Document text
Principal Investigator: Nabila El-Bassel
Organization: COLUMBIA UNIV NEW YORK MORNINGSIDE
Fiscal Year: 2024
Award: $1,105,729
Funding agency: National Institute on Drug Abuse
Project Summary
HIV prevalence in correctional facilities in the US is about five times greater than in the general
population and about 14% of people living with HIV (PLWH) experience incarceration/release
every year and 15% of those incarcerated do not know their HIV status. Over 50,000 people are
incarcerated in New York state and 1-2% are estimated to be PLWH. Similarly, 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 are at high risk of relapse, overdose-
related mortality and HIV infection post-release. Intervening during incarceration provides an
opportunity to address HIV care in hard-to-reach individuals, though more robust interventions
are needed to improve care continuity. Increasing point-of-care rapid testing would maximize
HIV detection and results receipt among people in jails, and prepare them with needed
knowledge and skills post-release. To fill this gap, we propose a Regional Research Hub (RRH)
and 2-phase, Hybrid Type II effectiveness/implementation study 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=1125 ) in 15 New York State county jails.
In the first phase, we will pilot TechMPower to prepare for the phase two full R33 trial,
informed by PRISM/RE-AIM and the health equity framework, by recruiting in one NYS county
jail (n=50) and an existing HEALing Communities Study coalition to implement the selected
EBPs to increase: 1) HIV screening/testing via self-testing (TRUST); 2) SUD screening/testing
(SBIRT); and 3) access to and uptake of biomedical HIV and SUD prevention and treatment
(PrEP/PEP/ART); overdose education/naloxone distribution [OEND], opioid use disorder
medication [MOUD]) delivered through 4) hybrid linkage (telehealth, face-to-face) to services via
Navigation Enhanced Case Management (NCM). To optimize EBP delivery, TechMPower
applies key implementation strategies including: a) data driven, equity-focused, community
coalitions; b) implementation teams led by champions; c) training in intersectional stigma/harm
reduction for service providers/organizations from CHHANGE; and d) tech-mediated trainings.
This study capitalizes on investigators’ experience in community-driven implementation studies,
EBP design, and equity/anti-stigma approaches to provide evidence for tech-mediated HIV and
SUD service delivery integration in jails with linkages to community-based care.
Terms: <AIDS Virus><AIDS prevention><AIDS test><AIDS/HIV test><Acquired Immune Deficiency Syndrome Virus><Acquired Immunodeficiency Syndrome Virus><Address><Adoption><Age><Caring><Case Management><Communities><Community Services><Complex><Continuity of Care><Continuity of Patient Care><Continuum of Care><Cost Effectiveness Analysis><County><Data><Detection><Drugs><Effectiveness><Epidemic><Equity><Ethnic Origin><Ethnicity><Evaluation><Evidence based intervention><Funding><Gender><General Population><General Public><Goals><HIV><HIV Infections><HIV Prevention><HIV test><HIV-1 test><HIV-2 test><HIV/AIDS prevention><HTLV-III Infections><HTLV-III-LAV Infections><Harm Minimization><Harm Reduction><Health><Healthcare><Human Immunodeficiency Viruses><Human T-Lymphotropic Virus Type III Infections><Human immunodeficiency virus test><Hybrids><Imprisonment><Individual><Infection><Intervention><Intervention Strategies><Intervention Studies><Investigators><Jail><Knowledge><LAV-HTLV-III><Legal system><Lymphadenopathy-Associated Virus><Maintenance><Maps><Mediating><Medication><Methods><Modeling><New York><Outcome><Outcome Study><Overdose><Persons><Pharmaceutical Preparations><Phase><PrEP><Prevalence><Prevention><Provider><RE-AIM><Race><Races><Reach, Effectiveness, Adoption, Implementation, and Maintenance><Research><Research Design><Research Personnel><Researchers><Risk><Sampling><Services><Site><Study Type><Substance Use Disorder><Survey Instrument><Surveys><Technology><Testing><Training><Virus-HIV><ages><assess effectiveness><behavior outcome><behavioral outcome><care delivery><community based care><cost><cost effectiveness><cost efficient analysis><cost-effective analysis><design><designing><determine effectiveness><disease prevention><disorder prevention><distribute naloxone><drug/agent><effectiveness assessment><effectiveness evaluation><effectiveness outcome><effectiveness testing><effectiveness-related outcomes><effectiveness/implementation hybrid study><effectiveness/implementation study><evaluate effectiveness><examine effectiveness><experience><healing><health care><health equity><high risk><implementation outcomes><implementation strategy><implementation study><improved><incarcerated><incarceration><internet based platform><internet platform><intervention delivery><intervention design><intervention research><interventional research><interventional strategy><interventional study><interventions research><member><mortality><naloxone availability><naloxone dispensary><naloxone dispensation><naloxone dispensing><naloxone distribution><naloxone provision><opiate use disorder><opioid use disorder><overdose death><overdose education><overdose fatalities><point of care><pre-exposure prophylaxis><prevent><preventing><primary outcome><programs><provide naloxone><provider intervention><racial><racial background><racial origin><rapid testing><reach, efficacy, adoption, implementation, and maintenance><recruit><relapse risk><response><screening><screenings><self testing><service delivery><service providers><sex><skills><social stigma><stigma><strategies for implementation><study design><substance use and disorder><success><telehealth><therapy design><treatment design><uptake><web based platform><web based system><web enabled platform><web platform>