ACTION Study – Addressing Risk Through Community Treatment for Infectious Disease and Opioid Use Disorder Now
The JCOIN Yale HIV Hub is conducting a type 1 effectiveness-implementation random control trial study to compare two models, Patient Navigation (PN) and Mobile Health Unit (MHU) service delivery, for linking individuals recently involved in the justice system (prison, jail, mandated substance use treatment program, probation, parole) to the continuum of community-based HIV and opioid use disorder (OUD) prevention and treatment service cascades of care.
The study team is recruiting justice-involved adults age 18 or older who are being released to communities in Connecticut and Texas who have pre-incarceration histories of opioid and/or stimulant use, and who are living with or at risk of HIV. Participants are randomized to receive either: (a) PN system of care, wherein patient navigators link study participants to community-based service providers during the six-month post-release intervention period (those without HIV will be provided access to Pre-Exposure Prophylaxis (PrEP) services, and those living with HIV will receive access to ART services; as well as care for hepatitis c virus [HCV], bacterial sexually transmitted infections [STIs], and stimulant and opioid use disorder treatment including medication treatment for opioid use disorder [MOUD]), or (b) MHU service delivery paired with a clinician and a community health worker (CHW), wherein study participants are linked to an MHU within their community, where they receive integrated PrEP/ART, MOUD, HCV, and bacterial STI care during the six-month post-release intervention period.
Study Aims
Study Sites
Study Settings
Principal Investigators
Sandra A. Springer, MD (Contact PI)
Professor of Medicine, Yale School of Medicine, Department of Internal Medicine, Section of Infectious Diseases
Kevin Knight, PhD (MPI)
Professor and Director of the Institute of Behavioral Research
Texas Christian University
Ank Nijhawan, MD, MPH, MSCS (MPI)
Professor in the Department of Internal Medicine, Division of Infectious Diseases and Geographic Medicine
University of Texas Southwestern Medical Center
Key Co-Investigators
- Brent Vander Wyk, PhD
Biostatistician
Yale School of Medicine
- Sandra Violette
Deputy Warden of Addiction Services
Connecticut Department of Corrections
- Irene Kuo, MPH, PhD
Associate Research Professor
Milken Institute School of Public Health, George Washington University
- Jennifer Pankow, PhD
Research Scientist
Texas Christian University
- Randi Proffitt, PhD
Associate Research Scientist
Texas Christian University
- Czarina Navos Behrends, PhD
Assistant Professor of Population Health Sciences
Weil Cornell Medical College, Cornell University
Community Partners
- Connecticut (Northeast and Southeast sites)
Jennifer Muggeo, Ledge Light Health District
Jill Corbin, Saint Vincent De Paul Place
Kisha Ellis, Sierra Work Release Program Center
Jackie Riberidy, Connecticut Food Share
- Texas (Dallas County site)
Donna Persaud, MD, Parkland Homeless Outreach Medical Services (HOMES) Program
Ellen Kitchell, MD, Parkland HIV Services
- Texas (Tarrant County site)
Melissa Acosta, John Peter Smith Hospital
Lynnette Howington, TCU Harris School of Nursing
Gary Kesling, Tarrant County Public Health Department
Amy Chairez, My Health My Resources (MHMR) of Tarrant County
Lonnetta Wilson, Tarrant County HIV Administration
Justice Agency Partners
- Connecticut (Northeast and Southeast sites)
Sandra Violette, Connecticut Department of Corrections
Christine Bachman, Connecticut Department of Corrections
Jennifer Baldwin, Senior Assistant Public Defender at State of Connecticut
- Texas (Dallas county site)
Vonda Freeman, Dallas Country Community Supervision and Corrections Department
Frank Davis, Gateway Foundation Corrections
- Texas (Tarrant county site)
Cobi Tittle, Tarrant Country Community Supervision and Corrections Department
Study Logo
JCOIN Yale HIV Papers
- Springer S.A., Nijhawan A.E., Knight K., Kuo I., Di Paola A., Schlossberg E., Frank C.A., Sanchez M., Pankow J., Proffitt R.P., Lehman W., Pulitzer Z., Thompson K., Violette S., Harding K.K.; (2022, April 15). ACTION Cooperative Group. Study protocol of a randomized controlled trial comparing two linkage models for HIV prevention and treatment in justice-involved persons. BMC Infectious Diseases, 22(1), 380. doi: 10.1186/s12879-022-07354-x. PMID: 35428213; PMCID: PMC9013109.
- Taweh N., Schlossberg E., Frank C., Nijhawan A., Kuo I., Knight K., Springer S.A. (2021, October). Linking criminal justice-involved individuals to HIV, hepatitis C, and opioid use disorder prevention and treatment services upon release to the community: Progress, gaps, and future directions. International Journal of Drug Policy. 96:103283. doi: 10.1016/j.drugpo.2021.103283. Epub 2021 May 18. PMID: 34020864; PMCID: PMC8568621.
- Nijhawan A.E., Pulitzer Z., Torres B., Noreen N., Schultheis A., Frank C., Colon R., Brooks R., Proffitt R., Pankow J., Bennett A., Salyards M., Kuo I., Knight K., Springer S.A. Indications for HIV pre-exposure prophylaxis (PrEP) in a Justice-involved Population: Intersection of substance use and sexual risk. Emerging Infectious Diseases. Accepted November 2023. In Press.
Photos of Our Mobile Health Units (MHU)
