Planning For SUCCESS

简介（由申请人提供）：摘要在美国，每年有七分之一的艾滋病毒感染者入狱。短期监禁与艾滋病毒治疗中断的可能性增加8倍有关。一个HIV阳性的人在入狱前可能已经接受了治疗，但出狱后可能不会继续接受门诊的HIV治疗，因为即使在监狱里呆上几个星期也会导致失业，导致无家可归和其他社会压力。释放者往往优先考虑解决这些问题，而不是重建医疗保健。滥用药物可能导致他或她被捕和拘留；解决成瘾问题往往是艾滋病毒护理的关键。由于监狱是国家艾滋病毒护理“寻求-测试-治疗和保留”战略的严重障碍，我们希望为从监狱开始的强化病例管理的创新干预提供证据，并在出院后辅以手机技术，这是可接受的，可以促进社区中艾滋病毒阳性监狱释放者的护理保留。这一可行性研究建议，计划成功（持续的，不间断的连接到护理，进入服务，和抑制），将测试后勤和接受这一干预措施及其评估工具。SUCCESS可行性研究的结果将为未来的随机对照试验和成本研究提供参考，以检验强化优势病例管理与常规护理相比对这一难以治疗的人群的长期有效性。我们的可行性研究将确定：1)招募的pac， 2)接受干预链接的释放者在监狱后照顾的比例，

DESCRIPTION (provided by applicant): Abstract Annually, 1 in 7 persons with HIV in the US cycles through jail. Short stays in jail are associated with an eight-fold increase in the likelihod of HIV treatment disruption. An HIV+ person may have been linked to care before incarceration, but might not follow up in outpatient HIV care after release because even a few week stay in jail can lead to the loss of a job, resulting homelessness and other social stressors. The releasee often prioritizes tackling these issues above reestablishing medical care. Substance abuse could have precipitated his or her arrest and detainment; addressing addiction issues are frequently key to retention in HIV care. Since jail is a serious impediment to a national Seek-Test-Treat and Retain strategy for HIV care, we want to build evidence for an innovative intervention of intensive case management beginning in jail, and supplemented with cell phone technology post-discharge, that is acceptable and can promote retention in care for HIV+ jail releasees in the community. This proposed feasibility study, Planning for SUCCESS (Sustained, Unbroken Connections to Care, Entry Services, and Suppression), will test the logistics and acceptance of this intervention and its evaluation tools. Findings from this feasibility study of SUCCESS will inform the planning of a future randomized, controlled trial and cost study to examine long-term effectiveness of intensive Strengths- Based Case Management compared with usual care for this hard-to-treat population. Our feasibility study will ascertain: 1) the pac of recruitment, 2) what proportion of releasees receiving the intervention link to care after jail, and 3) what proportion are retained in care with two visits to an HIV provider within the first yea after release. At 12 months, we will also examine viral loads and linkage to substance abuse and mental health treatment.