Investigators at the University of North Carolina at Chapel Hill comprise one of 12 scientific teams in more than a dozen states that will receive National Institutes of Health (NIH) grants to study effective ways to prevent and treat HIV/AIDS among people in the criminal justice system.
The five-year grants, announced September 23, will be awarded primarily by the National Institute on Drug Abuse (NIDA), with additional support from the National Institute of Mental Health (NIMH) and the National Institute of Allergy and Infectious Diseases (NIAID), all components of NIH.
Recent research has demonstrated that treatment with antiretroviral therapy makes HIV less infectious and that identifying and offering treatment to all medically eligible HIV-positive individuals can slow the spread of the virus. These new grants will apply this strategy to the criminal justice system, where the population has a relatively high prevalence of HIV/AIDS and often has poor access to treatment outside the system.
"People living with HIV in prison have high rates of treatment responses to HIV medications while they're in prison," said David Wohl, MD associate professor of medicine at the UNC School of Medicine. "However, this is typically lost after release." UNC will study a test, treat, link, and retain strategy among 525 prison inmates, pre- and post-release in North Carolina and Texas.
"Keeping people on their HIV medications after release will not only help them but, we think, reduce their risk of passing the virus on to others," said Wohl, who also serves as co-director of HIV services for the North Carolina Department of Correction and co-principal investigator on the study.
The research project, which is being conducted in collaboration with Texas Christian University, employs a multi-dimensional intervention which spans the time before and after release and is designed to boost treatment adherence and keep inmates engaged in the health care system.
"A critical component after release will be helping participants get linked into their HIV care right away." said Carol Golin, MD, co-principal investigator on the study and associate professor of medicine in the UNC School of Medicine. "We know from studies in other settings that multi-faceted programs help people stay on antiretroviral medicines better than single-pronged approaches," Golin said.
The investigators will use multimedia materials, including videos and face-to-face counseling with study participants while they are still in prison. "After they are released, we will employ cell phone technologies to reinforce the intervention," said Golin, who is also associate professor of health behavior and health education in the UNC Gillings School of Global Public Health.
Each year, an estimated one in seven individuals infected with HIV passes through a correctional facility suggesting that a disproportionate number of people in the criminal justice system are infected with the virus.
Seek, Test, and Treat: Addressing HIV in the Criminal Justice System represents NIH's largest research initiative to date to aggressively identify and treat HIV-positive inmates, parolees and probationers and to help them continue care when they return to their communities. Close to $50 million dollars in grants over a five-year period are expected under this research initiative.
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