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携带者的健康，旨在减少传统上服务不足的患者群体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终身教职的初级教员，成为一名独立调查员，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、混合的方法来全面评估为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，将使用不同类型和来源的数据来解决这个问题，以确定导致次优护理的因素是最重要的，也是最有可能受到干预的因素。目的1将利用艾滋病与静脉注射经验(ALIVE)研究相关的纵向数据，检查与监禁后护理联系不佳的个人和邻里层面的因素。目标2将是对艾滋病毒护理结果的扩展分析，纳入1998年至2011年期间被监禁的在世参与者在惩教设施中回溯收集的医疗记录数据。目标3将通过对在狱中接受艾滋病毒护理的患者进行半结构化访谈，并在获释后几个月内对社区进行后续访谈，确认并通报研究的量化阶段的结果。职业发展计划：我建议的培训和指导活动将围绕(1)获得复杂纵向数据分析方面的专业知识；(2) 利用定性研究方法培养能力；(3)在艾滋病毒研究方面与惩教机构建立伙伴关系；(4)更深入地了解惩教环境中研究的伦理问题。我的应用研究将与我的培训活动密切协调，并将在该奖项的第四年申请R01资助的项目。研究环境：我将在威斯康星大学麦迪逊分校的医学部得到很好的支持。此外，我将受益于约翰霍普金斯大学的Alive研究(目标1和2)的出色研究基础设施，以及由NIDA资助的威斯康星州惩教部艾滋病毒寻求、检测和治疗策略的大型研究(目标3)。

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).