Corrections2Community: Post-release retention in HIV care for ex-inmates in South Africa

Corrections2Community：南非刑满释放人员出狱后继续接受艾滋病毒护理

基本信息

批准号：
9481618
负责人：
CHRISTOPHER J HOFFMANN
金额：
$ 28.5万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-12-01 至 2020-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9481618
关键词：
AIDS/HIV problem Achievement Address Adherence Adult Advisory Committees Africa Age Alcohol or Other Drugs use Area Caring Cause of Death Centers for Disease Control and Prevention (U.S.)Collaborations Communities Confusion Continuity of Patient Care Country Data Demographic Factors Development Drug usage Economics Effectiveness Employment Epidemic Failure Family Feasibility Studies Fibrinogen Focus Groups Goals HIV HIV Seropositivity Health Imprisonment Individual Interview Knowledge Lead Maintenance Measures Medical Methods Modeling Morbidity - disease rate Observational Study Occupations Outcome Participant Patients Pharmaceutical Preparations Population Prevalence Prevention Procedures Process Process Measure Randomized Clinical Trials Reporting Research Research Priority Services South Africa South African Support Groups Testing Time United States National Institutes of Health Use Effectiveness Viral Load result Visit Vulnerable Populations Woman antiretroviral therapy arm base care delivery care systems community setting correctional system experience follow-up group support health disparity improved injection drug use longitudinal dataset member men mortality primary outcome satisfaction secondary analysis skills training social social attachment social capital social stigma traditional care transmission process treatment response trial comparing uptake virology

项目摘要

PROJECT SUMMARY The availability of antiretroviral therapy (ART) has markedly reduced HIV-related mortality and morbidity in Africa. Yet HIV remains the leading cause of death among adult men and women in South Africa due fails to initiated ART or remain in care. Between 2 and 3% of HIV-infected men in South Africa pass through the corrections system annually. While incarcerated uptake of ART is excellent, unfortunately after release most are lost from care. Qualitative and quantitative research conducted by the research team with 492 ex-inmates in South Africa indicates that upon release from correctional settings, this population encounters confusion regarding where and when to receive care, long queueing times, family abandonment and limited social capital, enacted stigma, economic insecurity, and substance use (injection drug use reported by 11% of our participants). This project seeks to further characterize loss from care following release and to develop and pilot test a group support and HIV care model to retain ex-inmates in HIV care. This support group approach is based on adapting the South African community adherence clubs for a special vulnerable population. Such a care and support group for ex-inmates transitioning in care (a transition community adherence club or TCAC) has the potential to simultaneously address the multiple barriers to medical care through addressing social and care delivery barriers. We hypothesize that intervening on these levels will impact retention in care, virologic suppression, morbidity, and HIV transmission. The current proposal will allow for the development and piloting of this TCAC strategy to improve HIV care for ex-inmates to increase knowledge regarding care engagement for ex-inmates and to prepare for a randomized clinical trial of the TCAC powered for an effectiveness outcome of in-care with an undetectable viral load at 6 months after release.

项目概要抗逆转录病毒疗法（ART）的出现显着降低了艾滋病毒相关死亡率非洲的发病率。然而，艾滋病毒仍然是成年男性和女性死亡的主要原因南非未能启动抗逆转录病毒疗法或继续接受护理。 2% 至 3% 的男性感染艾滋病毒在南非，每年都要经过惩教系统。在监禁期间吸收 ART 非常好，不幸的是，释放后大多数人都因护理而失去了生命。定性和定量研究小组对南非 492 名刑满释放人员进行的研究表明从惩教机构释放后，这些人对去哪里感到困惑何时接受护理、排队时间长、家庭遗弃和社会资本有限，造成耻辱、经济不安全和药物滥用（11% 的人报告注射毒品使用）我们的参与者）。该项目旨在进一步描述释放后护理损失的特征开发并试点测试团体支持和艾滋病毒护理模式，以保留前囚犯接受艾滋病毒护理。这种支持小组方法是基于调整南非社区的依从性针对特殊弱势群体的俱乐部。这样一个关爱和支持刑满释放人员的小组护理过渡（过渡社区依从俱乐部或 TCAC）有可能通过解决社会和护理问题，同时解决医疗保健的多重障碍交付障碍。我们假设对这些水平的干预将影响护理的保留，病毒学抑制、发病率和艾滋病毒传播。目前的提案将允许制定和试点该 TCAC 战略，以改善对刑满释放人员的艾滋病毒护理有关前囚犯护理参与的知识并为随机临床做好准备 TCAC 试验为无法检测到病毒的护理提供了有效结果发布后 6 个月加载。