Seek, Test, and Treat Strategies

寻求、测试和治疗策略

• 批准号: 8331082
• 负责人: David W Seal
• 金额: $ 74.12万
• 依托单位: TULANE UNIVERSITY OF LOUISIANA
• 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/8331082
• 关键词: AIDS/HIV problem; Accounting; Acquired Immunodeficiency Syndrome; Address; Area; Back; Caring; Case Management; Cities; Communities; Computerized Medical Record; Continuity of Patient Care; County; Criminal Justice; DA10; Data; Drug usage; Economics; Effectiveness; Elements; Ensure; HIV; HIV Infections; HIV Seropositivity; Health; Health Personnel; Human immunodeficiency virus test; Imprisonment; Individual; Infection; Intake; Jail; Life; Link; Medical; Methods; Modeling; Needle Sharing; Outcome; Persons; Play; Population; Prisons; Program Sustainability; Provider; Research Personnel; Resources; Risk; Risk Reduction; Role; Screening procedure; Secure; Services; Sexually Transmitted Diseases; Site; System; Testing; Treatment Cost; Walking; Wisconsin; base; beneficiary; comparative; correctional system; cost; cost effectiveness; experience; high risk; innovation; metropolitan; parole; prevention service; probation; programs; public health relevance; response; social; treatment program

DESCRIPTION (provided by applicant): "A Systemic Approach to Seek, Test, and Treat Strategies for Correctional Populations" It is estimated that 25% of all HIV-positive people in the U.S. pass through a correctional facility each year. Yet, many correctional systems and facilities do not provide a comprehensive and systemically coordinated approach to HIV testing, treatment, and transitional referral, resulting in many missed opportunities to identify previously undiagnosed cases of HIV and link individuals to treatment and prevention services. To address this gap, and in response to RFA-DA-10-017 (Seek, Test, and Treat (STT): Addressing HIV in the Criminal Justice System), we propose to: AIM1: (1) Comprehensively test a high-risk population (people in a state correctional facility being released to a major metropolitan area that accounts for nearly 60% of all state HIV cases, has experienced a recent and significant increase in the rate of HIV, and has perennially high rates of sexually transmitted infections); (2) (re)-link HIV-positive people being released from a state correctional facility to this metropolitan area into low- or no-cost treatment and case management services; and (3) seek to evaluate an innovative network method of HIV testing referral to utilize high-risk negatives in the correctional system to, upon release, encourage other high-risk individuals in their social-sexual networks who might not otherwise access testing services to get HIV tested. Aim 2. Conduct cost and cost-effectiveness analyses to assess: (1) the overall, systemic cost of the proposed STT program; (2) the cost of individual program components and cost to individual payers; (3) the comparative cost-effectiveness of testing in the state prison versus standard walk-in testing at the community treatment provider who will be lined to people testing positive in the prison, and a local county jail that was the site of a recent cost-effectiveness STT study; (4) the potential increase in economic efficiency that could be achieved through risk reduction screening prior to testing in detention facilities; and (5) the cost-effectiveness of implementing post-release partner seeking/testing services for high-risk detainees. The proposed study is highly innovative in that it (1) comprehensively addresses all 3 STT elements across all state correctional facilities who release people to a large metropolitan region with rising rates of HIV; (2) facilitates in-depth cost and cost-effectiveness analyses of this coordinated and systemic STT approach; and (3) involves a unique partnership between academic investigators, HIV treatment providers, a Department of Corrections, a state Division of AIDS/HIV, and a City Health Department. PUBLIC HEALTH RELEVANCE: "A Systemic Approach to Seek, Test, and Treat Strategies for Correctional Populations" We propose to (1) comprehensively test a high-risk population (people in a state correctional facility being released to a major metropolitan area that accounts for nearly 60% of all HIV cases in its state, has experienced a recent and significant increase in the rate of HIV, and has perennially high rates of sexually transmitted infections); (2) (re)-link HIV-positive people being released from a state correctional facility to this metropolitan region into low- or no-cost treatment and case management services; and (3) seek to evaluate an innovative network method of HIV testing referral to utilize high-risk negatives in the correctional system to, upon release, encourage other high-risk individuals in their social-sexual networks who might not otherwise access testing services to get HIV tested. We further will conduct extensive (4) cost and cost-effectiveness analyses to evaluate the likelihood of the proposed STT program's sustainability.

描述（由申请人提供）：“一个系统的方法来寻求，测试和治疗策略的惩教人口”据估计，25%的艾滋病毒阳性的人在美国通过惩教设施每年。然而，许多惩教系统和设施没有提供全面和系统协调的艾滋病毒检测、治疗和过渡性转诊办法，导致许多机会被错过，无法查明以前未确诊的艾滋病毒病例，并将个人与治疗和预防服务联系起来。为了解决这一差距，并响应RFA-DA-10-017（寻求，测试和治疗（STT）：在刑事司法系统中解决艾滋病毒问题），我们建议：目标1：（一）全面检测一个高危人群（一个州教养所的人被释放到一个主要的大都市地区，占该州艾滋病病例的近60%，最近艾滋病毒感染率显著上升，性传播感染率常年居高不下）;（2）（重新）将从国家教养所释放的艾滋病毒阳性者与这一大都市地区联系起来，接受低成本或无成本的治疗和病例管理服务;以及（3）寻求评估一种创新的艾滋病毒检测转介网络方法，以利用惩教系统中的高风险阴性者，在释放后鼓励其社交性网络中其他可能无法获得检测服务的高风险个人接受艾滋病毒检测。目标二。进行成本和成本效益分析，以评估：（1）拟议短期培训计划的总体系统成本;（2）单个计划组成部分的成本和单个支付者的成本;（3）在州立监狱进行检测与在社区治疗提供者进行标准的上门检测的成本效益比较，社区治疗提供者将与监狱中检测呈阳性的人联系起来，和当地一所县监狱，这是最近一项短期培训成本效益研究的地点;（4）通过在拘留设施进行测试之前进行风险降低筛查，可以提高经济效率;（5）为高风险被拘留者提供释放后伴侣寻找/测试服务的成本效益。拟议的研究具有高度创新性，因为它（1）全面解决了所有州教养设施的所有3个短期培训要素，这些要素将人释放到艾滋病毒感染率不断上升的大都市地区;（2）促进对这种协调和系统的短期培训方法进行深入的成本和成本效益分析;和（3）涉及学术研究人员，艾滋病毒治疗提供者，惩教部，艾滋病/艾滋病毒的国家部门，和城市卫生部门之间的独特伙伴关系。 公共卫生相关性：《矫正人群的系统性寻找、测试和治疗策略》我们建议（1）对高危人群进行全面测试（一个州教养所的人被释放到一个占该州所有艾滋病毒病例近60%的主要大都市地区，最近艾滋病毒感染率显著增加，并且性传播感染率常年居高不下）;（2）（重新）将从州惩教机构释放到这个大都市地区的艾滋病毒阳性者与低成本或免费治疗和病例管理服务联系起来;以及（3）寻求评估一种创新的艾滋病毒检测转介网络方法，以利用惩教系统中的高风险阴性者，在释放后鼓励其社交性网络中其他可能无法获得检测服务的高风险个人接受艾滋病毒检测。我们还将进行广泛的成本和成本效益分析，以评估拟议的短期培训计划的可持续性的可能性。