Addressing overdose risk among recently incarcerated people living with HIV/AIDS

解决最近被监禁的艾滋病毒/艾滋病感染者的用药过量风险

• 批准号: 9349087
• 负责人: Megan Reed
• 金额: $ 5.37万
• 依托单位: DREXEL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-01 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9349087
• 关键词: AIDS/HIV problem; Address; Admission activity; Attitude; Cause of Death; Cessation of life; Clinical; Communities; Criminal Justice; Data; Drug usage; Effectiveness of Interventions; Environment; Epidemic; Evidence based intervention; Evidence based program; Future; General Population; Goals; HIV; HIV Seropositivity; Health; Imprisonment; Intervention; Jail; Knowledge; Mission; National Institute of Drug Abuse; Opioid; Outcome; Overdose; Pharmaceutical Preparations; Policies; Population; Preventive Intervention; Prisons; Public Health; RQ2; Research; Risk; Risk Behaviors; Risk Factors; Risk Reduction; Services; Substance Addiction; Time; Training; United States; Vulnerable Populations; base; clinical practice; design; experience; high risk; high risk behavior; high risk population; improved; innovation; opioid use; overdose death; overdose prevention; programs; response

PROJECT SUMMARY People released from correctional facilities are at a greater risk of all-cause death in the first two weeks after their release compared to the general population.1 During this period, people who use drugs have a 3.8 times greater risk of death for drug-related causes than they have at other times.2 At an additional elevated risk for death among people who use opioids are people living with HIV/AIDS (PLWHA).5 There is an urgent need for evaluated, evidence-based programs designed to address overdose risk in these populations before they enter the most critical risk period for an overdose death. The long-term goal of the proposed study is to inform future policies and interventions to reduce overdose deaths in people exiting incarceration as they reenter their communities. The overall objective of this proposal, which is the next step toward attainment of the long-term goal, is to evaluate the intervention's effectiveness among HIV-positive inmates, specifically within the context of other inmate outcomes. The rationale for the proposed research is that outcomes can be used to develop tailored interventions to reduce overdose deaths among high-risk correctional populations. The proposed research objectives will be achieved through the following specific aims: Aim 1: Evaluate a pilot program to provide HIV+ inmates with 1:1 overdose prevention training while incarcerated; Aim 2: identify the criminal justice, health, and HIV-related factors associated with overdose risk; and Aim 3: use a risk environment approach to describe the overdose risk experiences of HIV+ former inmates who use opioids after release. The first aim will longitudinally evaluate changes in overdose knowledge and attitudes. The second aim will investigate overdose risk behaviors in recently released people living with HIV/AIDS, and the third aim will qualitatively describe facilitators and barriers to using risk reduction training content after release from jail. This contribution is important because evidence accumulated from this study has applications for correctional facilities and HIV clinical practice throughout the United States. The proposed research is innovative, in the applicant's opinion, because it represents a substantive departure from the status quo by addressing risk specific to HIV and incarceration status and contextualizing risk in the months after release from jail. Findings will provide evidence on (i) whether overdose training produces sustained positive changes in overdose knowledge and attitudes for this population, (ii) what factors influence the overdose risks of trained inmates, (iii) specific considerations for these populations when addressing overdose risk. Study findings will inform scalable, evidence-based interventions that can be used in a variety of correctional settings and will inform those who provide services to these groups about best practices in overdose prevention.

项目概要 从惩教所释放的人在释放后的前两周内全因死亡的风险更大 其释放量与一般人群相比。1 在此期间，吸毒者的释放量是普通人群的 3.8 倍 与其他时候相比，因毒品相关原因死亡的风险更大。2 使用阿片类药物的人中死亡的是艾滋病毒/艾滋病患者 (PLWHA)。5 迫切需要 经过评估的、基于证据的计划，旨在在这些人群进入之前解决他们的用药过量风险 过量死亡的最关键风险期。拟议研究的长期目标是为未来提供信息 减少出狱人员重新入狱时因服药过量死亡的政策和干预措施 社区。该提案的总体目标是实现长期目标的下一步 目标是评估干预措施在艾滋病毒阳性囚犯中的有效性，特别是在这种情况下 其他囚犯的结果。拟议研究的基本原理是结果可用于开发 量身定制的干预措施，以减少高风险惩教人群中的服药过量死亡。拟议的 研究目标将通过以下具体目标来实现： 目标 1：评估试点计划 为艾滋病毒携带者在监禁期间提供 1:1 的药物过量预防培训；目标2：识别罪犯 与用药过量风险相关的正义、健康和艾滋病毒相关因素；目标 3：使用风险环境 方法来描述艾滋病毒+前囚犯在释放后使用阿片类药物的过量风险经历。这 第一个目标将纵向评估用药过量知识和态度的变化。第二个目标将 调查最近出院的艾滋病毒/艾滋病患者的服药过量风险行为，第三个目标是 定性描述出狱后使用降低风险培训内容的促进因素和障碍。这 贡献很重要，因为从这项研究中积累的证据可用于矫正 美国各地的设施和艾滋病毒临床实践。所提出的研究具有创新性， 申请人的意见，因为它代表着通过解决风险与现状的实质性背离 具体针对艾滋病毒和监禁状况，以及出狱后几个月内的风险背景。发现 将提供以下证据：(i) 过量训练是否会对过量服用产生持续的积极变化 该人群的知识和态度，(ii) 哪些因素影响受过训练的囚犯的服药过量风险，(iii) 在解决用药过量风险时对这些人群的具体考虑。研究结果将告知 可扩展的、基于证据的干预措施，可用于各种惩教环境，并将提供信息 向这些群体提供有关预防过量用药最佳做法的服务的人员。