Addressing overdose risk among recently incarcerated people living with HIV/AIDS

项目摘要 从教养所释放出来的人在出狱后的头两周内全因死亡的风险更大。 1在此期间，使用毒品的人有3.8倍的 与其他时间相比，药物相关原因的死亡风险更高。 使用类阿片者中的死亡者是艾滋病毒/艾滋病感染者。 经过评估的循证计划，旨在解决这些人群在进入前的过量风险 用药过量死亡的最危险时期拟议研究的长期目标是为未来提供信息 政策和干预措施，以减少退出监禁的人在重新进入监狱时过量死亡 社区.该提案的总体目标是实现长期目标的下一步， 目标是评估干预措施在艾滋病毒阳性囚犯中的有效性，特别是在 其他囚犯的结果。拟议研究的基本原理是，结果可用于开发 为减少高风险管教人群中的过量死亡采取有针对性的干预措施。拟议 研究目标将通过以下具体目标来实现：目标1：评估一项试点计划， 在监禁期间为艾滋病毒阳性囚犯提供1：1的过量预防培训;目标2：查明罪犯 与过量风险相关的司法、健康和艾滋病毒相关因素;以及目标3：使用风险环境 该研究旨在描述释放后使用阿片类药物的艾滋病毒阳性前囚犯的过量风险经历。的 第一个目标将纵向评价过量知识和态度的变化。第二个目标将 调查最近释放的艾滋病毒/艾滋病感染者的过量风险行为，第三个目标将 定性描述出狱后使用减少风险培训内容的促进者和障碍。这 贡献是重要的，因为从这项研究中积累的证据可以应用于矫正 在美国各地的艾滋病毒临床实践和设施。该研究具有创新性， 申请人的意见，因为它代表了一个实质性的偏离现状，解决风险 具体到艾滋病毒和监禁状态和从监狱释放后几个月的背景风险。结果 将提供以下证据：（i）过量训练是否会对过量产生持续的积极变化 这一群体的知识和态度，㈡哪些因素影响受过训练的囚犯的过量服用风险，㈢ 在解决过量用药风险时，应特别考虑这些人群。研究结果将告知 可扩展的，基于证据的干预措施，可用于各种矫正环境，并将告知 那些向这些群体提供服务的人，了解预防过量用药的最佳做法。

PROJECT SUMMARY People released from correctional facilities are at a greater risk of all-cause death in the first two weeks after their release compared to the general population.1 During this period, people who use drugs have a 3.8 times greater risk of death for drug-related causes than they have at other times.2 At an additional elevated risk for death among people who use opioids are people living with HIV/AIDS (PLWHA).5 There is an urgent need for evaluated, evidence-based programs designed to address overdose risk in these populations before they enter the most critical risk period for an overdose death. The long-term goal of the proposed study is to inform future policies and interventions to reduce overdose deaths in people exiting incarceration as they reenter their communities. The overall objective of this proposal, which is the next step toward attainment of the long-term goal, is to evaluate the intervention's effectiveness among HIV-positive inmates, specifically within the context of other inmate outcomes. The rationale for the proposed research is that outcomes can be used to develop tailored interventions to reduce overdose deaths among high-risk correctional populations. The proposed research objectives will be achieved through the following specific aims: Aim 1: Evaluate a pilot program to provide HIV+ inmates with 1:1 overdose prevention training while incarcerated; Aim 2: identify the criminal justice, health, and HIV-related factors associated with overdose risk; and Aim 3: use a risk environment approach to describe the overdose risk experiences of HIV+ former inmates who use opioids after release. The first aim will longitudinally evaluate changes in overdose knowledge and attitudes. The second aim will investigate overdose risk behaviors in recently released people living with HIV/AIDS, and the third aim will qualitatively describe facilitators and barriers to using risk reduction training content after release from jail. This contribution is important because evidence accumulated from this study has applications for correctional facilities and HIV clinical practice throughout the United States. The proposed research is innovative, in the applicant's opinion, because it represents a substantive departure from the status quo by addressing risk specific to HIV and incarceration status and contextualizing risk in the months after release from jail. Findings will provide evidence on (i) whether overdose training produces sustained positive changes in overdose knowledge and attitudes for this population, (ii) what factors influence the overdose risks of trained inmates, (iii) specific considerations for these populations when addressing overdose risk. Study findings will inform scalable, evidence-based interventions that can be used in a variety of correctional settings and will inform those who provide services to these groups about best practices in overdose prevention.