Incarceration represents an important opportunity to provide testing and treatment for HIV and other infectious diseases and to deliver prevention education to persons at increased risk of infection or transmission. Incarcerated populations are disproportionately affected by HIV and viral hepatitis, and many inmates may be marginalized from healthcare resources in their communities. Given the short length of jail incarceration, screening and intervention delivery need to be conducted efficiently and cost-effectively. This research will adapt and evaluate information and communication technology-(ICT) based tools used for HIV testing and for improving adherence to HIV treatment, adding rapid hepatitis C virus (HCV) testing and prevention to the delivery of HIV services for jailed populations. These tools will facilitate: 1) HIV and HCV risk assessment, testing, and prevention counseling;2) linkage to community-based care for HIV-infected jail detainees;and 3) viral suppression for jail detainees on antiretrovirals being released to the community. Specifically, this project will adapt CARE (Computer Assessment and Risk-Reduction Education), an HIV prevention counseling and rapid HIV testing developed for use in clinical and community settings, and CARE+, a version of CARE for HIV-infected persons, for use among jailed populations. The new tools, CARE Corrections and CARE+ Corrections, will have content relevant and specific to incarcerated populations including HCV infection, substance use behaviors, and maintenance of HIV treatment with linkage to community care following jail release. This also will include new functionality that will allow for automated text messaging to support linkage to community HIV (CARE+ Corrections 'Call'system). In a two-site randomized controlled trial conducted within the Rhode Island Department of Corrections jail and the Washington DC jail system, we will evaluate: 1) whether CARE Corrections delivered counseling is more effective than staff delivered counseling in decreasing HIV and HCV transmission behaviors among n=840 HIV-negative persons released from jail;2) whether CARE+ Corrections Call is more effective than standard jail discharge planning services with respect to linking n=320 HIV-infected jail detainees to community based HIV care and achieving or maintaining HIV viral suppression following community re-entry;and 3) the cost-effectiveness of using CARE and CARE + Corrections Call within jail facilities compared to traditional services. This innovative approach will expand testing, prevention, and treatment in jails and address the essential components of the Seek, Test, and Treat strategy. In addition, this research will complement a major initiative underway in Washington DC (HPTN 065 Testing and Linkage to Care-Plus) by focusing on the jail system. This project has the potential to result in the creation of effective ICT tools that can be easily disseminated to a broad array of correctional facilities in order to facilitate the implementation of the Seek, Test, and Treat strategy in the incarcerated setting.

Public Health Relevance

This research will adapt and evaluate technology-based tools to facilitate rapid HIV and hepatitis C testing, primary and secondary prevention counseling, and adherence to HIV treatment for jailed populations in Providence RI and Washington DC. This innovative research will use computerized counseling and tailored text messaging to expand testing, prevention, and treatment in both low- and high-HIV prevalence jail settings, addressing essential components of the Seek, Test, and Treat strategy among criminal justice populations. This research has the potential to result in the creation of effective technology-based tools that can be readily disseminated to a broad array of correctional facilities across the U.S in order to facilitate efficient identification, treatment, and linkage to care for HIV-infected persons.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1-AARR-K (50))
Program Officer
Kahana, Shoshana Y
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Miriam Hospital
United States
Zip Code
Yellin, Hannah; Beckwith, Curt; Kurth, Ann et al. (2018) Syndemic effect of mental illness and substance use on viral suppression among recently-incarcerated, HIV-infected individuals in the CARE+ Corrections study. AIDS Care 30:1252-1256
Chandler, Redonna; Gordon, Michael S; Kruszka, Bridget et al. (2017) Cohort profile: seek, test, treat and retain United States criminal justice cohort. Subst Abuse Treat Prev Policy 12:24
Beckwith, Curt; Castonguay, Breana Uhrig; Trezza, Claudia et al. (2017) Gender Differences in HIV Care among Criminal Justice-Involved Persons: Baseline Data from the CARE+ Corrections Study. PLoS One 12:e0169078
Nance, Robin M; Delaney, J A Chris; Golin, Carol E et al. (2017) Co-calibration of two self-reported measures of adherence to antiretroviral therapy. AIDS Care 29:464-468
Christopoulos, Katerina A; Cunningham, William E; Beckwith, Curt G et al. (2017) Lessons Learned From the Implementation of Seek, Test, Treat, Retain Interventions Using Mobile Phones and Text Messaging to Improve Engagement in HIV Care for Vulnerable Populations in the United States. AIDS Behav 21:3182-3193
Zaller, Nickolas D; Patry, Emily J; Bazerman, Lauri B et al. (2016) A Pilot Study of Rapid Hepatitis C Testing in Probation and Parole Populations in Rhode Island. J Health Care Poor Underserved 27:214-23
Beckwith, Curt G; Kurth, Ann E; Bazerman, Lauri B et al. (2016) A pilot study of rapid hepatitis C virus testing in the Rhode Island Department of Corrections. J Public Health (Oxf) 38:130-7
Peterson, James; Cota, Michelle; Gray, Holly et al. (2015) Technology use in linking criminal justice reentrants to HIV care in the community: a qualitative formative research study. J Health Commun 20:245-51
Solomon, Liza; Montague, Brian T; Beckwith, Curt G et al. (2014) Survey finds that many prisons and jails have room to improve HIV testing and coordination of postrelease treatment. Health Aff (Millwood) 33:434-42
Beckwith, Curt G; Larney, Sarah; Flanigan, Timothy P (2014) Editorial commentary: Hepatitis C virus testing and drug use in north america; is there more than meets the eye? Clin Infect Dis 58:762-4

Showing the most recent 10 out of 13 publications