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 #
5K23DA032306-03
Application #
8677850
Study Section
AIDS Behavioral Research Subcommittee (NIDA)
Program Officer
Jones, Dionne
Project Start
2012-07-15
Project End
2017-06-30
Budget Start
2014-07-01
Budget End
2015-06-30
Support Year
3
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of Wisconsin Madison
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
City
Madison
State
WI
Country
United States
Zip Code
53715
Hochstatter, Karli R; Stockman, Lauren J; Holzmacher, Ryan et al. (2017) The continuum of hepatitis C care for criminal justice involved adults in the DAA era: a retrospective cohort study demonstrating limited treatment uptake and inconsistent linkage to community-based care. Health Justice 5:10
Kemnitz, Rebecca; Kuehl, Theresa C; Hochstatter, Karli R et al. (2017) Manifestations of HIV stigma and their impact on retention in care for people transitioning from prisons to communities. Health Justice 5:7
Hochstatter, Karli R; Hull, Shawnika J; Stockman, Lauren J et al. (2017) Using database linkages to monitor the continuum of care for hepatitis C virus among syringe exchange clients: Experience from a pilot intervention. Int J Drug Policy 42:22-25
Ferro, Enrico G; Culbert, Gabriel J; Wickersham, Jeffrey A et al. (2017) Physician Decisions to Defer Antiretroviral Therapy in Key Populations: Implications for Reducing Human Immunodeficiency Virus Incidence and Mortality in Malaysia. Open Forum Infect Dis 4:ofw219
Linas, Beth S; Genz, Andrew; Westergaard, Ryan P et al. (2016) Ecological Momentary Assessment of Illicit Drug Use Compared to Biological and Self-Reported Methods. JMIR Mhealth Uhealth 4:e27
Golden, Sean K; Harringa, John B; Pickhardt, Perry J et al. (2016) Prospective evaluation of the ability of clinical scoring systems and physician-determined likelihood of appendicitis to obviate the need for CT. Emerg Med J 33:458-64
Petroll, Andrew E; Staden, Rose A; Westergaard, Ryan P (2016) Pre-exposure Prophylaxis in Primary Care--A New Era in HIV Prevention. WMJ 115:6-8
Repplinger, Michael D; Levy, Joseph F; Peethumnongsin, Erica et al. (2016) Systematic review and meta-analysis of the accuracy of MRI to diagnose appendicitis in the general population. J Magn Reson Imaging 43:1346-54
Repplinger, Michael D; Li, Annabel J; Svenson, James E et al. (2016) Emergency Department Patients' Perceptions of Radiation From Medical Imaging. WMJ 115:22-8
Barocas, Joshua A; Linas, Benjamin P; Kim, Arthur Y et al. (2016) Acceptability of Rapid Point-of-Care Hepatitis C Tests Among People Who Inject Drugs and Utilize Syringe-Exchange Programs. Open Forum Infect Dis 3:ofw075

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