Linkage to Community-Based HIV Pre-Exposure Prophylaxsis Care Among at Risk Women upon Release from Incarceration

被监禁的妇女从事与性和毒品有关的行为的比率很高 他们有感染艾滋病毒的风险。暴露前预防(PrEP)是减少HIV的有效手段 收购。高龄女性普遍缺乏对PrEP的了解 目前只有一小部分高危妇女参与了PrEP护理。这个 监禁期是识别高危妇女的机会，在 监禁，并建立与社区为基础的PrEP护理的联系 监禁。此外，发布后是一个特别有风险的时间段，而且有 许多障碍可能会阻碍与基于社区的护理的联系 干预。到目前为止，几乎没有进行研究来改善与PrEP护理之间的联系 我们女人。拟议的研究将审查可接受性、可行性和初步 心理教育和动机访谈干预促进PrEP的效果 在监禁期间启动，随后进行患者导航仪干预，以促进与 出狱后以社区为基础的PrEP护理。这条线路的长期目标是 这项研究旨在为高危妇女提供有效的PrEP护理联动干预 从监禁中释放。本提案力求编写干预材料，并 进行干预的小型随机对照试验(RCT)。在第一阶段， 建议的研究，我们将对高危被监禁妇女进行个人访谈(IDI) (n=18-30)以及与惩教机构的利益攸关方(n=6-10)和基于社区的 预科护理站点(n=6-10)。第二阶段将包括试点阶段，在这一阶段中，有风险的、监禁的 妇女(n=8-12)接受干预并提供关于干预的反馈。 第三阶段(n=80)包括一项初步随机对照试验，将干预与对照进行比较 接近护理标准(SOC)的情况。RCT参与者将完成基线 在1个月、3个月和6个月时进行访谈和随访。主要结果将是与 以社区为基础的护理，通过医疗记录核实。我们预计，作为这个项目的结果， 我们将确定我们提议的方案的可行性、可接受性和初步效果 干预。如果被发现是有效的，这种干预措施有可能减少艾滋病毒 在高需求、服务不足的社区进行收购。

Incarcerated women engage in high rates of sex- and drug-related behavior that place them at risk for HIV. Pre-exposure prophylaxis (PrEP) is an efficacious means of reducing HIV acquisition. There is a general lack of knowledge regarding PrEP among women at elevated risk, and only a small percentage of at-risk women are currently engaged in PrEP care. The period of incarceration represents an opportunity to identify at-risk women, initiate PrEP during incarceration, and establish linkage to community-based PrEP care upon release from incarceration. Further, post-release is a time period that is particularly risky, and there are numerous barriers that may impede linkage to community-based care in the absence of intervention. To date, very little research has been done to improve linkage to PrEP care among US women. The proposed study will examine the acceptability, feasibility, and preliminary efficacy of a psychoeducation and motivational interviewing intervention to promote PrEP initiation during incarceration, followed by a patient navigator intervention to facilitate linkage to community-based PrEP care upon release from incarceration. The long-term goal of this line of research is to disseminate an efficacious PrEP Care linkage intervention for at-risk women post- release from incarceration. The present proposal seeks to develop intervention materials and conduct a small randomized controlled trial (RCT) of the intervention. In Phase 1 of the proposed study, we will conduct individual interviews (IDIs) with at-risk incarcerated women (n=18-30) and with stakeholders at the correctional facility (n=6-10) and the community-based PrEP care site (n=6-10). Phase 2 will consist of a pilot phase in which at-risk, incarcerated women (n=8-12) receive the intervention and provide feedback regarding the intervention. Phase 3 (n=80) will consist of a preliminary RCT comparing the intervention to a control condition that approximates standard-of-care (SOC). RCT participants will complete a baseline interview and follow-up interviews at 1, 3, and 6 months. The primary outcome will be linkage to community-based care, verified via medical records. We expect that, as a result of this project, we will have determined the feasibility, acceptability, and preliminary efficacy of our proposed intervention. If found to be efficacious, this intervention has the potential to reduce HIV acquisition in a high-need, underserved community.