Improving HIV and opioid use disorder (OUD) management and implementation for justice-involved individuals requires effective approaches to screening, linkage, and adherence to integrated services across community agencies and service providers. Community reentry represents a critical opportunity to link individuals to HIV prevention, treatment, and OUD service providers.
The Yale University JCOIN Research Center is conducting an effectiveness-implementation random control trial study to compare two models, Patient Navigation (PN) and Mobile Health Unit (MHU) service delivery, of linking individuals recently released from prison and jail to the continuum of community-based HIV and OUD prevention and treatment service cascades of care.
The study will recruit justice-involved individuals who are being released to communities in Connecticut and Texas with pre-arrest histories of opioid/injection drug use and are living with or at-risk of HIV. At post-release, participants will be randomized to receive either: (a) PN system for care, wherein patient navigators will link study participants to community-based service providers during the six-month post-release intervention period (those without HIV will be provided access to PrEP services, and those living with HIV will receive access to ART services); or (b) MHU service delivery, wherein study participants will be linked to a MHU within their community where they will receive integrated PrEP/ART, MOUD, and harm reduction services during the six-month post-release intervention period.
Study Settings: Community Corrections, Treatment/Healthcare Settings
Study Locations: Connecticut, Texas
- 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 (2021)
- Study protocol of a randomized controlled trial comparing two linkage models for HIV prevention and treatment in justice involved persons (2022)
- Ending the HIV Epidemic for Persons Who Use Drugs: The Practical Challenges of Meeting People Where They Are (2023)
PI: Kevin Knight, Sandra Springer, MD, Ank Nijhawan
• Compare the effectiveness of the use of PN versus MHU service delivery on participant length of time for taking initial post-release PrEP (prevention)/ART (treatment) medication within 6 months following release from custody
• Evaluate PN and MHU feasibility, acceptability, and costs
• Evaluate feasibility (health care utilization impact among released individuals, contributions of interagency workgroup members on outcomes), acceptability (participant satisfaction, perceived usefulness), sustainment (continued utilization), and costs required to implement and sustain the approaches as well as to scale-up in additional communities
• Identify barriers to service access across the community provider spectrum
Clinical Trial, Linkage Strategies