Comfort M, Lopez AM, Kral AH, Murdoch O, Lorvick J. Addressing Structural Barriers to HIV Care among Triply Diagnosed Adults: Project Bridge Oakland. HEALTH & SOCIAL WORK 2017; 42:e53-e61. [PMID: 28340193 PMCID: PMC6251694 DOI: 10.1093/hsw/hlx013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 05/09/2016] [Indexed: 05/05/2023]
Abstract
People who are "triply diagnosed" with HIV, mental health issues, and substance-related disorders face tremendous barriers connecting to and remaining in HIV care. Authors of this article implemented Project Bridge Oakland (PBO), an intervention based on harm reduction and trauma-informed care, to help maintain continuity of care for triply diagnosed adults through cycles of criminal justice involvement. From August 2011 to December 2014, a clinical social worker and an HIV physician provided intensive case management for 19 clients living in Oakland, California. By working with clients across a multitude of community, clinic, and correctional spaces while maintaining a low threshold for services, the social worker was able to engage a severely marginalized population in HIV care. This article details the PBO strategies for assisting with a wide range of services needed for community stabilization, navigating criminal justice involvement, and establishing a therapeutic relationship through mundane practices such as eating and waiting for appointments. This article illustrates how programs aimed at stabilizing triply diagnosed clients in the community and connecting them to HIV care require coordination among providers, outreach to engage clients, ample time to work with them, and flexibility to account for the complexities of their day-to-day lives and experiences.
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Affiliation(s)
- Christina Powers
- Christina Powers, LCSW, is a licensed clinical social worker, San Francisco
Public Defender's Office. Megan Comfort, PhD, is a senior research sociologist,
RTI International, San Francisco. Andrea M. Lopez, PhD, is assistant professor,
Department of Anthropology, University of Maryland, College Park. Alex H. Kral,
PhD, is senior research epidemiologist, RTI International, San Francisco.
Owen Murdoch, MD, is a physician, HIV Services, Family Health Centers of San
Diego. Jennifer Lorvick, DrPH, is a senior public health scientist, RTI
International, San Francisco
| | - Megan Comfort
- Christina Powers, LCSW, is a licensed clinical social worker, San Francisco
Public Defender's Office. Megan Comfort, PhD, is a senior research sociologist,
RTI International, San Francisco. Andrea M. Lopez, PhD, is assistant professor,
Department of Anthropology, University of Maryland, College Park. Alex H. Kral,
PhD, is senior research epidemiologist, RTI International, San Francisco.
Owen Murdoch, MD, is a physician, HIV Services, Family Health Centers of San
Diego. Jennifer Lorvick, DrPH, is a senior public health scientist, RTI
International, San Francisco
- Address correspondence to Megan Comfort, RTI International, 351
California Street, Suite 500, San Francisco, CA 94104; e-mail:
. This research was supported by funding from the
National Institutes of Health (R01MH094090, PI: Kral; R01DA033847, PI: Comfort; and
R01MD007679, PI: Lorvick). The authors thank Caroline Ahlstrom, David Greenberg, Elizabeth
Kita, and the Project Bridge Oakland clients for their insights and
collaboration
| | - Andrea M. Lopez
- Christina Powers, LCSW, is a licensed clinical social worker, San Francisco
Public Defender's Office. Megan Comfort, PhD, is a senior research sociologist,
RTI International, San Francisco. Andrea M. Lopez, PhD, is assistant professor,
Department of Anthropology, University of Maryland, College Park. Alex H. Kral,
PhD, is senior research epidemiologist, RTI International, San Francisco.
Owen Murdoch, MD, is a physician, HIV Services, Family Health Centers of San
Diego. Jennifer Lorvick, DrPH, is a senior public health scientist, RTI
International, San Francisco
| | - Alex H. Kral
- Christina Powers, LCSW, is a licensed clinical social worker, San Francisco
Public Defender's Office. Megan Comfort, PhD, is a senior research sociologist,
RTI International, San Francisco. Andrea M. Lopez, PhD, is assistant professor,
Department of Anthropology, University of Maryland, College Park. Alex H. Kral,
PhD, is senior research epidemiologist, RTI International, San Francisco.
Owen Murdoch, MD, is a physician, HIV Services, Family Health Centers of San
Diego. Jennifer Lorvick, DrPH, is a senior public health scientist, RTI
International, San Francisco
| | - Owen Murdoch
- Christina Powers, LCSW, is a licensed clinical social worker, San Francisco
Public Defender's Office. Megan Comfort, PhD, is a senior research sociologist,
RTI International, San Francisco. Andrea M. Lopez, PhD, is assistant professor,
Department of Anthropology, University of Maryland, College Park. Alex H. Kral,
PhD, is senior research epidemiologist, RTI International, San Francisco.
Owen Murdoch, MD, is a physician, HIV Services, Family Health Centers of San
Diego. Jennifer Lorvick, DrPH, is a senior public health scientist, RTI
International, San Francisco
| | - Jennifer Lorvick
- Christina Powers, LCSW, is a licensed clinical social worker, San Francisco
Public Defender's Office. Megan Comfort, PhD, is a senior research sociologist,
RTI International, San Francisco. Andrea M. Lopez, PhD, is assistant professor,
Department of Anthropology, University of Maryland, College Park. Alex H. Kral,
PhD, is senior research epidemiologist, RTI International, San Francisco.
Owen Murdoch, MD, is a physician, HIV Services, Family Health Centers of San
Diego. Jennifer Lorvick, DrPH, is a senior public health scientist, RTI
International, San Francisco
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El-Bassel N, Marotta PL, Shaw SA, Chang M, Ma X, Goddard-Eckrich D, Hunt T, Johnson K, Goodwin S, Almonte M, Gilbert L. Women in community corrections in New York City: HIV infection and risks. Int J STD AIDS 2017; 28:160-169. [PMID: 26887890 PMCID: PMC5367917 DOI: 10.1177/0956462416633624] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although the incidence of HIV among women on probation, parole and alternatives to incarceration programs is significant to public health, drivers of this concentrated epidemic among women under community corrections remain understudied. This study examined prevalence of HIV and sexually transmitted infections and the associations between substance use, socio-demographic factors and the prevalence of biologically-confirmed HIV and other sexually transmitted infections among a sample of 337 substance-using women recruited from community correction sites in New York City. Prevalence of HIV was 13% and sexually transmitted infections was 26% ( Chlamydia, trachomatis and Neisseria gonorrhea). After adjusting for covariates, HIV-positive women were 1.42 times more likely to use crack/cocaine than HIV-negative women (95% CI = 1.05-1.92). HIV-positive women were 25% less likely than HIV-negative women to report any unprotected vaginal and anal sex with their main partner (95% CI = 0.57-0.99). They were 70% less likely than HIV-negative women to report unprotected vaginal sex with a non-paying casual partner (95% CI = 0.1-0.9) and 22% less likely to report unprotected vaginal sex across all partners (95% CI = 0.61-0.99). Community corrections settings may be optimal venues to launch HIV/sexually transmitted infections prevention that have potential to reach and engage an ever-growing number of substance-using women.
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Affiliation(s)
- Nabila El-Bassel
- Social Intervention Group, Columbia University, New York, New York, USA
| | - Phillip L Marotta
- Social Intervention Group, Columbia University, New York, New York, USA
| | - Stacey A Shaw
- Social Intervention Group, Columbia University, New York, New York, USA
| | - Mingway Chang
- Social Intervention Group, Columbia University, New York, New York, USA
| | - Xin Ma
- Social Intervention Group, Columbia University, New York, New York, USA
| | | | - Tim Hunt
- Social Intervention Group, Columbia University, New York, New York, USA
| | - Karen Johnson
- Social Intervention Group, Columbia University, New York, New York, USA
| | - Sharun Goodwin
- The New York City Department of Probation, New York, New York, USA
| | - Maria Almonte
- Bronx Community Solutions, Center for Court Innovation, Bronx, New York, USA
| | - Louisa Gilbert
- Social Intervention Group, Columbia University, New York, New York, USA
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Beckwith C, Castonguay BU, Trezza C, Bazerman L, Patrick R, Cates A, Olsen H, Kurth A, Liu T, Peterson J, Kuo I. Gender Differences in HIV Care among Criminal Justice-Involved Persons: Baseline Data from the CARE+ Corrections Study. PLoS One 2017; 12:e0169078. [PMID: 28081178 PMCID: PMC5231337 DOI: 10.1371/journal.pone.0169078] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 12/07/2016] [Indexed: 11/17/2022] Open
Abstract
Background HIV-infected individuals recently released from incarceration have suboptimal linkage and engagement in community HIV care. We conducted a study to evaluate an information and communication technology intervention to increase linkage to community care among HIV-infected persons recently involved in the criminal justice (CJ) system. Baseline characteristics including risk behaviors and HIV care indicators are reported and stratified by gender. Methods We recruited HIV-infected individuals in the District of Columbia jail and persons with a recent history of incarceration through community and street outreach. Participants completed a baseline computer-assisted personal interview regarding HIV care and antiretroviral treatment (ART) adherence, substance use, and sexual behaviors. CD4 and HIV plasma viral load testing were performed at baseline or obtained through medical records. Data were analyzed for the sample overall and stratified by gender. Results Of 110 individuals, 70% were community-enrolled, mean age was 40 (SD = 10.5), 85% were Black, and 58% were male, 24% female, and 18% transgender women. Nearly half (47%) had condomless sex in the three months prior to incarceration. Although drug dependence and hazardous alcohol use were highly prevalent overall, transgender women were more likely to have participated in drug treatment than men and women (90%, 61%, and 50% respectively; p = 0.01). Prior to their most recent incarceration, 80% had an HIV provider and 91% had ever taken ART. Among those, only 51% reported ≥90% ART adherence. Fewer women (67%) had received HIV medications during their last incarceration compared to men (96%) and transgender women (95%; p = 0.001). Although neither was statistically significant, transgender women and men had higher proportions of baseline HIV viral suppression compared to women (80%, 69%, and 48.0% respectively, p>0.05); a higher proportion of women had a CD4 count ≤200 compared to men and transgender women (17%, 8% and 5% respectively; p>0.05). Conclusions In this study, HIV-infected persons with recent incarceration in Washington, DC reported important risk factors and co-morbidities, yet the majority had access to HIV care and ART prior to, during, and after incarceration. Self-reported ART adherence was sub-optimal, and while there were not statistically significant differences, CJ-involved women appeared to be at greatest risk of poor HIV outcomes. Trial registration Registered on ClinicalTrials.gov on 10/16/2012. Reference number: NCT01721226.
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Affiliation(s)
- Curt Beckwith
- The Miriam Hospital, Providence, RI, United States of America.,Brown University Alpert School of Medicine, Providence, RI, United States of America
| | - Breana Uhrig Castonguay
- George Washington University Milken Institute School of Public Health, Washington, DC, United States of America
| | - Claudia Trezza
- George Washington University Milken Institute School of Public Health, Washington, DC, United States of America
| | - Lauri Bazerman
- The Miriam Hospital, Providence, RI, United States of America
| | - Rudy Patrick
- George Washington University Milken Institute School of Public Health, Washington, DC, United States of America
| | - Alice Cates
- George Washington University Milken Institute School of Public Health, Washington, DC, United States of America
| | - Halli Olsen
- George Washington University Milken Institute School of Public Health, Washington, DC, United States of America
| | - Ann Kurth
- Yale University School of Nursing, New Haven, CT, United States of America
| | - Tao Liu
- Brown University School of Public Health, Providence, RI, United States of America
| | - James Peterson
- George Washington University Milken Institute School of Public Health, Washington, DC, United States of America
| | - Irene Kuo
- George Washington University Milken Institute School of Public Health, Washington, DC, United States of America
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Valera P, Chang Y, Lian Z. HIV risk inside U.S. prisons: a systematic review of risk reduction interventions conducted in U.S. prisons. AIDS Care 2016; 29:943-952. [PMID: 28027663 DOI: 10.1080/09540121.2016.1271102] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
HIV prevalence in correctional populations is approximately five times that of the general adult population. This systematic review examines the broad question of HIV prevention and interventions to reduce inmate HIV-related risk behaviors in U.S. federal and state prisons. We conducted a systematic review of multiple databases and Google Scholar to identify behavioral, biomedical, social, and policy studies related to HIV among U.S. prison populations from 1980-2014. Studies were excluded if they did not focus on HIV, prison inmates, if they were conducted outside of the U.S., if they involved juvenile offenders, or if they included post-release outcomes. Twenty-seven articles met the study criteria. Evidence suggests that research related to the HIV care continuum, risk behaviors, gender, prevention (e.g., peer education), and policy are key topics to enhance HIV prevention interventions in the criminal justice system. This review provides a prison-specific overview of HIV in U.S. correctional populations and highlight effective interventions, including inmate peer education. There is an urgent need to continue to implement HIV prevention interventions across all prisons and improve the quality of life among those at heightened risk of HIV infection.
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Affiliation(s)
- Pamela Valera
- a Nathan Kline Institute for Psychiatric Research , Orangeburg , NY , USA.,b Department of Psychiatry , New York School of Medicine , New York , NY , USA
| | - Yvonne Chang
- c Department of Sociology , McGill University , Montreal , Quebec , Canada
| | - Zi Lian
- d Teachers College, Columbia University , New York , NY , USA
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Fox AD, Anderson MR, Bartlett G, Valverde J, Starrels JL, Cunningham CO. Health outcomes and retention in care following release from prison for patients of an urban post-incarceration transitions clinic. J Health Care Poor Underserved 2016; 25:1139-52. [PMID: 25130230 DOI: 10.1353/hpu.2014.0139] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Chronic health conditions are overrepresented among prisoners who often face barriers to medical care following release. Transitions clinics seek to provide timely access to medical care following release. This retrospective cohort study investigated care delivery and health outcomes for recently released prisoners receiving care at the Bronx Transitions Clinic. Among 135 recently released prisoners, median time from release to initial medical visit was 10 days (IQ Range: 5-31). Six-month retention in care was high for HIV-infection (86%), but lower for opioid dependence (33%), hypertension (45%) and diabetes (43%). At six months, 54% of HIV-patients had a suppressed viral load, but fewer buprenorphine-treated patients reduced opioid use (19%), and fewer hypertensive and diabetic patients reached respective blood pressure (35%) and hemoglobin A1c (14%) goals. Access to medical care is necessary but not sufficient to control chronic health conditions. Additional interventions are necessary for formerly incarcerated people to achieve optimal health outcomes.
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Solomon L, Montague BT, Beckwith CG, Baillargeon J, Costa M, Dumont D, Kuo I, Kurth A, Rich JD. Survey finds that many prisons and jails have room to improve HIV testing and coordination of postrelease treatment. Health Aff (Millwood) 2016; 33:434-42. [PMID: 24590942 DOI: 10.1377/hlthaff.2013.1115] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Early diagnosis of HIV and effective antiretroviral treatment are key elements in efforts to reduce the morbidity and mortality associated with HIV. Incarcerated populations are disproportionately affected by HIV, with the disease's prevalence among inmates estimated to be three to five times higher than among the general population. Correctional institutions offer important opportunities to test for HIV and link infected people to postrelease treatment services. To examine HIV testing and policies that help HIV-positive people obtain treatment in the community after release, we administered a survey to the medical directors of the fifty state prison systems and of forty of the largest jails in the United States. We found that 19 percent of prison systems and 35 percent of jails provide opt-out HIV testing, which is recommended by the Centers for Disease Control and Prevention (CDC). Additionally, fewer than 20 percent of prisons and jails conform to the CDC's recommendations regarding discharge planning services for inmates transitioning to the community: making an appointment with a community health care provider, assisting with enrollment in an entitlement program, and providing a copy of the medical record and a supply of HIV medications. These findings suggest that opportunities for HIV diagnosis and linking HIV-positive inmates to community care after release are being missed in the majority of prison systems and jails.
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Culbert GJ, Bazazi AR, Waluyo A, Murni A, Muchransyah AP, Iriyanti M, Finnahari, Polonsky M, Levy J, Altice FL. The Influence of Medication Attitudes on Utilization of Antiretroviral Therapy (ART) in Indonesian Prisons. AIDS Behav 2016; 20:1026-38. [PMID: 26400080 PMCID: PMC4805506 DOI: 10.1007/s10461-015-1198-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Negative attitudes toward HIV medications may restrict utilization of antiretroviral therapy (ART) in Indonesian prisons where many people living with HIV (PLH) are diagnosed and first offered ART. This mixed-method study examines the influence of medication attitudes on ART utilization among HIV-infected Indonesian prisoners. Randomly-selected HIV-infected male prisoners (n = 102) completed face-to-face in-depth interviews and structured surveys assessing ART attitudes. Results show that although half of participants utilized ART, a quarter of those meeting ART eligibility guidelines did not. Participants not utilizing ART endorsed greater concerns about ART efficacy, safety, and adverse effects, and more certainty that ART should be deferred in PLH who feel healthy. In multivariate analyses, ART utilization was independently associated with more positive ART attitudes (AOR = 1.09, 95 % CI 1.03-1.16, p = 0.002) and higher internalized HIV stigma (AOR = 1.03, 95 % CI 1.00-1.07, p = 0.016). Social marketing of ART is needed to counteract negative ART attitudes that limit ART utilization among Indonesian prisoners.
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Affiliation(s)
- Gabriel J Culbert
- Department of Health Systems Science, University of Illinois at Chicago, College of Nursing, 845 S. Damen Ave., Chicago, IL, 60612, USA.
- Center for HIV/AIDS Nursing Research, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia.
- Section of Infectious Diseases, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia.
| | - Alexander R Bazazi
- Section of Infectious Diseases, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
| | - Agung Waluyo
- Center for HIV/AIDS Nursing Research, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Astia Murni
- Directorate General of Corrections, Indonesian Ministry of Law and Human Rights, Jakarta, Indonesia
| | | | - Mariska Iriyanti
- Center for HIV/AIDS Nursing Research, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Finnahari
- Directorate General of Corrections, Indonesian Ministry of Law and Human Rights, Jakarta, Indonesia
| | - Maxim Polonsky
- Section of Infectious Diseases, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Judith Levy
- Department of Health Policy & Administration, University of Illinois at Chicago School of Public Health, Chicago, IL, USA
| | - Frederick L Altice
- Section of Infectious Diseases, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
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Opt-Out HIV Testing of Inmates in North Carolina Prisons: Factors Associated with not Wanting a Test and not Knowing They Were Tested. AIDS Behav 2016; 20:859-69. [PMID: 26386591 DOI: 10.1007/s10461-015-1203-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Opt-out HIV testing is recommended for correctional settings but may occur without inmates' knowledge or against their wishes. Through surveying inmates receiving opt-out testing in a large prison system, we estimated the proportion unaware of being tested or not wanting a test, and associations [prevalence ratios (PRs)] with inmate characteristics. Of 871 tested, 11.8 % were unknowingly tested and 10.8 % had unwanted tests. Not attending an educational HIV course [PR = 2.34, 95 % confidence interval (CI) 1.47-3.74], lower HIV knowledge (PR = 0.95, 95 % CI 0.91-0.98), and thinking testing is not mandatory (PR = 9.84, 95 % CI 4.93-19.67) were associated with unawareness of testing. No prior incarcerations (PR = 1.59, 95 % CI 1.03-2.46) and not using crack/cocaine recently (PR = 2.37, 95 % CI 1.21-4.64) were associated with unwanted testing. Residence at specific facilities was associated with both outcomes. Increased assessment of inmate understanding and enhanced implementation are needed to ensure inmates receive full benefits of opt-out testing: being informed and tested according to their wishes.
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Monarca R, Madeddu G, Ranieri R, Carbonara S, Leo G, Sardo M, Choroma F, Casari S, Marri D, Muredda AA, Nava FA, Babudieri S. HIV treatment and care among Italian inmates: a one-month point survey. BMC Infect Dis 2015; 15:562. [PMID: 26653247 PMCID: PMC4676105 DOI: 10.1186/s12879-015-1301-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 11/30/2015] [Indexed: 01/14/2023] Open
Abstract
Background HIV infection, with an estimated prevalence be between 2 and 50 times those of the general adult population is a major health challenge for prison authorities worldwide. Since no nationwide surveillance system is present in Italy, data on HIV prevalence and treatment in prisons are limited to only a few and small observational studies. We aimed to estimate HIV prevalence and obtain an overview on diagnostic and therapeutic activities concerning HIV infection in the Italian penitentiary system. Methods We piloted a multi-centre cross-sectional study investigating the prevalence of HIV infection and assessing HIV-related medical activities in Italian correctional institutions. Results A total of 15,675 prisoners from 25 institutions, accounting for approximately one-fourth of the prison inmates in Italy, were included in the study, of whom, 97.7 % were males, 37.1 % foreigners and 27 % had a history of intravenous drug addiction. HIV-tests were available in 42.3 % of the total population, with a known HIV Infection proportion of 5.1 %. In the month prior to the study, 604 of the 1,764 subjects who entered prison were tested for HIV, with a HIV-positive prevalence of 3.3 %. Among the 338 HIV-positive prisoners, 81.4 % were under antiretroviral treatment and 73.5 % showed undetectable HIV-RNA. In 23/338 (6.8 %) a coinfection with HBV and in 189/338 (55.9 %) with HCV was also present. Among the 67 (19.8 %) inmates with HIV who did not receive HIV treatment, 13 (19.5 %) had T-CD4+ count <350 cells/mm3 and 9 (69.2 %) of these had refused the treatment. The majority of the inmates with HIV-infection were on a PI-based (62.5 %) or on NNRTIs-based (24.4 %) regimen. Only a minority of patients received once daily regimens (17.2 %). Conclusions Although clinical and therapeutic management of HIV infection remains difficult in Italian prisons, diagnostics, treatment and care were offered to the majority of HIV-infected inmates. Specific programs should be directed towards the prison population and strict cooperation between prison and health institutions is needed to increase HIV treatment.
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Affiliation(s)
- R Monarca
- Infectious Diseases Unit, Belcolle Hospital, Viterbo, Italy.
| | - G Madeddu
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 35b, 07100, Sassari, Italy.
| | - R Ranieri
- Infectious Diseases Unit, A.O. San Paolo, Milan, Italy.
| | - S Carbonara
- Institute of Infectious Diseases, University of Bari, Bari, Italy.
| | - G Leo
- Infectious Diseases Unit, Amedeo di Savoia Hospital, Torino, Italy.
| | - M Sardo
- Cotugno Hospital, Infectious Diseases Unit, Naples, Italy.
| | - F Choroma
- Infectious Diseases Unit, AUSL, Parma, Italy.
| | - S Casari
- Institute of Infectious Diseases, University of Brescia, Brescia, Italy.
| | - D Marri
- Infectious Diseases Unit, A.O. Santa Maria alle Scotte, Siena, Italy.
| | - A A Muredda
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 35b, 07100, Sassari, Italy.
| | - F A Nava
- Penitentiary Medicine, Padova, Italy.
| | - S Babudieri
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 35b, 07100, Sassari, Italy.
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Visher CA, Yang Y, Mitchell SG, Patterson Y, Swan H, Pankow J. Understanding the sustainability of implementing HIV services in criminal justice settings. HEALTH & JUSTICE 2015; 3:5. [PMID: 25893155 PMCID: PMC4399763 DOI: 10.1186/s40352-015-0018-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 02/23/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND In the growing field of implementation science, sustainability is a critical component of the implementation process of moving evidence-based treatments to regular practice. This paper is intended to extend our understanding of factors that influence the sustainability of HIV services in correctional settings following an organization-level intervention designed to implement improvements in preventing, detecting, or treating HIV for persons under correctional supervision. METHODS Using semi-structured interviews to elicit perceptions from the principal researcher and executive sponsor at each of nine participating sites, this study explores the variations in the sustainability of HIV services in these criminal justice settings following the experimental implementation intervention. RESULTS In six of the nine sites, changes in HIV services implemented as a result of the organizational intervention were sustained six to nine months following the end of project implementation. Organizational endorsement at multiple levels is likely the principal factor that facilitates sustainability. CONCLUSIONS The factors that result in the sustainability of changes to health services in correctional organizations include elements internal and external to the organization. Implementation strategies, such as the change team model strategy used in this study, are also sustainable and can be used to identify other changes that could be made, or improve other aspects of service delivery.
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Affiliation(s)
- Christy A Visher
- Center for Drug & Health Studies, Department of Sociology and Criminal Justice, University of Delaware, Newark, USA
| | - Yang Yang
- Department of Psychology, University of Louisiana at Lafayette, Lafayette, USA
| | | | | | - Holly Swan
- Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial VA Medical Center, Bedford, USA
| | - Jennifer Pankow
- Institute of Behavioral Research, Texas Christian University, Fort Worth, USA
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Alpert M, Wickersham JA, Vázquez M, Altice FL. Alcohol use disorders and antiretroviral therapy among prisoners in Argentina. Int J Prison Health 2015; 9:40-50. [PMID: 24772187 DOI: 10.1108/17449201311310797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE While Argentina has significantly improved access to HIV care and antiretroviral therapy (ART) for both the general population and prisoners, the prevalence of alcohol use disorders (AUDs) among HIV-infected prisoners and their relationship to accessing ART in Argentina is currently unknown. This study aims to characterize the substance abuse patterns of HIV-infected prisoners in Argentina and to assess the independent correlates of receipt of pre-incarceration ART. DESIGN/METHODOLOGY/APPROACH An anonymous, cross-sectional survey of 100 HIV-infected federal prisoners was conducted in the Buenos Aires municipality from July-December 2010. AUDs were assessed using the AUDIT scale. FINDINGS A majority (63 per cent) of participants met criteria for AUDs, 45 per cent of subjects were diagnosed with HIV in prison and one-quarter had initiated ART during the current incarceration. In addition, over one-third (35 per cent) of participants did not receive ART during the pre-incarceration period despite receiving it upon incarceration. This correlated significantly with the presence of having an AUD (AOR 0.20, 95 per cent CI 0.06-0.74, p = 0.016). PRACTICAL IMPLICATIONS AUDs are prevalent among HIV-infected prisoners in Argentina and are significantly related to negative secondary HIV prevention and treatment outcomes. While Argentina has provided an exemplary model of HIV-related health care reform within its prisons, future efforts to provide screening and treatment for AUDs are needed to improve the health of the nation’s incarcerated population. ORIGINALITY/VALUE This paper is the first to describe pre-incarceration drug and alcohol use disorders and issues related to access to ART among prisoners in Argentina.
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Affiliation(s)
- Michael Alpert
- Department of Medicine, Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, New Haven, Connecticut, USA
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Shaikh RA, Simonsen KA, O'Keefe A, Earley M, Foxall M, Islam KM, Person A, Boyle C, Sandkovsky U, Margalit R. Comparison of Opt-In Versus Opt-Out Testing for Sexually Transmitted Infections Among Inmates in a County Jail. JOURNAL OF CORRECTIONAL HEALTH CARE 2015; 21:408-16. [PMID: 26285597 DOI: 10.1177/1078345815600447] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A majority of jails in the United States rely on an opt-in (voluntary) rather than opt-out (universal) approach to testing for sexually transmitted infections (STIs). This study compares an opt-out approach at intake to opt-in testing during incarceration and estimates the prevalence of common STIs among jail inmates. Data derive from a universal intake pilot testing program (n = 298) and an established, student-led voluntary testing program (n = 1,963), respectively. The adjusted prevalence as well as the odds of testing positive for chlamydia were significantly higher in the opt-out program (p = .025 and .008, respectively) than the opt-in program but not for gonorrhea (p = .402 and .300, respectively). These results demonstrate the potential public health benefit of implementation of universal STI testing of jail inmates.
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Affiliation(s)
- Raees A Shaikh
- Department of Health Promotion, Social and Behavioral Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kari A Simonsen
- Department of Pediatrics, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, USA
| | - Anne O'Keefe
- Douglas County Health Department, Omaha, NE, USA
| | - Mary Earley
- Douglas County Department of Corrections, Omaha, NE, USA
| | - Mark Foxall
- Douglas County Department of Corrections, Omaha, NE, USA
| | - K M Islam
- Department of Health Promotion, Social and Behavioral Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Austin Person
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Cole Boyle
- Department of Health Promotion, Social and Behavioral Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Uriel Sandkovsky
- Department of Internal Medicine, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, USA
| | - Ruth Margalit
- Department of Health Promotion, Social and Behavioral Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
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STI/HIV Sexual Risk Behavior and Prevalent STI Among Incarcerated African American Men in Committed Partnerships: The Significance of Poverty, Mood Disorders, and Substance Use. AIDS Behav 2015; 19:1478-90. [PMID: 25863467 DOI: 10.1007/s10461-015-1062-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
African Americans face disproportionate sexually transmitted infection including HIV (STI/HIV), with those passing through a correctional facility at heightened risk. There is a need to identify modifiable STI/HIV risk factors among incarcerated African Americans. Project DISRUPT is a cohort study of incarcerated African American men recruited from September 2011 through January 2014 from prisons in North Carolina who were in committed partnerships with women at prison entry (N = 207). During the baseline (in-prison) study visit, participants responded to a risk behavior survey and provided a urine specimen, which was tested for STIs. Substantial proportions reported multiple partnerships (42 %), concurrent partnerships (33 %), and buying sex (11 %) in the 6 months before incarceration, and 9 % tested positive for an STI at baseline (chlamydia: 5.3 %, gonorrhea: 0.5 %, trichomoniasis: 4.9 %). Poverty and depression appeared to be strongly associated with sexual risk behaviors. Substance use was linked to prevalent STI, with binge drinking the strongest independent risk factor (adjusted odds ratio: 3.79, 95 % CI 1.19-12.04). There is a continued need for improved prison-based STI testing, treatment, and prevention education as well as mental health and substance use diagnosis.
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Lorvick J, Comfort ML, Krebs CP, Kral AH. Health service use and social vulnerability in a community-based sample of women on probation and parole, 2011–2013. HEALTH & JUSTICE 2015; 3:13. [PMCID: PMC5151512 DOI: 10.1186/s40352-015-0024-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 05/13/2015] [Indexed: 05/21/2023]
Abstract
Background Most women involved in the criminal justice system are not incarcerated, but rather on probation or parole. We examined the receipt of health services and social vulnerability among women on parole or probation in the past year. Methods In a community-based sample of 776 women who use crack cocaine or injection drugs, we compared those who had been on probation or parole in the past year with those who had no criminal justice involvement in the past year. Results Women recently on probation or people were no more likely have health insurance, or to receive most health services, than women not in the criminal justice system. In addition, we found social vulnerabilities that contribute to poor health to be significantly more prevalent among women on probation or parole. Conclusions There is a missed opportunity to address health and social needs of women on probation or parole.
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Affiliation(s)
- Jennifer Lorvick
- Behavioral and Urban Health Program RTI International, 351 California Street, Suite 500 San Francisco, CA 94104 USA
| | - Megan L Comfort
- Behavioral and Urban Health Program RTI International, 351 California Street, Suite 500 San Francisco, CA 94104 USA
| | - Christopher P Krebs
- Center for Justice, Safety and Resilience RTI International, 3040 East Cornwallis Road, HILL 412 Research Triangle Park, NC, 27709 USA
| | - Alex H Kral
- Behavioral and Urban Health Program RTI International, 351 California Street, Suite 500 San Francisco, CA 94104 USA
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Lima VD, Graf I, Beckwith CG, Springer S, Altice FL, Coombs D, Kim B, Messina L, Montaner JSG, Spaulding A. The Impact of Implementing a Test, Treat and Retain HIV Prevention Strategy in Atlanta among Black Men Who Have Sex with Men with a History of Incarceration: A Mathematical Model. PLoS One 2015; 10:e0123482. [PMID: 25905725 PMCID: PMC4408043 DOI: 10.1371/journal.pone.0123482] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 02/19/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Annually, 10 million adults transition through prisons or jails in the United States (US) and the prevalence of HIV among entrants is three times higher than that for the country as a whole. We assessed the potential impact of increasing HIV Testing/Treatment/Retention (HIV-TTR) in the community and within the criminal justice system (CJS) facilities, coupled with sexual risk behavior change, focusing on black men-who-have-sex-with-men, 15-54 years, in Atlanta, USA. METHODS We modeled the effect of a HIV-TTR strategy on the estimated cumulative number of new (acquired) infections and mortality, and on the HIV prevalence at the end of ten years. We additionally assessed the effect of increasing condom use in all settings. RESULTS In the Status Quo scenario, at the end of 10 years, the cumulative number of new infections in the community, jail and prison was, respectively, 9246, 77 and 154 cases; HIV prevalence was 10815, 69 and 152 cases, respectively; and the cumulative number of deaths was 2585, 18 and 34 cases, respectively. By increasing HIV-TTR coverage, the cumulative number of new infections could decrease by 15% in the community, 19% in jail, and 8% in prison; HIV prevalence could decrease by 8%, 9% and 7%, respectively; mortality could decrease by 20%, 39% and 18%, respectively. Based on the model results, we have shown that limited use and access to condoms have contributed to the HIV incidence and prevalence in all settings. CONCLUSIONS Aggressive implementation of a CJS-focused HIV-TTR strategy has the potential to interrupt HIV transmission and reduce mortality, with benefit to the community at large. To maximize the impact of these interventions, retention in treatment, including during the period after jail and prison release, and increased condom use was vital for decreasing the burden of the HIV epidemic in all settings.
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Affiliation(s)
- Viviane D. Lima
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
- Department of Medicine, Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Isabell Graf
- Department of Mathematics, Simon Fraser University, Burnaby, Canada
| | - Curt G. Beckwith
- Alpert Medical School of Brown University, The Miriam Hospital, Providence, Rhode Island, United States of America
| | - Sandra Springer
- Yale University School of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, Connecticut, United States of America
| | - Frederick L. Altice
- Yale University School of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, Connecticut, United States of America
- Yale University School of Public Health, Division of Epidemiology of Microbial Diseases, New Haven, Connecticut, United States of America
| | - Daniel Coombs
- Department of Mathematics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Brian Kim
- Rollins School of Public Health Department of Epidemiology, Emory University School of Medicine, Atlanta, United States of America
| | - Lauren Messina
- Rollins School of Public Health Department of Epidemiology, Emory University School of Medicine, Atlanta, United States of America
| | - Julio S. G. Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
- Department of Medicine, Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anne Spaulding
- Rollins School of Public Health Department of Epidemiology, Emory University School of Medicine, Atlanta, United States of America
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Efficacy of a group-based multimedia HIV prevention intervention for drug-involved women under community supervision: project WORTH. PLoS One 2014; 9:e111528. [PMID: 25372149 PMCID: PMC4221040 DOI: 10.1371/journal.pone.0111528] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 09/23/2014] [Indexed: 11/19/2022] Open
Abstract
IMPORTANCE This study is designed to address the need for evidence-based HIV/STI prevention approaches for drug-involved women under criminal justice community supervision. OBJECTIVE We tested the efficacy of a group-based traditional and multimedia HIV/STI prevention intervention (Project WORTH: Women on the Road to Health) among drug-involved women under community supervision. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTION We randomized 306 women recruited from community supervision settings to receive either: (1) a four-session traditional group-based HIV/STI prevention intervention (traditional WORTH); (2) a four-session multimedia group-based HIV/STI prevention intervention that covered the same content as traditional WORTH but was delivered in a computerized format; or (3) a four-session group-based Wellness Promotion intervention that served as an attention control condition. The study examined whether the traditional or multimedia WORTH intervention was more efficacious in reducing risks when compared to Wellness Promotion; and whether multimedia WORTH was more efficacious in reducing risks when compared to traditional WORTH. MAIN OUTCOMES AND MEASURES Primary outcomes were assessed over the 12-month post-intervention period and included the number of unprotected sex acts, the proportion of protected sex acts, and consistent condom use. At baseline, 77% of participants reported unprotected vaginal or anal sex (n = 237) and 63% (n = 194) had multiple sex partners. RESULTS Women assigned to traditional or multimedia WORTH were significantly more likely than women assigned to the control condition to report an increase in the proportion of protected sex acts (β = 0.10; 95% CI = 0.02-0.18) and a decrease in the number of unprotected sex acts (IRR = 0.72; 95% CI = 0.57-0.90). CONCLUSION AND RELEVANCE The promising effects of traditional and multimedia WORTH on increasing condom use and high participation rates suggest that WORTH may be scaled up to redress the concentrated epidemics of HIV/STIs among drug-involved women in the criminal justice system. TRIAL REGISTRATION ClinicalTrials.gov NCT01784809.
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Underhill K, Dumont D, Operario D. HIV prevention for adults with criminal justice involvement: a systematic review of HIV risk-reduction interventions in incarceration and community settings. Am J Public Health 2014; 104:e27-53. [PMID: 25211725 PMCID: PMC4202946 DOI: 10.2105/ajph.2014.302152] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2014] [Indexed: 11/04/2022]
Abstract
We summarized and appraised evidence regarding HIV prevention interventions for adults with criminal justice involvement. We included randomized and quasi-randomized controlled trials that evaluated an HIV prevention intervention, enrolled participants with histories of criminal justice involvement, and reported biological or behavioral outcomes. We used Cochrane methods to screen 32,271 citations from 16 databases and gray literature. We included 37 trials enrolling n = 12,629 participants. Interventions were 27 psychosocial, 7 opioid substitution therapy, and 3 HIV-testing programs. Eleven programs significantly reduced sexual risk taking, 4 reduced injection drug risks, and 4 increased testing. Numerous interventions may reduce HIV-related risks among adults with criminal justice involvement. Future research should consider process evaluations, programs involving partners or families, and interventions integrating biomedical, psychosocial, and structural approaches.
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Affiliation(s)
- Kristen Underhill
- At the time of the study, Kristen Underhill was with Center for Alcohol and Addiction Studies, Department of Community Health, Brown University, Providence, RI, and Center for Interdisciplinary Research on AIDS and Yale Law School, Yale University, New Haven, CT. Dora Dumont was with The Center for Prisoner Health and Human Rights, Miriam Hospital, Providence, and Rhode Island Department of Health, Providence. Don Operario is with Center for Alcohol and Addiction Studies, School of Public Health, Brown University
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