Identifying Opportunities to Reduce STI/HIV Disparities among Recent Offenders

寻找机会减少新犯罪者中性传播感染/艾滋病毒的差异

• 批准号: 9208770
• 负责人: Sarah Elizabeth Wiehe
• 金额: $ 24.33万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-03-01 至 2019-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9208770
• 关键词: Identifying; Opportunities; Reduce; STI; HIV

 DESCRIPTION (provided by applicant): Juvenile and adult offenders have high rates of sexually transmitted infections (STI) and incident HIV after arrest or release from prison, jail or juvenile facilities, though few studies have identified when and where this population presents for clinical care or are tested for STI/HIV. This now-identifiable population - i.e., those with a criminal record - may be targeted for increased STI and HIV surveillance. To date, however, there are few data to inform STI/HIV screening, treatment and prevention among these individuals because we do not know when and where they present for clinical care and whether they receive STI/HIV care in these settings. The long-term goal of this research is to develop informed interventions to improve the health of recent offenders in community and clinical settings, particularly by reducing the burden of STI and HIV. The purpose of this study is to investigate when and where offenders after arrest or release from incarceration are seen in the health system and, at points where they access clinical care, whether they are being screened for STI and HIV. The hypothesis is that offenders following arrest or release from incarceration have different patterns of clinical care encounters, including fewer routine preventive visits, and thus fewer STI/HIV screening tests compared to non-offenders. In collaboration with criminal justice, clinical and public health agencies serving Marion County (Indianapolis), Indiana, all individual-level arrest, juvenile detention, jail and prison records were linked with positive STI/HIV test results over a 9-year period. Building on this foundation of expertise and resources, this study will incorporate inpatient, emergency room and outpatient encounter data using the Indiana Network for Patient Care system, one of the most comprehensive clinical encounter data sets for a U.S. metropolitan area. The specific aims are to: (1) describe if, when, where and for what purposes recent offenders present for clinical care in the 1-year after arrest or release from incarceration, compared to the non-offender population during a 1-year period; and (2) assess the quality of STI/HIV care among recent offenders with at least 1 clinical encounter in the 1-year after arrest or release from incarceration. This project fits well within the scope of AHRQ's Prevention and Care Management Portfolio as it will result in STI/HIV screening recommendations for this vulnerable population to prevent disease among both offenders in the post-incarceration period as well as their communities.

 描述（由申请人提供）：青少年和成年罪犯在被捕或从监狱、看守所或监狱释放后，性传播感染 (STI) 和艾滋病毒感染率很高。 青少年设施，尽管很少有研究确定该人群何时何地接受临床护理或接受性传播感染/艾滋病毒检测。这些现已可识别的人群（即有犯罪记录的人群）可能会成为加强性传播感染和艾滋病毒监测的目标。然而，迄今为止，这些人中性传播感染/艾滋病毒筛查、治疗和预防的数据很少，因为我们不知道他们何时何地接受临床护理，以及他们是否在这些环境中接受性传播感染/艾滋病毒护理。这项研究的长期目标是制定知情干预措施，以改善社区和临床环境中新罪犯的健康，特别是减轻性传播感染和艾滋病毒的负担。本研究的目的是调查被捕或出狱后的罪犯何时何地出现在卫生系统中，以及在他们获得临床护理的地点，他们是否正在接受性传播感染和艾滋病毒筛查。假设是，被捕或出狱后的罪犯有不同的临床护理经历模式，包括较少的例行预防性就诊，以及 因此，与非犯罪者相比，性传播感染/艾滋病毒筛查测试较少。与印第安纳州马里恩县（印第安纳波利斯）的刑事司法、临床和公共卫生机构合作，在 9 年的时间里，所有个人逮捕、少年拘留、监狱和监狱记录都与阳性 STI/HIV 检测结果相关联。在此专业知识和资源的基础上，本研究将使用印第安纳州患者护理网络系统整合住院、急诊室和门诊患者的就诊数据，该系统是美国大都市区最全面的临床就诊数据集之一。具体目标是： (1) 与非罪犯人口一年内相比，描述新近犯罪者在被捕或释放后 1 年内是否、何时、何地以及出于何种目的接受临床护理； (2) 评估在被捕或出狱后 1 年内至少有过 1 次临床接触的新罪犯的性传播感染/艾滋病毒护理质量。该项目非常适合 AHRQ 的预防和护理管理组合的范围，因为它将为这一弱势群体提出性传播感染/艾滋病毒筛查建议，以预防监禁后罪犯及其社区的疾病。