CARE Corrections: Technology for Jail HIV/HCV Testing, Linkage, and Care (TLC)

CARE 矫正：监狱 HIV/HCV 检测、关联和护理技术 (TLC)

• 批准号: 8467803
• 负责人: CURT G BECKWITH
• 金额: $ 11.61万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8467803
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Admission activity; Affect; Alcohol or Other Drugs use; Behavior; Caring; Cellular Phone; Cities; Client; Clinical; Communicable Diseases; Communication; Communities; Complement; Computer software; Computers; Counseling; Criminal Justice; DA10; Development; District of Columbia; Education; Effectiveness; Environment; HCV screening; HIV; HIV Infections; HIV Seropositivity; Healthcare; Hepatitis C; Hepatitis C Transmission; Hepatitis C virus; Human immunodeficiency virus test; Imprisonment; Infection; Information Technology; Intervention; Jail; Length; Life; Link; Maintenance; Methods; Minority Groups; Persons; Population; Prevalence; Prevention; Prevention education; Primary Prevention; Process Assessment; Public Health; Randomized Controlled Trials; Research; Resources; Rhode Island; Risk; Risk Assessment; Risk Behaviors; Risk Reduction; Screening procedure; Secondary Prevention; Services; Site; System; Technology; Testing; Text; United States; Viral; Viral hepatitis; Work; antiretroviral therapy; base; community based care; community reentry; community setting; computerized; correctional system; cost; cost effectiveness; flexibility; improved; innovation; novel; prevention service; public health relevance; therapy adherence; tool; transmission process; usability

DESCRIPTION (provided by applicant): Incarceration represents an important opportunity to provide testing and treatment for HIV and other infectious diseases and to deliver prevention education to persons at increased risk of infection or transmission. Incarcerated populations are disproportionately affected by HIV and viral hepatitis, and many inmates may be marginalized from healthcare resources in their communities. Given the short length of jail incarceration, screening and intervention delivery need to be conducted efficiently and cost-effectively. This research will adapt and evaluate information and communication technology-(ICT) based tools used for HIV testing and for improving adherence to HIV treatment, adding rapid hepatitis C virus (HCV) testing and prevention to the delivery of HIV services for jailed populations. These tools will facilitate: 1) HIV and HCV risk assessment, testing, and prevention counseling; 2) linkage to community-based care for HIV-infected jail detainees; and 3) viral suppression for jail detainees on antiretrovirals being released to the community. Specifically, this project will adapt CARE (Computer Assessment and Risk-Reduction Education), an HIV prevention counseling and rapid HIV testing developed for use in clinical and community settings, and CARE+, a version of CARE for HIV-infected persons, for use among jailed populations. The new tools, CARE Corrections and CARE+ Corrections, will have content relevant and specific to incarcerated populations including HCV infection, substance use behaviors, and maintenance of HIV treatment with linkage to community care following jail release. This also will include new functionality that will allow for automated text messaging to support linkage to community HIV (CARE+ Corrections 'Call' system). In a two-site randomized controlled trial conducted within the Rhode Island Department of Corrections jail and the Washington DC jail system, we will evaluate: 1) whether CARE Corrections delivered counseling is more effective than staff delivered counseling in decreasing HIV and HCV transmission behaviors among n=840 HIV-negative persons released from jail; 2) whether CARE+ Corrections Call is more effective than standard jail discharge planning services with respect to linking n=320 HIV-infected jail detainees to community based HIV care and achieving or maintaining HIV viral suppression following community re-entry; and 3) the cost-effectiveness of using CARE and CARE + Corrections Call within jail facilities compared to traditional services. This innovative approach will expand testing, prevention, and treatment in jails and address the essential components of the Seek, Test, and Treat strategy. In addition, this research will complement a major initiative underway in Washington DC (HPTN 065 Testing and Linkage to Care-Plus) by focusing on the jail system. This project has the potential to result in the creation of effective ICT tools that can be easily disseminated to a broad array of correctional facilities in order to facilitate the implementation of the Seek, Test, and Treat strategy in the incarcerated setting. PUBLIC HEALTH RELEVANCE: This research will adapt and evaluate technology-based tools to facilitate rapid HIV and hepatitis C testing, primary and secondary prevention counseling, and adherence to HIV treatment for jailed populations in Providence RI and Washington DC. This innovative research will use computerized counseling and tailored text messaging to expand testing, prevention, and treatment in both low- and high-HIV prevalence jail settings, addressing essential components of the Seek, Test, and Treat strategy among criminal justice populations. This research has the potential to result in the creation of effective technology-based tools that can be readily disseminated to a broad array of correctional facilities across the U.S in order to facilitate efficient identification, treatment, and linkage to care for HIV-infected persons.

描述（由申请人提供）：监禁是提供艾滋病毒和其他传染病检测和治疗的重要机会，并向感染或传播风险增加的人提供预防教育。被监禁的人口受艾滋病毒和病毒性肝炎的影响不成比例，许多囚犯可能被边缘化，无法获得社区的医疗资源。鉴于监狱监禁时间短，筛查和干预措施的提供需要以高效率和具有成本效益的方式进行。这项研究将调整和评估用于艾滋病毒检测和改善艾滋病毒治疗依从性的基于信息和通信技术（ICT）的工具，在为被监禁人口提供艾滋病毒服务时增加快速丙型肝炎病毒（HCV）检测和预防。这些工具将有助于：1）艾滋病毒和丙型肝炎病毒的风险评估，检测和预防咨询; 2）与艾滋病毒感染的监狱被拘留者的社区护理联系起来; 3）对释放到社区的抗逆转录病毒药物的监狱被拘留者进行病毒抑制。具体而言，该项目将调整CARE（计算机评估和降低风险教育），这是一种艾滋病毒预防咨询和艾滋病毒快速检测，用于临床和社区环境，CARE+是艾滋病毒感染者的CARE版本，用于监禁人口。新工具CARE Corrections和CARE+ Corrections将包含与监禁人群相关和特定的内容，包括HCV感染，药物使用行为以及在监狱释放后与社区护理联系起来的艾滋病毒治疗的维持。这还将包括新的功能，将允许自动短信，以支持链接到社区艾滋病毒（关怀+矫正'呼叫'系统）。在罗得岛惩教署监狱和华盛顿监狱系统内进行的一项两点随机对照试验中，我们将评估：1）在n=840名HIV阴性的监狱释放人员中，CARE惩教所提供的咨询是否比工作人员提供的咨询更有效地减少HIV和HCV传播行为; 2）在将n=320名感染艾滋病毒的监狱被拘留者与基于社区的艾滋病毒护理联系起来以及在重返社区后实现或维持艾滋病毒抑制方面，CARE+ Corrections Call是否比标准的监狱释放规划服务更有效;和3）与传统服务相比，在监狱设施内使用CARE和CARE + Corrections Call的成本效益。这一创新方法将扩大监狱中的检测、预防和治疗，并解决“寻找、检测和治疗”战略的基本组成部分。此外，这项研究将通过关注监狱系统来补充华盛顿特区正在进行的一项重大举措（HPTN 065测试和与Care-Plus的联系）。该项目有可能导致创建有效的信息和通信技术工具，这些工具可以很容易地传播到广泛的惩教设施，以促进在监禁环境中执行“寻找、测试和治疗”战略。 公共卫生相关性：这项研究将适应和评估技术为基础的工具，以促进快速艾滋病毒和丙型肝炎检测，初级和二级预防咨询，并坚持艾滋病毒治疗的被监禁人口在普罗维登斯RI和华盛顿DC。这项创新的研究将使用计算机化的咨询和量身定制的短信，以扩大测试，预防和治疗在低和高艾滋病毒流行率监狱设置，解决刑事司法人口中的寻求，测试和治疗战略的基本组成部分。这项研究有可能导致创建有效的技术为基础的工具，可以很容易地传播到广泛的美国各地的惩教设施，以促进有效的识别，治疗，并连接到照顾艾滋病毒感染者。