PS06-011, HIV Prevention Research with HIV+ Incarcerated Populations

描述（由申请人提供）：本研究的目的是评估两种干预措施在HIV阳性囚犯中对HIV传播相关风险行为的有效性，并改善释放后护理和预防服务的可及性。离开监狱或监狱的艾滋病毒阳性者将艾滋病毒传染给其性伴侣和共用针头的伴侣的风险极高;针对这一人群的有效干预措施将通过减少新的艾滋病毒感染对公共卫生领域作出重大贡献。这项研究的结果将有助于疾病预防控制中心减少艾滋病毒传播的努力和中心力量的使命，即通过“加强受监禁影响的个人和家庭”来改善返回社区成员的健康和福祉。“具体目标是招募即将获释的艾滋病毒阳性者，并比较两种个人层面干预措施（1）标准护理（SC）和（2）加强干预（El）对1）性和毒品相关的艾滋病毒传播风险行为的影响，2）获得适当的艾滋病毒相关的医疗，包括艾滋病毒相关的医疗坚持和3）利用适当的预防服务。“强制性拘留”将包括最高法院和六次个人级别的会议（监禁期间每周两次，为期两周，释放后每周一次，为期两周）。释放后的后续行动将侧重于社区综合医疗和预防服务的利用。基线/干预前评估将在受试者出院前不超过60天进行。将在干预后3个月（两组）进行随访评估。主要成果将包括衡量与性和毒品有关的艾滋病毒传播风险的变化，以及增加获得与艾滋病毒有关的医疗和预防服务的机会。我们先前对艾滋病毒阳性囚犯的研究表明，该项目是有效的二级艾滋病毒预防的逻辑演变的下一步。由于我们的监狱和监狱中艾滋病毒感染率很高，针对艾滋病毒阳性囚犯的有效干预措施将对惩教系统、我们的社区和家庭产生巨大和积极的公共卫生影响。

DESCRIPTION (provided by applicant): The goal of this study is to evaluate the efficacy of two interventions among HIV+ prisoners on HIV transmission related risk behaviors and to improve access to both post-release care and prevention services. HIV+ individuals leaving jail or prison are at extremely high risk to transmit HIV to their sexual and needle-sharing partners; an effective intervention targeting this population would be a major contribution to the field of public health by reducing new HIV infections. The results of this study will contribute to the efforts of the CDC to reduce HIV transmissions and Center-force's mission to improve the health and well being of returning community members by "strengthening individuals and families affected by incarceration." The specific aims are to recruit HIV+ individuals who are soon to be released from custody and to compare the effect of the two individual-level interventions (1) Standard Care (SC) and (2) Enhanced Intervention (El) on 1) sexual and drug-related HIV transmission risk behaviors, 2) access to appropriate HIV-related medical treatment including HIV-related medical adherence and 3) utilization of appropriate prevention services. The El will consist of both the SC as well as six individual-level sessions (twice weekly over a two-week period while incarcerated, and weekly over a two-week period after release). The post release follow up will focus on utilization of comprehensive medical and prevention services in the community. The baseline/pre- intervention assessment will be administered no more than 60 days prior to the participant's release. Follow-up assessments will be administered 3 months (with both arms) post intervention time period. The primary outcomes will include measures of change in sexual and drug-related HIV transmission risk, and increase in access to HIV-related medical treatment and prevention services. Our prior research with HIV+ prisoners indicate that this project is the next step in the logical evolution of effective secondary HIV prevention. With high rates of HIV in our prisons and jails, an effective intervention targeting HIV+ prisoners that reduces new HIV infections would have an enormous and positive public health impact on correctional systems, our communities and families.