PS06-011, HIV Prevention Research with HIV+ Incarcerated Populations

描述(由申请人提供)：摘要：囚犯中艾滋病毒的流行率是普通社区的几倍。每年有超过四分之一的艾滋病毒携带者在美国惩教系统中循环。惩教设施是返回我们社区的艾滋病毒高危人群的一个有系统但重要的接触点。到目前为止，还没有完全全面的监狱释放方案，旨在满足获释囚犯及其社区的需要。它们主要仅以各种病例管理模式为基础，没有显示出艾滋病毒释放后结果的持续稳定性。因此，综合方案缺乏对抗逆转录病毒治疗的坚持，也没有减少对过渡到社区的艾滋病毒+囚犯进行干预的艾滋病毒风险。在这项提案中，我们寻求整合康涅狄格州现有的两个项目(TLC项目和CONNECT项目)，并将根据整体健康恢复计划(HHRP)修改的艾滋病毒风险降低干预措施层，在监狱内实施，并在获释三个月后作为助推器会议。我们打算将HHRP修改为在释放前90天内在监狱环境中进行四次干预。我们将这称为发布前的健康过渡(PHT)。将PHT与现有的项目TLC(针对获释囚犯的过渡性病例管理服务)和项目CONNECT(一项关于直接给予抗逆转录病毒治疗与阿片依赖患者获释后与阿片类药物激动剂治疗相关的标准护理的随机对照试验)相结合，将产生现在称为TLC+项目的全面监狱释放计划。TLC项目和CONNECT项目的现有资源使基础设施能够充分实施针对艾滋病毒+囚犯的全面过渡方案。这项提议的其他优势是在监狱释放计划(艾滋病哈特福德计划)方面经验丰富的社区组织、耶鲁大学的监狱艾滋病毒计划以及康涅狄格州惩教和公共卫生部之间的合作。现有的资源、强有力的合作、在社区和惩教环境中工作的调查人员的经验以及这些方案过去的记录显著影响着成功实施有效干预和完成拟议研究的可能性。

DESCRIPTION (provided by applicant): ABSTRACT: The prevalence of HIV among prisoners is several-fold greater than found in the general community. Over one quarter of all HIV+ individuals cycle through the U.S. correctional system annually. Correctional facilities are a structured, but important point of contact for high risk HIV+ individuals who return to our communities. To date, there have not been fully comprehensive prison-release programs that are designed to meet the needs of released prisoners and their community. They have primarily been predicated only on various case management models and have not demonstrated continued stability in HIV outcomes after release. Hence, integrated programs have lacked adherence to antiretroviral therapy and reduction in HIV risk taking interventions for HIV+ prisoners transitioning to the community. In this proposal, we seek to integrate two existing programs in Connecticut (Project TLC and Project CONNECT) and layer on a modified HIV risk reduction intervention, adapted from the Holistic Health Recovery Program (HHRP), to be administered within prison and as a booster session three months after release. We intend to modify the HHRP to a four-session intervention within the prison setting during the 90 days prior to release. We will call this the Pre-Release Healthy Transition (PHT). Combining the PHT with the existing Project TLC (transitional case management services for released prisoners) and Project CONNECT (a randomized controlled trial of directly administered antiretroviral therapy versus standard of care for opioid dependent patients who are linked to opiate agonist therapy after release) will result in the comprehensive prison release program now called Project TLC+. The availability of existing resources for Project TLC and Project CONNECT allow for the infrastructure to fully implement a comprehensive transitional program for HIV+ prisoners. Additional strengths of this proposal are the collaborations between a community based organization experienced with prison release programs (AIDS Project Hartford), the HIV in Prisons Program at Yale University, and the Connecticut Departments of Correction and Public Health. The existing resources, the strong collaborations, the experience of the investigators working in community and correctional settings and past track record of these programs markedly influence the likelihood of successfully implementing an effective intervention and completing the proposed research.