This application is a request for a Mentored Patient-Oriented Research Career Development Award (K23) to prepare Dr. Jennifer Mitty to design and implement studies to increase medication adherence and provide secondary prevention to HIV(+) individuals being released from the correctional setting. Dr. Mitty is an Assistant Professor of Medicine at Brown Medical School. The clinical research training environments at the Miriam Hospital and Brown Medical School are ideal for a K23 because of their extensive experience in prevention, directly observed therapy for HIV(+) patients and their work within corrections as well as following individuals being released from prison. The primary mentor for this award is Timothy Flanigan, MD, who has extensive experience in substance abuse, prevention and observed therapy research, and is involved in many research projects with HIV(+) individuals leaving prison. Dr Mitty will also have the full support of a strong mentorship team including Dr. Kenneth Mayer who is a leader in the field of H1V prevention, Dr. Kathleen Morrow whose expertise is in behavioral prevention and qualitative research, and Dr. Rick Altice who will serve as an off-site mentor and has an expertise in medication adherence, directly observed therapy, substance use and incarcerated populations. Drs Macalino and Hogan will be involved in study design, instrument development and analysis. HIV(+) persons leaving prison on highly active antiretroviral therapy are at increased risk of medication non-adherence and increased plasma viral load. In addition, our site and others have documented an increase in HIV risk behaviors after release from prison. Through this project a combined modified directly observed therapy and secondary prevention intervention will be developed for HIV(+) individuals leaving prison. Phase I of this study will use quantitative and qualitative techniques to evaluate facilitators and barriers to the intervention. During Phase II, a pilot intervention will be developed, modeled on existing DOT and secondary prevention programs. In phase III, this intervention will be piloted on 50 HIV(+) individuals transitioning to the community after release from the Adult Correctional Institution in Rhode Island. Acceptability and feasibility of the intervention will be evaluated, as well as efficacy of the intervention on plasma viral load suppression and self-reported HIV-risk behaviors during the first 6 months post release.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DA017622-02
Application #
6891278
Study Section
Special Emphasis Panel (ZDA1-EXL-T (21))
Program Officer
Mcnamara-Spitznas, Cecilia M
Project Start
2004-05-01
Project End
2009-04-30
Budget Start
2005-05-01
Budget End
2006-04-30
Support Year
2
Fiscal Year
2005
Total Cost
$154,796
Indirect Cost
Name
Miriam Hospital
Department
Type
DUNS #
063902704
City
Providence
State
RI
Country
United States
Zip Code
02906
Beckwith, Curt G; DeLong, Allison K; Desjardins, Simon F et al. (2009) HIV infection in refugees: a case-control analysis of refugees in Rhode Island. Int J Infect Dis 13:186-92
Mitty, Jennifer A; Bazerman, Lauri B; Selwyn, Kyra et al. (2008) Decrease in the proportion of injecting drug use-related HIV/AIDS in Massachusetts, New York, Connecticut, and Rhode Island. AIDS Read 18:596-600
Macalino, Grace E; Hogan, Joseph W; Mitty, Jennifer A et al. (2007) A randomized clinical trial of community-based directly observed therapy as an adherence intervention for HAART among substance users. AIDS 21:1473-7
McKenzie, Michelle; Rich, Josiah D (2007) Heroin in the corrections system: introduction. Med Health R I 90:140-1
Ciambrone, Desiree; Loewenthal, Helen G; Bazerman, Lauri B et al. (2006) Adherence among women with HIV infection in Puerto Rico: the potential use of modified directly observed therapy (MDOT) among pregnant and postpartum women. Women Health 44:61-77
Flanigan, Timothy P; Mitty, Jennifer A (2006) The good, the bad, and the ugly: providing highly active antiretroviral therapy when it is most difficult. Clin Infect Dis 42:1636-8
Mitty, Jennifer A; Macalino, Grace E; Bazerman, Lauri B et al. (2005) The use of community-based modified directly observed therapy for the treatment of HIV-infected persons. J Acquir Immune Defic Syndr 39:545-50