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Principal Investigator: Emily F Dauria
Organization: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
Fiscal Year: 2024
Award: $281,857
Funding agency: National Institute on Drug Abuse
Project Summary/Abstract
There is a strong scientific premise for the study of integrated substance use disorders (SUDs) and HIV-
prevention interventions for criminal justice-involved (CJI) populations. SUDs lead to increased rates of justice
involvement as well as increased risk for HIV-acquisition. Estimates of the proportion of the CJI-population with a
SUD reach 72%, and ~150,000 persons with HIV pass through a correctional facility annually. Although pre-
exposure prophylaxis (PrEP), is a proven effective intervention for HIV-prevention, its maximal impact depends
on uptake, and adherence among those at high risk. To date, few published studies have examined PrEP uptake
among CJI populations. Our ongoing work with CJI women (San Francisco, CA) has identified high rates of risk
behaviors (including substance use), low levels of PrEP awareness, and high levels of interest in PrEP once
learning of it. Participants reported a strong interest in participating in a navigator-led intervention to screen and
link them to PrEP-related services; younger participants (i.e., those aged 18 to 29 years) were eager to
incorporate electronic health (eHealth) into navigation services. Navigator models use a one-on-one relationship
to promote the timely movement of an individual through a health care continuum by eliminating barriers and
have successfully increased healthcare access for CJI HIV-positive adults and individuals with SUDs. eHealth
approaches to SUD and HIV prevention also hold promise because they improve access to effective intervention
services, particularly for younger people. As a multidisciplinary team with expertise in behavioral health
(substance use and HIV prevention) among justice-involved populations, and eHealth supported and navigator-
led healthcare access and engagement interventions, we propose to develop and test an eHealth enhanced,
navigator-led substance use and HIV-prevention referral and linkage intervention for CJI-young adults. Study
aims are to: 1) Adapt an existing evidence-based navigator model (The Navigation Project) to incorporate
codeveloped eHealth technology, to refer and link CJI young adults (aged 18 to 29 years) to substance use
treatment and HIV-prevention services; 2) Refine and test the adapted, eHealth enhanced, navigator-led
substance use treatment and HIV prevention intervention for CJI-young adults for fidelity, satisfaction, and
appropriateness; 3) Assess the feasibility, acceptability, and impact of the adapted eHealth enhanced, navigator
program to refer and link CJI-young adults substance use treatment and HIV-prevention services. The proposed
study has the potential to: 1) reduce HIV-acquisition and improve access to substance use treatment among a
high-risk, underserved group of young adults in the US; 2) test the feasibility, acceptability, fidelity, effectiveness,
appropriateness, and satisfaction of implementing an eHealth enhanced, navigator-led substance use and HIV-
prevention intervention, and 3) create an intervention suitable for large-scale efficacy testing and translation to
other criminal justice settings.
Terms: <21+ years old><AIDS Virus><AIDS prevention><Acquired Immune Deficiency Syndrome Virus><Acquired Immunodeficiency Syndrome Virus><Active Follow-up><Adherence><Adult><Adult Human><Anti-HIV Positivity><Awareness><Case Management><Characteristics><CoV pandemic><Communities><Community of Practice><Consolidated Framework for Implementation Research><Consolidated Framework for Implementation Science><Consolidated Framework for Implementing Change><Continuity of Care><Continuity of Patient Care><Continuum of Care><Criminal Justice><Development><Drug Compounding><Drug Preparation><Drug abuse><Effectiveness><Enhancement Technology><Feasibility Studies><Feedback><Focus Groups><Future><Goals><HIV><HIV Positive><HIV Positivity><HIV Prevention><HIV Seroconversion><HIV Seropositivity><HIV antibody positive><HIV/AIDS prevention><HTLV-III Seroconversion><HTLV-III Seropositivity><Health Care Technology><Health Technology><Healthcare><Healthcare Technology><Human Immunodeficiency Viruses><Imprisonment><Improve Access><Individual><Intervention><Intervention Strategies><Interview><Investigators><Justice><LAV-HTLV-III><Lead><Learning><Link><Lymphadenopathy-Associated Virus><Mental Health><Mental Hygiene><Modeling><Movement><Participant><Pb element><Persons><Phase><Pilot Projects><Population><PrEP><Preventative intervention><Preventative strategy><Prevention strategy><Prevention trial><Preventive strategy><Process><Provider><Psychological Health><Publishing><Randomized, Controlled Trials><Reporting><Research><Research Personnel><Researchers><Risk><Risk Behaviors><Risky Behavior><San Francisco><Services><Substance Use Disorder><Supervision><System><Technology><Testing><Time><Translations><Underserved Population><United States><Virus-HIV><Woman><Work><abuse of drugs><abuses drugs><acceptability and feasibility><access to health care><access to healthcare><accessibility of health care><accessibility to health care><accessibility to healthcare><active followup><adult youth><adulthood><aged><alcohol abuse prevention><at risk behavior><behavioral health><behavioral health intervention><body movement><coronavirus pandemic><design><designing><developmental><disease prevention><disorder prevention><disparities in race><disparity due to race><disparity in ethnic><e-Health><eHealth><effective intervention><efficacy testing><electronic health><ethnic based disparity><ethnic disadvantage><ethnic disparity><ethnic inequality><ethnic inequity><ethnic minority><ethnicity disparity><evidence base><feasibility testing><follow up><follow-up><followed up><followup><health care><health care access><health care availability><health care service access><health care service availability><healthcare access><healthcare accessibility><healthcare availability><healthcare service access><healthcare service availability><heavy metal Pb><heavy metal lead><high risk><implementation process><improved><incarcerated><incarceration><inequality due to race><inequity due to race><innovate><innovation><innovative><interest><intervention delivery><intervention for prevention><interventional strategy><multidisciplinary><navigator intervention><parole><pilot study><pilot trial><population health><pre-exposure prophylaxis><prevent alcohol abuse><prevention intervention><prevention service><preventional intervention strategy><preventive intervention><primary outcome><probation><programs><race based disparity><race based inequality><race based inequity><race disparity><race related disparity><race related inequality><race related inequity><racial disparity><racial inequality><racial inequity><racial minority><racially unequal><randomized control trial><satisfaction><service intervention><standard of care><study population><substance use><substance use and disorder><substance use treatment><substance using><tool><translation><treatment services><trial comparing><under served group><under served individual><under served people><under served population><underserved group><underserved individual><underserved people><uptake><young adult><young adulthood>