DOT and Prevention for HIV(+) Persons Leaving Prison

描述（由申请人提供）： 此应用程序是一个指导的病人为导向的研究职业发展奖（K23）的请求准备博士詹妮弗·米蒂设计和实施研究，以增加药物依从性，并提供二级预防艾滋病毒（+）个人被释放的矫正设置。 博士米蒂是布朗医学院的医学助理教授。Miriam医院和布朗医学院的临床研究培训环境非常适合K23，因为他们在预防方面拥有丰富的经验，直接观察HIV（+）患者的治疗以及他们在 以及跟踪从监狱释放的个人。该奖项的主要导师是医学博士Timothy Flanigan，他在药物滥用，预防和观察治疗研究方面拥有丰富的经验，并参与了许多HIV（+）个人离开监狱的研究项目。Mitty博士还将得到一个强大的导师团队的全力支持，包括H1V预防领域的领导者Kenneth Mayer博士，专门从事行为预防和定性研究的Kathleen Morrow博士，以及Rick Altice博士，他将担任场外导师，并在药物依从性，直接观察治疗，物质使用和监禁人群方面具有专业知识。Macalino和Hogan博士将参与研究设计、仪器开发和分析。 离开监狱接受高效抗逆转录病毒治疗的艾滋病毒（+）感染者不坚持服药和血浆病毒载量增加的风险增加。此外，我们的网站和其他网站记录了从监狱释放后艾滋病毒风险行为的增加。通过这一项目，将为出狱的艾滋病毒（+）感染者制定一种经改良的直接观察治疗和二级预防干预相结合的方法。 本研究的第一阶段将使用定量和定性技术来评估干预的促进者和障碍。在第二阶段，将以现有的DOT和二级预防方案为模型，制定一项试点干预措施。在第三阶段，将对50名从罗得岛成人教养所释放后过渡到社区的艾滋病毒（+）感染者试行这一干预措施。将评估干预的可接受性和可行性，以及干预对血浆病毒载量抑制和释放后前6个月内自我报告的HIV风险行为的有效性。

DESCRIPTION (provided by applicant): This application is a request for a Mentored Patient-Oriented Research Career Development Award (K23) to prepare Dr. Jennifer Mitty to design and implement studies to increase medication adherence and provide secondary prevention to HIV(+) individuals being released from the correctional setting. Dr. Mitty is an Assistant Professor of Medicine at Brown Medical School. The clinical research training environments at the Miriam Hospital and Brown Medical School are ideal for a K23 because of their extensive experience in prevention, directly observed therapy for HIV(+) patients and their work within corrections as well as following individuals being released from prison. The primary mentor for this award is Timothy Flanigan, MD, who has extensive experience in substance abuse, prevention and observed therapy research, and is involved in many research projects with HIV(+) individuals leaving prison. Dr Mitty will also have the full support of a strong mentorship team including Dr. Kenneth Mayer who is a leader in the field of H1V prevention, Dr. Kathleen Morrow whose expertise is in behavioral prevention and qualitative research, and Dr. Rick Altice who will serve as an off-site mentor and has an expertise in medication adherence, directly observed therapy, substance use and incarcerated populations. Drs Macalino and Hogan will be involved in study design, instrument development and analysis. HIV(+) persons leaving prison on highly active antiretroviral therapy are at increased risk of medication non-adherence and increased plasma viral load. In addition, our site and others have documented an increase in HIV risk behaviors after release from prison. Through this project a combined modified directly observed therapy and secondary prevention intervention will be developed for HIV(+) individuals leaving prison. Phase I of this study will use quantitative and qualitative techniques to evaluate facilitators and barriers to the intervention. During Phase II, a pilot intervention will be developed, modeled on existing DOT and secondary prevention programs. In phase III, this intervention will be piloted on 50 HIV(+) individuals transitioning to the community after release from the Adult Correctional Institution in Rhode Island. Acceptability and feasibility of the intervention will be evaluated, as well as efficacy of the intervention on plasma viral load suppression and self-reported HIV-risk behaviors during the first 6 months post release.