Candidate: My career goal is to improve the health of people living with HIV through interdisciplinary research aimed at reducing barriers to optimal HIV care for traditionally underserved patient groups. My short term goal is to establish myself as an independent investigator as a tenure-track junior faculty member at the University of Wisconsin-Madison, and to develop an innovative research program in collaboration with state and federal prison systems. Research Project: My proposed research uses an innovative, mixed-methods approach to comprehensively evaluate barriers to accessing continuous HIV care for people who become incarcerated. I propose three distinct aims which will address this question using different types and sources of data, in order to identify which factors causing suboptimal care are the most important and potentially amenable to intervention.
Aim 1 will utilize longitudinal data from the AIDS Linked to the Intravenous Experience (ALIVE) study to examine individual and neighborhood-level factors associated with poor linkage to care following incarceration.
Aim 2 will be an expanded analysis of HIV care outcomes that incorporates retrospectively-collected medical records data from correctional facilities for ALIVE participants who were incarcerated between 1998 and 2011.
Aim 3 will confirm and inform the findings of quantitative phase of the study through semi-structured interviews with patients while they are receiving HIV care in prison, and follow-up interviews within several months after release to the community. Career Development Plan: My proposed training and mentoring activities will center around (1) attaining expertise in analysis of complex longitudinal data;(2) developing competence using qualitative research methods;(3) building partnerships with correctional agencies for HIV research;and (4) deeper understanding of ethical issues surrounding research in correctional settings. My applied research will be closely coordinated with my training activities, and will build toward an application for an R01-funded project in the fourth year of this award. Research Environment: I will be well-supported within the Department of Medicine at UW-Madison. In addition, I will benefit from the excellent research infrastructure of the ALIVE study at Johns Hopkins (Aims 1 &2), and a large, NIDA-funded study of Seek, Test, and Treat Strategies for HIV in the WI Department of Corrections (Aim 3).

Public Health Relevance

People in prison in the U.S. have a higher prevalence of HIV than the general population and may also be more likely to engage in behaviors that place others at risk for HIV when released back to the community. Developing strategies to ensure that incarcerated people continue to receive effective antiretroviral treatment after release may reduce the transmission of HIV in communities and decrease long-term complications of HIV infection.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DA032306-02
Application #
8507700
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Kahana, Shoshana Y
Project Start
2012-07-15
Project End
2017-06-30
Budget Start
2013-07-01
Budget End
2014-06-30
Support Year
2
Fiscal Year
2013
Total Cost
$194,940
Indirect Cost
$14,440
Name
University of Wisconsin Madison
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
161202122
City
Madison
State
WI
Country
United States
Zip Code
53715
Barocas, Joshua A; Brennan, Meghan B; Hull, Shawnika J et al. (2014) Barriers and facilitators of hepatitis C screening among people who inject drugs: a multi-city, mixed-methods study. Harm Reduct J 11:1
Westergaard, Ryan P; Beach, Mary Catherine; Saha, Somnath et al. (2014) Racial/ethnic differences in trust in health care: HIV conspiracy beliefs and vaccine research participation. J Gen Intern Med 29:140-6
Westergaard, Ryan P; Hess, Timothy; Astemborski, Jacquie et al. (2013) Longitudinal changes in engagement in care and viral suppression for HIV-infected injection drug users. AIDS 27:2559-66
Westergaard, Ryan P; Spaulding, Anne C; Flanigan, Timothy P (2013) HIV among persons incarcerated in the USA: a review of evolving concepts in testing, treatment, and linkage to community care. Curr Opin Infect Dis 26:10-6