prevention support for people leaving jail

Conditions: HIV Infections; Sexually Transmitted Diseases, Bacterial; Hepatitis C; Substance Use Disorders

Summary: this study will provide hiv prevention and related support services to men who have sex with men and transgender women who have substance use disorders and are either leaving jail or recently released from jail. the researchers will compare the utilization of hiv prevention and other support services between individuals who receive routine case management provided following enrollment to those who have access to geopassport, a global position service (gps)-based mobile app, incentives, and peer mentor support.

the investigators will enroll 200 people in jail or within 12 months post-release from incarceration. during the trial, half of participants will be randomized into a control group that will receive usual care consistent with the setting in which they live, along with referrals customized to their needs and preferences to share with a case manager. they will be compared to the other half of participants randomized to the intervention group that, in addition to receiving customized referral sources, will also receive the geopassport app, incentives, and the support of a trained peer mentor for six months. the geopassport app will provide participants with tools for tracking goals and progress toward meeting them, assistance in locating services, appointment and medication reminders, opportunities to provide feedback on service providers, and built-in tracking and distribution of rewards (incentives) for service utilization. geopassport will assist peer mentors in monitoring participants' service utilization. the peer mentors will provide encouragement, role modeling, accompaniment to appointments, and assistance with goal setting, problem-solving, and reducing logistical and psychosocial barriers to service engagement. the intervention can be delivered in person or remotely in order to comply with necessary social distancing during the covid-19 pandemic. participants in both groups will be followed to assess whether those offered the intervention are more likely to meet the specific prevention targets described in the specific aims. the intervention lasts 6 months from the start of participation. participants are interviewed at 3, 6, and 9 months from the same point as the intervention.

Eligibility criteria:
inclusion criteria: 1. housed in k6g unit or within 12 months post-release from incarceration 2. ages 18-49 years 3. screens positive for substance use disorder (sud), or has sought or received sud treatment at any time starting 12 months before the most recent incarceration until the present day. 4. reports sexual intercourse with a male or a male-to-female transgender woman in the six months prior to jail entry 5. if recruited in jail, is likely to be remain either in custody for at least four more days, but less than three more months based on scheduled court dates, current sentence, treatment plan, etc. 6. has not received an hiv diagnosis (based on self-report) 7. plans to reside in los angeles county for the 12 months following enrollment exclusion criteria: 1. does not have a smartphone and is not willing to obtain one post-release, 2. is not able to speak and understand english, and 3. does not have sufficient reading skills to operate a mobile app

Keywords: hiv prevention and testing sexually transmitted disease (std) prevention and testing hiv pre-exposure prophylaxis (prep) incarceration