NIH awards $7 million grant to provide sustained care for HIV-positive inmates

The University of Illinois at Chicago has received a $7 million grant from the National Institutes of Health to study effective ways to seek, test, and treat inmates with HIV.

The project is led by researchers from the UIC School of Public Health, the UIC College of Medicine and the Cook County Jail.

The researchers will focus on inmates at Cook County Jail and at Illinois state prisons to increase the number of inmates tested, provide effective anti-retroviral therapy to HIV-positive prisoners, and provide case management after release to maintain effective treatment.

"Each year, an estimated one in seven individuals infected with HIV passes through a correctional facility," said Dr. Lawrence Ouellet, research professor of epidemiology and one of the principal investigators, "which suggests that these facilities are key sites for public health interventions targeting HIV/AIDS."

In an effort to identify those with undetected or untreated infection and potentially reduce HIV transmission in the community, the research team will help to implement and evaluate "opt-out" testing when a person enters jail or prison.

The researchers believe that by making HIV testing a routine feature of health exams the number of inmates tested will increase, according to Dr. Michael Puisis, a co-principal investigator and the chief operating officer at Cermak Health Services of Cook County Jail.

Currently, inmates must "opt-in" for HIV testing, which is not part of standard tests when they enter the system. Under the new procedures, inmates still have the option to refuse testing.

The project will also evaluate telemedicine as a way to provide HIV care to state prison inmates. Using confidential, interactive video teleconferencing, a physician at UIC will perform a complete history and physical exam and eliminate the need for prisoners to be transported from remote locations for care.

"In the past, inmates housed in the Illinois Department of Corrections prison facilities had very limited access to subspecialty care," said Dr. Jeremy Young, assistant professor of infectious diseases at UIC and a co-principal investigator. "Several studies of HIV-positive patients have shown improved adherence to antiretroviral treatment regimens and superior clinical outcomes when physicians with specialized training in HIV medicine are involved in their care."

Another part of the project will offer case-management services to newly-released HIV-positive inmates to encourage sustained care. The grant will also provide partner notification and counseling and testing for people who are part of the detainees' social networks who may be at risk for infection.

In addition to Cook County Jail and UIC, the research partnership includes the Illinois Department of Corrections, AIDS Foundation of Chicago, South Side Help Center, and the Public Health Institute of Metropolitan Chicago.

Source: University of Illinois

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