Seek, Test, and Treat Strategies

寻求、测试和治疗策略

• 批准号: 8142960
• 负责人: David W Seal
• 金额: $ 6.37万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8142960
• 关键词: AIDS/HIV problem; Accounting; Acquired Immunodeficiency Syndrome; Address; Area; Back; Caring; Case Management; Cities; Communities; Computerized Medical Record; Continuity of Patient Care; County; Criminal Justice; DA10; Data; Drug usage; Economics; Effectiveness; Elements; Ensure; HIV; HIV Infections; HIV Seropositivity; Health; Health Personnel; Human immunodeficiency virus test; Imprisonment; Individual; Infection; Intake; Jail; Life; Link; Medical; Methods; Modeling; Needle Sharing; Outcome; Persons; Play; Population; Prisons; Program Sustainability; Provider; Research Personnel; Resources; Risk; Risk Reduction; Role; Screening procedure; Secure; Services; Sexually Transmitted Diseases; Site; System; Testing; Treatment Cost; Walking; Wisconsin; base; beneficiary; comparative; correctional system; cost; cost effectiveness; experience; high risk; innovation; metropolitan; parole; prevention service; probation; programs; public health relevance; response; social; treatment program

DESCRIPTION (provided by applicant): "A Systemic Approach to Seek, Test, and Treat Strategies for Correctional Populations" It is estimated that 25% of all HIV-positive people in the U.S. pass through a correctional facility each year. Yet, many correctional systems and facilities do not provide a comprehensive and systemically coordinated approach to HIV testing, treatment, and transitional referral, resulting in many missed opportunities to identify previously undiagnosed cases of HIV and link individuals to treatment and prevention services. To address this gap, and in response to RFA-DA-10-017 (Seek, Test, and Treat (STT): Addressing HIV in the Criminal Justice System), we propose to: AIM1: (1) Comprehensively test a high-risk population (people in a state correctional facility being released to a major metropolitan area that accounts for nearly 60% of all state HIV cases, has experienced a recent and significant increase in the rate of HIV, and has perennially high rates of sexually transmitted infections); (2) (re)-link HIV-positive people being released from a state correctional facility to this metropolitan area into low- or no-cost treatment and case management services; and (3) seek to evaluate an innovative network method of HIV testing referral to utilize high-risk negatives in the correctional system to, upon release, encourage other high-risk individuals in their social-sexual networks who might not otherwise access testing services to get HIV tested. Aim 2. Conduct cost and cost-effectiveness analyses to assess: (1) the overall, systemic cost of the proposed STT program; (2) the cost of individual program components and cost to individual payers; (3) the comparative cost-effectiveness of testing in the state prison versus standard walk-in testing at the community treatment provider who will be lined to people testing positive in the prison, and a local county jail that was the site of a recent cost-effectiveness STT study; (4) the potential increase in economic efficiency that could be achieved through risk reduction screening prior to testing in detention facilities; and (5) the cost-effectiveness of implementing post-release partner seeking/testing services for high-risk detainees. The proposed study is highly innovative in that it (1) comprehensively addresses all 3 STT elements across all state correctional facilities who release people to a large metropolitan region with rising rates of HIV; (2) facilitates in-depth cost and cost-effectiveness analyses of this coordinated and systemic STT approach; and (3) involves a unique partnership between academic investigators, HIV treatment providers, a Department of Corrections, a state Division of AIDS/HIV, and a City Health Department. PUBLIC HEALTH RELEVANCE: "A Systemic Approach to Seek, Test, and Treat Strategies for Correctional Populations" We propose to (1) comprehensively test a high-risk population (people in a state correctional facility being released to a major metropolitan area that accounts for nearly 60% of all HIV cases in its state, has experienced a recent and significant increase in the rate of HIV, and has perennially high rates of sexually transmitted infections); (2) (re)-link HIV-positive people being released from a state correctional facility to this metropolitan region into low- or no-cost treatment and case management services; and (3) seek to evaluate an innovative network method of HIV testing referral to utilize high-risk negatives in the correctional system to, upon release, encourage other high-risk individuals in their social-sexual networks who might not otherwise access testing services to get HIV tested. We further will conduct extensive (4) cost and cost-effectiveness analyses to evaluate the likelihood of the proposed STT program's sustainability.

描述（由申请人提供）：“一种系统的寻求，测试和治疗惩教策略的方法”，据估计，美国所有HIV阳性人群中有25％每年都通过惩教设施。然而，许多惩教系统和设施并未为艾滋病毒测试，治疗和过渡性转诊提供全面且系统地协调的方法，从而导致许多机会识别以前未诊断的HIV病例，并将个人与治疗和预防服务联系起来。解决这一差距，并回应RFA-DA-10-017（寻求，测试和治疗（STT）：解决刑事司法系统中的艾滋病毒），我们建议：AIM1：（1）全面测试高风险人口（1）国家惩处的人（在所有较高的Metropolitan地区）占据了近60％的案例，并且在所有州的近60％中都有一定的速度，并且是HIV的近60％，并且是HIV的范围，并且是HIV的范围，并且是HIV的范围，并且是HIV的范围，并且是HIV的范围，并且占HIV的范围，并且占HIV的范围，并且是HIV的近60％，并且占据了HIV的范围。性传播感染率）； （2）（re） - 链接艾滋病毒阳性人士从州惩教所释放到该大都市地区的低成本或无成本治疗和病例管理服务； （3）试图评估一种创新的艾滋病毒测试网络方法转介的转介，以利用惩教系统中的高风险负面因素，以鼓励在其社交性性别网络中其他高风险的人在其社交性性别网络中可能无法访问测试服务来接受HIV测试。目标2。进行成本和成本效益分析以评估：（1）拟议的STT计划的全身成本； （2）单个计划组件的成本和个人付款人成本； （3）在州监狱中进行测试的比较成本效益与社区治疗提供商的标准步入式测试，后者将与在监狱中测试呈阳性的人们以及当地的县监狱，这是最近成本效益STT研究的所在地； （4）通过在拘留设施进行测试之前，通过降低风险筛查可以实现的经济效率的潜在提高； （5）实施释放后合作伙伴为高风险被拘留者寻求/测试服务的成本效益。拟议的研究具有很高的创新性，因为它（1）全面解决了所有州惩教设施中的所有3个Stt元素，这些设施将人们释放到大型大都市地区，HIV率上升； （2）促进对这种协调和系统的STT方法的深入成本和成本效益分析； （3）涉及学术研究人员，艾滋病毒治疗提供者，惩教局，艾滋病/艾滋病毒州和城市卫生部门之间的独特伙伴关系。 公共卫生相关性：“一种系统的寻求，测试和治疗惩教策略的方法”，我们建议（1）全面测试高风险人群（州惩教设施中的人们正在向主要的大都市地区释放，占其州所有艾滋病毒案件的近60％的近60％，在该州的所有艾滋病毒案件中占HIV的近期和高度率的率，并具有较高的hiv率，并且性交的率很高。 （2）（re） - 链接艾滋病毒阳性的人从州惩教所释放到该大都市地区，以低成本或无成本的治疗和病例管理服务； （3）试图评估一种创新的艾滋病毒测试网络方法转介的转介，以利用惩教系统中的高风险负面因素，以鼓励在其社交性性别网络中其他高风险的人在其社交性性别网络中可能无法访问测试服务来接受HIV测试。我们将进一步进行广泛的（4）成本和成本效益分析，以评估拟议的STT计划可持续性的可能性。