People living with HIV/AIDS (PLWHA) do not engage in or discontinue care soon after prison-release, often in the context of competing needs. Despite HIV prevalence among women in criminal justice settings (CJS) being several-fold higher than among men, their HIV treatment outcomes have not been empirically examined nor have they been targeted for secondary prevention interventions. A particular gap exists for HIV-infected women under community supervision (e.g. probation, parole) whose competing stresses often include ongoing interpersonal violence, managing family responsibilities and navigating complex systems of care and supervision. To address these critical gaps, the first project is a secondary analysis of longitudinal data from 1250 released jail detainees with HIV (250 are women) enrolled in the Enhancing Linkages to HIV Primary Care and Services in Jail Settings Initiative, a HRSA-funded Special Project of National Significance. The analysis focuses on gender differences in this cohort, exploring the central hypothesis that, particularly for women with HIV leaving jail, the major barriers to persistent HIV care, antiretroviral adherence, and viral suppression are depression, active substance use, and intimate partner violence. Building on these findings, the second project employs mixed methods to adapt and pilot test the Holistic Health Recovery Program (HHRP), a CDC evidence-based intervention that will serve as a framework to optimize HIV treatment outcomes for women under community correctional supervision. The candidate, Dr.
J aimi e Meyer, is uniquely poised to perform this work because of her background as a medical anthropologist and HIV physician and her prolonged engagement with women with HIV in prison. She recently completed her clinical fellowship in Infectious Diseases and is currently a post-doctoral research fellow at the Center for Interdisciplinary Research on AIDS at Yale. Her long-term career goals and professional objectives are to: 1) Develop expertise in research methods necessary to design, perform, and evaluate clinical trials relating to HIV treatment outcomes among women in the CJS; 2) Gain experience in intervention development, adaptation, testing, implementation, and dissemination that will address gender-specific barriers to optimized HIV treatment outcomes; and 3) Develop an independent career path in patient-oriented research focused on the interface between HIV, women's health, and substance abuse. To achieve these goals and successfully transition from clinician to an independently funded physician-scholar, she has assembled a stellar interdisciplinary mentoring team with expertise in HIV, women's health, substance abuse, CJS, epidemiology and intervention development. Under their guidance, she will complete relevant didactic coursework, culminating in a Master degree with advanced training in statistics and epidemiology. Her successful career trajectory as independent clinical researcher in HIV, women's health in the CJS, and substance abuse is further fostered by the resource-rich environment available to her at Yale University.

Public Health Relevance

Despite HIV prevalence among women in criminal justice settings being several-fold higher than among men, their HIV treatment outcomes have not been empirically examined nor have they been targeted for secondary prevention interventions. A particular gap exists for women with HIV under community supervision (e.g., probation, parole) whose competing stresses often include intimate partner violence, mental illness, substance abuse, and navigating complex systems of care and supervision. The goal of this research is to inform, adapt and test an intervention that will improve HIV treatment outcomes for community-based women who interface with the criminal justice system, either after release from jail or during community supervision.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DA033858-04
Application #
8879086
Study Section
Training and Career Development Subcommittee (NIDA)
Program Officer
Jones, Dionne
Project Start
2012-07-01
Project End
2016-06-30
Budget Start
2015-07-01
Budget End
2016-06-30
Support Year
4
Fiscal Year
2015
Total Cost
Indirect Cost
Name
Yale University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
043207562
City
New Haven
State
CT
Country
United States
Zip Code
Peasant, Courtney; Sullivan, Tami P; Ritchwood, Tiarney D et al. (2018) Words can hurt: The effects of physical and psychological partner violence on condom negotiation and condom use among young women. Women Health 58:483-497
Odio, Camila D; Carroll, Megan; Glass, Susan et al. (2018) Evaluating concurrent validity of criminal justice and clinical assessments among women on probation. Health Justice 6:7
Azbel, Lyuba; Wegman, Martin P; Polonsky, Maxim et al. (2018) Drug injection within prison in Kyrgyzstan: elevated HIV risk and implications for scaling up opioid agonist treatments. Int J Prison Health 14:175-187
Loeliger, Kelsey B; Altice, Frederick L; Ciarleglio, Maria M et al. (2018) All-cause mortality among people with HIV released from an integrated system of jails and prisons in Connecticut, USA, 2007-14: a retrospective observational cohort study. Lancet HIV 5:e617-e628
Brinkley-Rubinstein, Lauren; Dauria, Emily; Tolou-Shams, Marina et al. (2018) The Path to Implementation of HIV Pre-exposure Prophylaxis for People Involved in Criminal Justice Systems. Curr HIV/AIDS Rep 15:93-95
Rutledge, Ronnye; Madden, Lynn; Ogbuagu, Onyema et al. (2018) HIV Risk perception and eligibility for pre-exposure prophylaxis in women involved in the criminal justice system. AIDS Care 30:1282-1289
Loeliger, Kelsey B; Altice, Frederick L; Desai, Mayur M et al. (2018) Predictors of linkage to HIV care and viral suppression after release from jails and prisons: a retrospective cohort study. Lancet HIV 5:e96-e106
Bernardo, Raffaele; Streiter, Shoshana; Tiberio, Perry et al. (2017) Answer to December 2017 Photo Quiz. J Clin Microbiol 55:3568
Hoff, Emily; Marcus, Ruthanne; Bojko, Martha J et al. (2017) The effects of opioid-agonist treatments on HIV risk and social stability: A mixed methods study of women with opioid use disorder in Ukraine. J Subst Abuse Treat 83:36-44
Vazquez Guillamet, Laia Jimena; Malinis, Maricar F; Meyer, Jaimie P (2017) Emerging role of Actinomyces meyeri in brain abscesses: A case report and literature review. IDCases 10:26-29

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