Linkage to Community-Based HIV Pre-Exposure Prophylaxsis Care Among at Risk Women upon Release from Incarceration

出狱后的高危妇女与基于社区的艾滋病毒暴露前预防护理的联系

• 批准号: 9410103
• 负责人: Susan E Ramsey
• 金额: $ 26.19万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-15 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9410103
• 关键词: AIDS/HIV problem; Adherence; Attitude; Behavior; Blood; Caring; Communities; Data; Feedback; Foundations; Goals; HIV; HIV Infections; High Risk Woman; Imprisonment; Incidence; Individual; Intervention; Intervention Trial; Interview; Jail; Knowledge; Link; Manuals; Medical Records; NIH Office of AIDS Research; Pamphlets; Participant; Patients; Pharmaceutical Preparations; Phase; Population; Preventive Intervention; Prisons; Randomized Controlled Trials; Recruitment Activity; Research; Rhode Island; Risk; Site; Spottings; Testing; Time; Training; Underserved Population; United States; United States National Institutes of Health; Woman; Work; base; cisgender; community based care; follow-up; improved; interest; iterative design; motivational enhancement therapy; navigator intervention; pre-exposure prophylaxis; prevent; prevention service; primary outcome; process repeatability; psychoeducation; sex; standard of care; therapy development; trial comparing; uptake

Incarcerated women engage in high rates of sex- and drug-related behavior that place them at risk for HIV. Pre-exposure prophylaxis (PrEP) is an efficacious means of reducing HIV acquisition. There is a general lack of knowledge regarding PrEP among women at elevated risk, and only a small percentage of at-risk women are currently engaged in PrEP care. The period of incarceration represents an opportunity to identify at-risk women, initiate PrEP during incarceration, and establish linkage to community-based PrEP care upon release from incarceration. Further, post-release is a time period that is particularly risky, and there are numerous barriers that may impede linkage to community-based care in the absence of intervention. To date, very little research has been done to improve linkage to PrEP care among US women. The proposed study will examine the acceptability, feasibility, and preliminary efficacy of a psychoeducation and motivational interviewing intervention to promote PrEP initiation during incarceration, followed by a patient navigator intervention to facilitate linkage to community-based PrEP care upon release from incarceration. The long-term goal of this line of research is to disseminate an efficacious PrEP Care linkage intervention for at-risk women post- release from incarceration. The present proposal seeks to develop intervention materials and conduct a small randomized controlled trial (RCT) of the intervention. In Phase 1 of the proposed study, we will conduct individual interviews (IDIs) with at-risk incarcerated women (n=18-30) and with stakeholders at the correctional facility (n=6-10) and the community-based PrEP care site (n=6-10). Phase 2 will consist of a pilot phase in which at-risk, incarcerated women (n=8-12) receive the intervention and provide feedback regarding the intervention. Phase 3 (n=80) will consist of a preliminary RCT comparing the intervention to a control condition that approximates standard-of-care (SOC). RCT participants will complete a baseline interview and follow-up interviews at 1, 3, and 6 months. The primary outcome will be linkage to community-based care, verified via medical records. We expect that, as a result of this project, we will have determined the feasibility, acceptability, and preliminary efficacy of our proposed intervention. If found to be efficacious, this intervention has the potential to reduce HIV acquisition in a high-need, underserved community.

被监禁的妇女从事高比率的性和毒品相关的行为， 他们有感染艾滋病毒的风险。暴露前预防（PrEP）是减少艾滋病毒感染的有效手段 采集有一个普遍缺乏知识的妇女之间的PrEP在提高 风险，目前只有一小部分高危女性参与PrEP护理。的 监禁期间是一个机会，以确定处于危险之中的妇女，启动PrEP期间， 监禁，并建立联系，以社区为基础的PrEP护理后，释放 监禁。此外，释放后是一个特别危险的时期， 许多障碍，可能会阻碍与社区护理的联系， 干预到目前为止，很少有研究已经做了，以改善联系，以PrEP护理之间 美国女人拟议的研究将审查可接受性、可行性和初步 心理教育和动机访谈干预对促进PrEP的有效性 在监禁期间启动，随后是患者导航员干预，以促进与 从监狱释放后的社区PrEP护理。这条线的长期目标是 研究的目的是传播一种有效的PrEP护理联动干预措施，为高危妇女后， 从监禁中释放。本建议旨在编制干预材料， 进行一项小型随机对照试验（RCT）。在第一阶段， 在一项拟议的研究中，我们将对处于危险之中的被监禁妇女进行个别访谈（IDIs） （n=18-30），并与惩教机构的利益攸关方（n=6-10）和社区 PrEP护理中心（n=6-10）。第二阶段将包括一个试点阶段， 妇女（n=8-12）接受干预并提供有关干预的反馈。 III期（n=80）将包括一项初步RCT，比较干预与对照 接近标准治疗（SOC）的情况。RCT参与者将完成基线 在1、3和6个月时进行访谈和随访。主要结果将与 通过医疗记录核实的社区护理。我们希望，由于这一项目， 我们将确定我们提出的建议的可行性、可接受性和初步功效， 干预如果发现有效，这种干预措施有可能减少艾滋病毒 在一个高需求，服务不足的社区收购。