People who leave prison with HIV and a substance use disorder (SUD) have the dual risks of relapse 14,6,50 and poor antiretroviral therapy (ART) medication adherence.4 These risks are exacerbated by the stress associated with community re-entry from prison.6, 67 The goal of the proposed research training grant is to test a hatha yoga intervention's (HYI) impact on the health outcomes of 72 people recently released from prison with HIV and SUD. Participants will be randomized to either treatment as usual (TAU) comprised of case management services, or HYI comprised of 12-weekly 90-minute hatha yoga classes in addition to case management services. The proposed mixed methods study will examine 1) the effects of HYI on stress, substance use, ART adherence, viral load and coping self-efficacy as compared with TAU;and 2) participants'perspectives regarding their stress responses and how these stress responses are affected by treatment assignment to HYI or TAU, as assessed through 30 semi-structured qualitative interviews. Findings will inform the development of interventions for people with HIV and SUD experiencing re-entry to the community from prison. The proposed randomized controlled trial will be accomplished through extensive quantitative and qualitative training provided by classwork and research seminars at the University of Pennsylvania, and mentorship from sponsor Dr. Jim McKay and co-sponsor Dr. Malitta Engstrom.

Public Health Relevance

The proposed study will impact people with HIV and a substance use disorder who are re-entering the community from prison, a population with increased risk of high viral burden, and therefore an increased risk of infectiousness and drug resistance.4 Looking at the effects of a Hatha yoga intervention (HYI) on stress, substance use, antiretroviral therapy medication adherence, viral load and coping self-efficacy will inform knowledge of interventions that improve health outcomes for this population.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Predoctoral Individual National Research Service Award (F31)
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Special Emphasis Panel (ZRG1)
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Aklin, Will
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University of Pennsylvania
Schools of Social Welfare/Work
United States
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Wimberly, Alexandra S; Hyatt, Jordan M; McKay, James R (2018) Effect of continuing care for people with cocaine dependence on criminal justice sentences. Behav Sci Law 36:116-129
Wimberly, Alexandra S; Engstrom, Malitta (2018) Stress, Substance Use, and Yoga in the Context of Community Reentry Following Incarceration. J Correct Health Care 24:96-103
Wimberly, Alexandra S; Engstrom, Malitta; Layde, Molly et al. (2018) A randomized trial of yoga for stress and substance use among people living with HIV in reentry. J Subst Abuse Treat 94:97-104
Wimberly, Alexandra S; Stern, Max R; Rosenbach, Sarah B et al. (2017) Challenges to Practicing HIV Sex-Risk Prevention Among People in Continuing Care for Cocaine Addiction. Subst Use Misuse 52:614-623
Wimberly, Alexandra S; Ivey, Megan; Rennert, Lior et al. (2017) Effect of Continuing Care for Cocaine Dependence on HIV Sex-Risk Behaviors. AIDS Behav 21:1082-1090