Mobile-Enhanced Prevention Support for People Leaving Jail
Creators: name: University Of California Office Of The President
Publisher: name: University of California Office of the President
publisherIdentifier: https://ror.org/00dmfq477
publisherIdentifierScheme: ROR
Year: 2024

description: Our proposal will reach a high-risk population at a critical point for increased risk of HIV infection � men who have sex with men (MSM) and transgender women (TG women) who have substance use disorders and are leaving jail. It will test the efficacy of a new GPS-based mobile app (call GeoPassport) for supporting the use of HIV prevention-related services and the added benefit of pairing individuals with Peer Mentors. We hypothesize that both interventions will increase rates of service utilization over more traditional approaches for supporting linkage to services during community reentry. Primary outcomes will include progress along the HIV prevention continuum, including uptake of pre-exposure prophylaxis (PrEP) to prevent HIV. We will enroll 399 people in jail and conduct a trial comparing one group that receives customized referrals and substance abuse-focused case management to two groups that receive the customized referrals in addition to the GeoPassport App. One of these groups will also receive the support of a trained Peer Mentor for six months. The GeoPassport App will provide participants with 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 (PMs) in monitoring participants� service utilization. The Peer Mentors will provide encouragement, role modelling, navigation to appointments, and assistance with goal setting, problem solving, and psychosocial barriers to service engagement. Participants in all intervention arms will be followed to assess which intervention groups are more likely to meet the following goals: 1) establish a primary provider who will prescribe PrEP, 2) obtain a PrEP evaluation, 3) begin PrEP, 4) adhere to PrEP, 5) remain on PrEP for at least 3 months, and obtain screening for the following in the community: 6) HIV (every 3 months), 7) other sexually transmitted diseases (every six months), and 8) hepatitis C (at least once), and obtain recommended treatment for substance use disorders. Outcomes will be assessed at 3, 6, and 12 months following jail release by comparing data from follow-up interviews to baseline. Detailed additional data on patterns of service utilization will be collected via GeoPassport and record abstraction. Our stellar investigative team involves experts in HIV prevention, mobile health interventions, treatment of substance use disorders, peer interventions, and research in MSM, transgender women, and incarcerated populations. This proposal builds on the successes of our National Institute on Drug Abuse-funded LINK LA, CHRP-funded Passport to Wellness, and Health Resources and Services Administration-funded Alexis Project -- all of which involve peer navigation-based interventions. It leverage new Medi-Cal contracts for the Los Angeles Centers for Alcohol and Drug Abuse to provide substance abuse treatment services in the LA County jail�s protected unit for MSM and transgender women. This new funding will transform the substance abuse treatment landscape in California. If funded, the proposal has the potential to move, one step ahead, efforts to reduce HIV risk and negative substance abuse sequelae in populations leaving jail and to reach goals for getting to zero new HIV infections, zero HIV disparities, and zero HIV/AIDS deaths in California.