The University of Massachusetts Amherst and Tufts Medical Center are conducting a study to provide HIV prevention, diagnosis and treatment for people with opioid use disorders who are incarcerated in the Boston area.
The study is funded with a $4.74 million CONNECT grant from the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health (NIH).
Elizabeth Evans, professor of community health education in the UMass Amherst School of Public Health and Health Sciences, and Dr. Alysse Wurcel, a physician and infectious disease consultant for the Massachusetts Sheriffs Association, will collaborate to lead the research.
Many people with opioid use disorder pass through carceral and legal systems. Improved access to high-quality, evidence-based treatment for HIV and other infectious diseases in justice settings is critical to addressing the overdose crisis."
Elizabeth Evans, professor of community health education, UMass Amherst School of Public Health and Health Sciences
Dr. Wurcel adds, "We're trying to increase the number of incarcerated people who are tested and treated. Overall people who are incarcerated are more likely to test positive for HIV than people who are not incarcerated. By the CDC guidelines, anyone in jail is at risk."
Those who test positive should be given treatment and those who test negative should be offered pre-exposure HIV medications to prevent the disease. Treatment and prevention while incarcerated involves taking medication every day, Wurcel says.
"Dr. Wurcel and I are fortunate to lead this study in collaboration with the Massachusetts Department of Public Health and the Suffolk County jail system, where there is unprecedented cross-sector motivation to learn how to improve HIV care for incarcerated people and integrate HIV care into the jails' existing programs," Evans says.
Initial study activities are focused on developing an intervention program called ID-TOUCH. Linnea Evans and Kaitlyn Jaffe, assistant professors of health promotion and policy at UMass Amherst, are co-leading efforts to examine the feasibility and acceptability of the intervention by incarcerated people, staff at the Suffolk jails and other community-based partners.
"HIV testing and medications that prevent HIV (pre-exposure prophylaxis, known as PrEP) are evidence-based and cost-effective, yet are not adequately reaching justice-involved people," Linnea Evans says. "Many are members of minoritized racial/ethnic groups and live in communities disproportionately impacted by HIV and the opioid epidemic. Addressing the health disparities that these service-need gaps exacerbate for socially and economically marginalized groups is a key impetus for our study."
The study will serve as the foundation for future research that may create a model HIV treatment and prevention program for other jurisdictions around the commonwealth and the country.
"Our research will help us better understand how to create equitable access to infectious disease healthcare and treatment for people living in jail settings and returning to the community," Jaffe says. "Along the way, we are involving people with lived and living experience of incarceration and opioid use to ensure that the intervention is matched to the needs of this population."
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