Research Hubs

The Mobile-Enhanced Prevention Support (MEPS) Intervention is an evidence-based intervention to promote engagement in services for HIV, STD, and hepatitis C testing and prevention and for addressing substance use disorders during reentry for sexual and gender minority individuals. The proposed research hub will adapt MEPS for a broader population and test it in three California counties to evaluate both the intervention's effectiveness in varied settings and its implementation using an Implementation Science framework, with the goal of developing guidance for broad intervention scale up and sustainment. The hub will also engage stakeholders throughout the state and other hubs to field pilot studies related to HIV prevention during reentry in people who use drugs.

HIV and substance use disorders are highly prevalent among people involved with the criminal legal system and multiple barriers complicate access to medical care in the period following incarceration. Interventions that address these barriers are critical to ending the HIV epidemic. The goal of this proposal is to evaluate a comprehensive, person-centered model of post-incarceration care for people with and at risk for HIV that uses peers with lived experience of incarceration to assist with linkage and engagement in medical care and substance use disorder treatment, community based- organization partnerships to meet unmet social needs, and decentralized medical care to address barriers to access.

The Massachusetts HIV/Justice Research Network will develop and study the outcomes and implementation of an intervention to increase access to carceral HIV healthcare. Findings will have implications for HIV treatment and prevention to end the HIV epidemic in jail populations.

Co-occurring substance use and HIV risk among people in carceral settings is a syn-demic. Yet, gold standard interventions to stem adverse opioid use disorder (OUD) outcomes and prevent HIV infection (e.g., pre-exposure prophylaxis, PrEP; and medications for opioid use disorder, or MOUD, e.g., buprenorphine) have been underemployed in carceral and community re-entry settings. Therefore, this investigator team proposed conducting a hybrid implementation-effectiveness type 2 study to optimize and test the efficacy of a long-acting injectable PrEP + buprenorphine (XR-B) co-located intervention in jail and prison settings located in Ending the Epidemic sites in Maryland and Washington, D.C.

In light of the ongoing overdose crisis, the investigators build on prior research evaluating SHIELD, a public-health oriented police education program and structural HIV prevention intervention. They will collaborate with the behavioral health workforce in several rural settings with high burdens of substance use in Appalachian Kentucky to evaluate SHIELD for its implementation and effectiveness outcomes (including increasing referrals to medications for opioid use disorder). This intervention will be a critical step towards broader implementation and scale-up in aligning policing practices with public health to address both HIV and substance use disorder outcomes.

Ending the HIV epidemic (EHE) requires improvement in HIV treatment (TREAT) and retention for people with HIV and increased HIV pre-exposure prophylaxis (PrEP) utilization (PREVENT) for people at risk for acquiring HIV. One highly impacted group that has been insufficiently engaged in these efforts is justice-involved people who use drugs. By building on existing partnerships (with justice, public health, HIV treatment and prevention, substance use disorder treatment providers, and people with lived experience), and adapting and testing a patient-centered approach (adding patient choice to a patient navigation intervention) this proposal has the potential to improve the PREVENT and TREAT pillars of the EHE plan and reduce HIV infections in this vulnerable population.

Over 50,000 people are incarcerated in New York state and 1-2% are estimated to be people living with HIV (PLWH), and substance use disorder (SUD) is highly prevalent among criminal- legal system (CLS)-involved people, with an estimated 70-80% of US jail detainees having a SUD and at high risk of relapse, overdose-related mortality and HIV infection post-release. The overall goal of this study is to evaluate the effectiveness of TechMPower, an intervention that bundles implementation strategies to increase delivery of evidence-based intervention (EBPs) to prevent adverse HIV-related (new infection, untreated HIV) and SUD-related outcomes (fatal and non-fatal overdose) among a sample of individuals (n = 1,125) in 15 New York State county jails. This study’s outcomes will fill vital gaps in knowledge regarding whether TechMPower can improve the health of incarcerated people with substance use disorder and HIV-related risk through tech-mediated EBP service delivery in jails with linkages to community-based care.

If successful, this project will provide evidence for the use of a peer navigation linkage to care model for integrated HIV care, HIV prevention care, and substance use disorder services for people living with HIV or at high risk for seroconversion, who also have a substance use disorder, as they are transitioning through jail. Development of an HIV-status neutral service delivery model for individuals with a range of substance use disorders, not only for opioids but also other illicit and licit substances, will benefit HIV prevention in Atlanta and other jurisdictions with similar drug use profiles.