|Rhode Island A Model for HIV/AIDS Testing and Treatment in Prisons Nationwide|
|By Tracey E. Zeckhausen , Chief of Information & Public Relations Rhode Island Department of Corrections|
O v e r the past 20 years, as prison populations have skyrocketed due to society’s failure to adequately treat addiction and mental illness in the community, a tremendous opportunity has been presented to researchers and physicians to improve public health. In Rhode Island, Brown researchers, the Miriam Hospital, the Center for Prisoner Health and Human Rights, and the RIDOC have capitalized on this opportunity. “It is a tremendous testimony to what we have achieved,” says Josiah Rich, M.D., “that three of the 12 newlyawarded National Institute of Health grants aimed at improving HIV prevention and treatment of prison and jail inmates have been awarded to The Miriam Hospital for this collaborative work.” Rich calls the grants, “the first major push by the NIH to study HIV in the corrections setting.”
The awards are part of Seek, Test, and Treat: Addressing HIV in the Criminal Justice System – the NIH’s largest initiative to date to aggressively identify and treat HIV-positive inmates, parolees, and probationers and help them continue care when they return to their home communities. There are currently approximately 1.1 million people in the U.S. who are infected with HIV. Approximately 56,000 new infections are reported annually. An estimated one in seven people infected with HIV annually passes through a correctional facility (prison or jail) suggesting that there is a disproportionate number of HIV-positive people in the criminal justice system.
The grants will fund three projects:
A randomized controlled trial and cohort study of HIV testing: Clearly there is a link between incarcerated individuals and HIV, but less is known about HIV high risk behaviors for those on probation and parole. In this case study, probationers and parolees from Providence and Baltimore, Md., will randomly receive HIV testing either at the Probation/ Parole Office or rapid HIV testing at a community center. In a separate cohort study, all individuals with HIV identified at Community Corrections will be offered enrollment into a 1-year intervention study to help improve the connection to HIV care. Dr. Rich is co-principal investigator of this study.
Improving Linkages to HIV Care Following Release from Incarceration: Led by Rich and co-principal investigator Liza Solomon, Ph.D. from ABT Associates, will focus on improving the link between HIV-positive inmates and HIV care following release from incarceration. The new Ryan White HIV/AIDS Program data set will be linked to corrections release data and then applied across many states, correctional jurisdictions and care environments. The goal is to better understand the elements influencing an inmate’s linkage to HIV care in the community in order to improve systems and future interventions.
CARE Corrections: Technology for Jail HIV/HCV Testing, Linkage and Care: Jails and correctional facilities provide a unique opportunity to offer HIV testing and treatment to a high-risk population. Since length of stay is often very short, however, HIV screening and intervention need to be conducted both efficiently and costeffectively. In this study, co-principal investigator Curt Beckwith, M.D., an infectious disease specialist at The Miriam Hospital, and colleagues at George Washington University and New York University will modify two interactive health communications tools, known as CARE and CARE+, which provide counseling and consent for rapid HIV testing in both clinical community settings, for use within jails and prisons. The newly adapted tools will include additional content relevant and specific to inmates, including hepatitis C (HCV) infection and maintaining HIV treatment in the community following release, as well as text messaging capabilities. As part of the study, researchers will assess the feasibility and accessibility of these new tools among jail detainees in Rhode Island and Washington, DC, and will analyze their costeffectiveness.
The grants were primarily awarded by the National Institute on Drug Abuse (NIDA), with additional support for Beckwith’s study provided by the National Institute of Allergy and Infectious Diseases (NIAID).
“The Miriam Hospital and our partners are proud to lend our collective expertise to this important initiative. Having the support of the NIH will go a long way toward our shared goal of improving HIV care and treatment in correctional facilities and ensuring HIV interventions continue after individuals are released from prison,” says Timothy Flanigan, M.D., Director of Infectious Diseases at Rhode Island and The Miriam Hospitals.
Flanigan, Rich and Beckwith are also on the faculty of The Warren Alpert Medical School of Brown University
Editor's note: Reprinted with permission from the RI Department of Corrections.
Other articles by Zeckhausen
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