Barriers to Effective HIV Care for Injection Drug Users After Release from Prison

描述（由申请人提供）：候选人：我的职业目标是通过跨学科研究改善艾滋病毒感染者的健康状况，旨在为传统上得不到充分服务的患者群体减少获得最佳艾滋病毒护理的障碍。我的短期目标是让自己成为威斯康星大学麦迪逊分校的一名独立调查员，成为一名终身教职的初级教员，并与州和联邦监狱系统合作开发一个创新的研究项目。研究项目：我提议的研究使用一种创新的混合方法来全面评估被监禁的人获得持续艾滋病毒护理的障碍。我提出了三个不同的目标，这些目标将使用不同类型和来源的数据来解决这个问题，以便确定导致次优护理的因素是最重要的，并且可能适合干预。目的1将利用来自艾滋病与静脉注射经验（ALIVE）研究的纵向数据来检查与监禁后护理联系不良相关的个人和社区因素。目标2将是对艾滋病毒护理结果的扩展分析，纳入回顾性收集的1998年至2011年间被监禁的ALIVE参与者的惩教机构医疗记录数据。目标3将通过对在监狱中接受艾滋病毒治疗的患者进行半结构化访谈，以及在释放到社区后的几个月内进行后续访谈，确认并告知研究定量阶段的结果。职业发展规划：我建议的培训和指导活动将围绕(1)获得分析复杂纵向数据的专业知识；（2）

DESCRIPTION (provided by applicant): Candidate: My career goal is to improve the health of people living with HIV through interdisciplinary research aimed at reducing barriers to optimal HIV care for traditionally underserved patient groups. My short term goal is to establish myself as an independent investigator as a tenure-track junior faculty member at the University of Wisconsin-Madison, and to develop an innovative research program in collaboration with state and federal prison systems. Research Project: My proposed research uses an innovative, mixed-methods approach to comprehensively evaluate barriers to accessing continuous HIV care for people who become incarcerated. I propose three distinct aims which will address this question using different types and sources of data, in order to identify which factors causing suboptimal care are the most important and potentially amenable to intervention. Aim 1 will utilize longitudinal data from the AIDS Linked to the Intravenous Experience (ALIVE) study to examine individual and neighborhood-level factors associated with poor linkage to care following incarceration. Aim 2 will be an expanded analysis of HIV care outcomes that incorporates retrospectively-collected medical records data from correctional facilities for ALIVE participants who were incarcerated between 1998 and 2011. Aim 3 will confirm and inform the findings of quantitative phase of the study through semi-structured interviews with patients while they are receiving HIV care in prison, and follow-up interviews within several months after release to the community. Career Development Plan: My proposed training and mentoring activities will center around (1) attaining expertise in analysis of complex longitudinal data; (2) developing competence using qualitative research methods; (3) building partnerships with correctional agencies for HIV research; and (4) deeper understanding of ethical issues surrounding research in correctional settings. My applied research will be closely coordinated with my training activities, and will build toward an application for an R01-funded project in the fourth year of this award. Research Environment: I will be well-supported within the Department of Medicine at UW-Madison. In addition, I will benefit from the excellent research infrastructure of the ALIVE study at Johns Hopkins (Aims 1 & 2), and a large, NIDA-funded study of Seek, Test, and Treat Strategies for HIV in the WI Department of Corrections (Aim 3).