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| Name | Class |
|---|---|
| San Francisco Jail Health Services - HIV and Integrated Services | UNKNOWN |
| San Francisco Pretrial Diversion Project | UNKNOWN |
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Each year, there are over 600 unduplicated HIV-infected persons incarcerated in the San Francisco jail. Two thirds of those released with HIV-focused discharge planning are reincarcerated within one year. More than half of HIV-infected jail inmates are diagnosed with mental health conditions severe enough to require medication and a similar proportion report substance use disorders at the time of detention. While some community-based services exist, there remains a critical need to improve linkages to care and adherence to care plans for HIV-infected adults as they move between community and jail. The Navigator Project is a five-year randomized study that will test the effectiveness of an intensive enhanced case management intervention to reduce sex and drug-related HIV transmission risk; increase HIV medication adherence; reduce drug dependence; and reduce reincarceration.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| FAP counseling | Active Comparator | Control arm utilizing the standard of care: access to services provided by the Forensic AIDS Project for up to 90 days after release |
|
| Navigator enhanced case-management | Experimental | Experimental arm: access to Navigator enhanced case-management services for one year after release |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Navigator enhanced case-management | Behavioral | Patient navigators are non-clinical, paraprofessional peers who are HIV-infected and have lifetime histories of detention and substance abuse. Working with the patient, they facilitate adherence to a comprehensive care plan designed to address clients' multiple risks and needs. Patients have access to Navigator services for one year after study enrollment. |
| Measure | Description | Time Frame |
|---|---|---|
| substance use | change from baseline in self-reported drug and alcohol use, measured by a survey tool, and actual use of five drugs (methamphetamine, cocaine, tetrahydrocannabinol, opiates, and benzodiazepines), measured by a urine screen, at three time points each | 2 months, 6 months, 12 months |
| recidivism | number of times re-detained during the twelve-month study period, collected from jail records | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| sexual risk behavior | change from baseline in self-reported sexual risk behaviors, measured by a survey tool at three time points after the initial detention | 2 months, 6 months, 12 months |
| adherence to HIV medications |
| Measure | Description | Time Frame |
|---|---|---|
| housing | change from baseline in self-reported housing status, measured by a survey tool at three time points after the initial detention | 2 months, 6 months, 12 months |
| medical coverage | change from baseline in self-reported insurance coverage, measured by a survey tool at three time points after the initial detention, and use of community health services and jail health services, measured continuously via a community database for 12 months after the initial detention |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Janet J Myers, PhD, MPH | University of California, San Francisco | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tenderloin Clinical Research Foundation | San Francisco | California | 94102 | United States |
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| ID | Term |
|---|---|
| D019966 | Substance-Related Disorders |
| ID | Term |
|---|---|
| D064419 | Chemically-Induced Disorders |
| D001523 | Mental Disorders |
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| Forensic AIDS Project | Behavioral | The Forensics AIDS Project provides primary care to HIV-infected detainees, as well as up to 90 post-release case-management services which include discharge planning. |
|
change from baseline in self-reported adherence (as a %) to antiretroviral therapy, measured by a survey tool at three time points after the initial detention
| 2 months, 6 months, 12 months |
| 2 months, 6 months,12 months |
| needle use | change from baseline in self-reported needle-use and needle-sharing, measured by a survey tool at three time points after the initial detention | 2 months, 6 months, 12 months |