HIV Infections, Opioid Use Disorder
Conditions
Keywords
Carceral system, HIV testing, Pre-exposure prophylaxis (PrEP), Justice Community Opioid Innovation Network (JCOIN), End HIV Epidemic (EHE), HIV Services
Brief summary
This pilot feasibility study represents part 3 of a larger R61 study, where the investigators will follow a cohort about their experiences with human immunodeficiency virus (HIV) testing. This project aims to assess the effectiveness of an intervention at two jail sites in the Boston area: South Bay House of Corrections and Nashua Street Jail implemented in January of 2025 that is aimed at improving HIV testing practices and HIV treatment in those carceral facilities. This implementation was developed independently of the investigators' study activities. The jails worked to develop changes in their electronic health record to offer HIV testing at various points in their intake and physical exam process. HIV care was not well-integrated with the jails' existing intake and healthcare administration systems and medications for opioid use disorder (MOUD) program. The investigators will evaluate the intervention the jails developed to address these issues. The outcomes of interest are more implementation than effectiveness outcomes. The primary goal of this study is to identify existing barriers in the carceral healthcare setting that prevent the improvement of HIV testing and treatment.
Interventions
None listed
Sponsors
Boston Medical Center
National Institute on Drug Abuse (NIDA)
South Bay House of Corrections
Nashua Street Jail
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Incarcerated at South Bay House of Corrections or Nashua Street Jail * Participant Report that they will be leaving jail within 1 month. * Participant must be comfortable speaking in the English Language * Has Opioid Use Disorder (OUD) indicated by participation in Medications for Opioid Use Disorder (MOUD) program and/or self-report
Exclusion criteria
* Cognitive ability that prevents obtained consent or completion of study activities (defined through Research Assistant (RA) determination)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of participants that use HIV services while incarcerated | on average 4-6 weeks | This will be assessed from a review of information abstracted from study questionnaires and interviews with study staff and recorded as a binary 'Yes or No'. If there is any mention of HIV services of any type such as testing, obtaining information. or counseling related to HIV while incarcerated, the participant will be categorized as using HIV services/Yes. |
| Number of participants that use of PrEP if HIV negative | 1 week, 3 months post incarceration | This will be assessed from a review of information abstracted from study questionnaires and interviews with study staff and recorded as a binary 'Yes or No'. For participants who are HIV negative, if there is any mention of PrEP being used the participant will be categorized as using PrEP/Yes. |
| Number of participants that have HIV testing in the community if unknown status during incarceration | 1 week, 3 months post incarceration | This will be assessed from a review of information abstracted from study questionnaires and interviews with study staff and recorded as a binary 'Yes or No'. Participants with unknown HIV status during incarceration who are tested for HIV in the community, will be categorized as Yes. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of participants that demonstrate HIV knowledge | 1 week, 3 months post incarceration | This will be assessed from a review of information abstracted from study questionnaires and interviews with study staff and recorded as a binary 'Yes or No'. Participants who demonstrate HIV knowledge will be categorized as Yes. |
| Number of participants that have Risk Behaviors for HIV | 1 week, 3 months post incarceration | This will be assessed from a review of information abstracted from study questionnaires and interviews with study staff and recorded as a binary 'Yes or No'. Participants who have rsk behaviors for HIV will be categorized as Yes. |
| Number of participants with Sexually Transmitted infections (STIs) | 1 month, 3 months post incarceration | This will be assessed from a review of information abstracted from study questionnaires and interviews with study staff and recorded as a binary 'Yes or No'. Participants who report that they were tested and told they have any STI other than HIV \[eg syphilis, gonorrhea, hepatitis C virus (HCV)\] will be categorized as Yes. |
| Number of participants that have substance use | 1 week, 3 months post incarceration | This will be assessed from a review of information abstracted from study questionnaires and interviews with study staff and recorded as a binary 'Yes or No'. Participants who report they use substances \[eg smoking cigarettes, drinking alcohol, or using any illicit drugs\] will be categorized as Yes. |
| Number of participants with PrEP Awareness | 1 week, 3 months post incarceration | This will be assessed from a review of information abstracted from study questionnaires and interviews with study staff and recorded as a binary 'Yes or No'. Participants who demonstrate awareness about PrEP will be categorized as Yes. |
| Number of participants with acute healthcare utilization | 1 week, 3 months post incarceration | This will be assessed from a review of information abstracted from study questionnaires and interviews with study staff and recorded as a binary 'Yes or No'. Participants who report they were either hospitalized or received care in an emergency room will be categorized as Yes. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORAlysse Wurcel, MD MS
Boston Medical Center
Outcome results
None listed