HIV Prevention Research with HIV+ Incarcerated Populations

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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.