A Healthy Transition for Newly Released HIV-Infected Prisoners

新释放的感染艾滋病毒的囚犯的健康过渡

• 批准号: 7295717
• 负责人: MICHAEL COPENHAVER
• 金额: $ 17.58万
• 依托单位: UNIVERSITY OF CONNECTICUT STORRS
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7295717
• 关键词: AIDS prevention; AIDS/HIV problem; Adherence; Age; Area; Behavior Therapy; Behavioral; CD4 Lymphocyte Count; Caring; Centers for Disease Control and Prevention (U.S.); Clinical; Communities; Community Health; Condition; Connecticut; Correctional Institutions; Coupled; Daily; Detection; Diagnostic and Statistical Manual; Doctor of Philosophy; Drug abuse; Drug usage; Ensure; Funding; General Population; Geography; HIV; HIV Infections; HIV diagnosis; Health; High Prevalence; Highly Active Antiretroviral Therapy; Housing; Illicit Drugs; Imprisonment; Individual; Infection; Intervention; Jail; Knowledge; Modeling; Motivation; New York; Opiate Addiction; Outcome; Participant; Persons; Pharmaceutical Preparations; Prevalence; Prevention approach; Prisoner; Prisons; Public Health; Randomized; Rate; Recording of previous events; Recruitment Activity; Relative (related person); Reporting; Request for Applications; Research; Research Design; Research Personnel; Resistance; Risk; Risk Behaviors; Risk Reduction; Risk Reduction Behavior; Sentinel; Site; Supervision; Testing; Time; Viral Load result; Woman; base; behavioral health; correctional system; cost; day; follow-up; improved; innovation; men; novel strategies; programs; response; sex; skills; transmission process; trend

DESCRIPTION (provided by applicant): Approximately seven million people are under correctional supervision and two million are in prisons and jails (Maruschack, 2002). As a consequence of high sexual and drug use risk behaviors among people who enter prisons (Altice, et al., 2005; 1998), the HIV prevalence among prisoners is four to seven times greater than in the general population. Because of the high prevalence of HIV infection in correctional institutions, they have become important sentinel sites for the detection of HIV as well as for the introduction of treatment (Altice, et al., 2001; Mostashari, et al., 1998). HIV prevalence varies by geography, with the highest rate in the northeast. Connecticut has the second highest HIV prevalence (2nd only to New York) among prisoners nationally; it houses approximately 20,000 inmates of whom we have demonstrated the HIV sero-prevalence to be 6.1% among men (Mostashari, 1998) and 9.2% among women (Altice, et al., 2005). On any given day, about 1,000 inmates in Connecticut are known to be HIV-infected and receiving care and, of these, over 650 are on HAART. One of the great public health challenges is ensuring that HIV-infected prisoners continue to receive HIV-related care when they are released. In Connecticut, about 150 prisoners are released to the community daily and 9 to 14 of these individuals are aware of their HIV-infected status. While HIV-infected prisoners have been demonstrated to respond extremely well to HAART within the correctional system, the benefit gain is soon lost after release (Springer, et al., 2004). There is an urgent need for HIV focused transition programs that optimize HIV risk reduction and HAART adherence among HIV-infected prisoners upon their release. In this revised R21 application, we propose to create 'Healthy Transition', an evidence- based HIV risk reduction and HAART adherence intervention - and evaluate it as a component of an innovative transition program that has already been funded to provide clinical care to newly released HIV- infected prisoners in Connecticut. This novel approach, if found to be effective, would likely be cost-effective and easy to replicate in areas such as urban centers that currently struggle with the continuity of HIV-related care from the prison to the community.

描述（由申请人提供）：大约有700万人受到惩教监督，200万人在监狱和拘留所（Maruschack, 2002）。由于进入监狱的人有较高的性和吸毒风险行为（Altice等人，2005;1998），囚犯中的艾滋病毒感染率是一般人群的4至7倍。由于教养机构中艾滋病毒感染率很高，它们已成为检测艾滋病毒和引入治疗的重要哨点（Altice等人，2001年；Mostashari等人，1998年）。艾滋病毒流行率因地区而异，东北地区的发病率最高。康涅狄格州在全国囚犯中艾滋病毒感染率第二高（仅次于纽约）；我们已经证明，其中男性艾滋病毒血清患病率为6.1% （Mostashari， 1998年），女性为9.2% （Altice等人，2005年）。在任何一天，康涅狄格洲大约有1000名囚犯感染了艾滋病毒并正在接受治疗，其中超过650人正在接受HAART治疗。一项重大的公共卫生挑战是确保感染艾滋病毒的囚犯获释后继续得到与艾滋病毒有关的护理。在康涅狄格州，每天约有150名囚犯被释放到社区，其中9至14人知道自己感染了艾滋病毒。虽然已证明感染艾滋病毒的囚犯对惩教系统内的高效抗逆转录病毒疗法反应极好，但释放后很快就失去了益处（bbb10等，2004年）。迫切需要以艾滋病毒为重点的过渡方案，优化艾滋病毒感染囚犯释放后的艾滋病毒风险降低和HAART治疗依从性。在修订后的R21申请中，我们建议创建“健康过渡”，这是一种基于证据的艾滋病毒风险降低和HAART依从性干预，并将其作为一项创新过渡计划的组成部分进行评估，该计划已获得资助，为康涅狄格州新释放的艾滋病毒感染囚犯提供临床护理。这种新颖的方法，如果被发现是有效的，可能具有成本效益，并且很容易在城市中心等地区复制，这些地区目前正在努力从监狱到社区的艾滋病毒相关护理的连续性。