Project Details
Description
Abstract
The period following release from incarceration is associated with increased risk for HIV and STI acquisition
and transmission and fatal drug overdose. Implementation of effective programs for linkage to pre-exposure
prophylaxis (PrEP) for HIV, screening for HIV/STIs/ hepatitis C virus (HCV), and rapid SUD treatment and
harm-reduction services in reentry populations is needed to counteract these harms. Scale up of such
programs may help to address racial/ethnic disparities in these outcomes given the overrepresentation of Black
and Latino people, sexual and gender minority people, and people who inject drugs in jails and prisons. The
proposed research Hub will study the implementation of a demonstrated-effective, 6-month intervention
designed to increase PrEP use and HIV/STI/HCV testing following reentry, in three high-priority California
counties. The Mobile Enhanced Prevention Support or MEPS intervention combines evidence-based
strategies, including Peer Mentors, cash incentives, and a mobile application for facilitating access, goal
tracking, and receipt of incentives. In the first (R61) phase of the project, we will adapt the MEPS
implementation to practical realities of new agencies in new areas. In the second (R33) phase, we will conduct
a Type 3 Hybrid Implementation-Effectiveness study using a stepped-wedge design to evaluate the adapted
MEPS intervention in Riverside, San Bernardino, and Alameda counties. Our academic-community partnership
will also provide infrastructure for robust stakeholder engagement and support of pilot studies related to
prevention during reentry. Our Study Aims are to: 1) Pilot the following aspects of the MEPS trial in one county:
participant recruitment and enrollment; baseline needs assessment and client-centered planning sessions;
retention and follow-up assessments; specimen collection for PrEP adherence monitoring; and peer mentor
identification and training for the full intervention. 2a). Formalize partnerships with community agencies in each
county and plans and adaptations for implementation of MEPS and the trial in their sites. 2b). Develop a set of
common core measures with community and justice system partners and other components of the NIDA
HIV/Justice Research Network. 3) Conduct a Type 3 Hybrid Effectiveness Trial, implementing the adapted
MEPS intervention in the 3 counties, with 300 participants. Use the RE-AIM framework and Proctor's
Implementation Science outcomes with a subset of participants, agency staff, and stakeholders to examine
MEPS' implementation and a step-wedge trial design to assess intervention effectiveness for increasing PrEP
uptake and adherence (self-reported and Tenofovir levels in hair), HIV testing, and SUD service utilization. 4)
Create and deploy a website as a Community Commons, with integrated research and communications utilities
designed to meet the study coordination, community engagement, and implementation needs of Hub partners
in Aims 1-3; disseminate findings related to MEPS intervention scale-up and other Hub activities, (e.g., pilot
studies); and support the sustainability and breadth of intervention adoption and knowledge production.
Status | Active |
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Effective start/end date | 05/15/24 → 04/30/25 |
Funding
- National Institute on Drug Abuse: $814,282.00
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