This study will provide HIV prevention and related support services to men who have sex with men and transgender women who have substance use disorders and are either leaving jail or recently released from jail. The researchers will compare the utilization of HIV prevention and other support services between individuals who receive routine case management provided following enrollment to those who have access to GeoPassport, a global position service (GPS)-based mobile app, incentives, and peer mentor support.
The investigators will enroll 200 people in jail or within 12 months post-release from incarceration. During the trial, half of participants will be randomized into a control group that will receive usual care consistent with the setting in which they live, along with referrals customized to their needs and preferences to share with a case manager. They will be compared to the other half of participants randomized to the intervention group that, in addition to receiving customized referral sources, will also receive the GeoPassport App, incentives, and the support of a trained Peer Mentor for six months. The GeoPassport App will provide participants with tools for tracking goals and progress toward meeting them, assistance in locating services, appointment and medication reminders, opportunities to provide feedback on service providers, and built-in tracking and distribution of rewards (incentives) for service utilization. GeoPassport will assist Peer Mentors in monitoring participants' service utilization. The Peer Mentors will provide encouragement, role modeling, accompaniment to appointments, and assistance with goal setting, problem-solving, and reducing logistical and psychosocial barriers to service engagement. The intervention can be delivered in person or remotely in order to comply with necessary social distancing during the COVID-19 pandemic. Participants in both groups will be followed to assess whether those offered the intervention are more likely to meet the specific prevention targets described in the Specific Aims. The intervention lasts 6 months from the start of participation. Participants are interviewed at 3, 6, and 9 months from the same point as the intervention.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
233
Access to the newly developed GeoPassport App, incentives for accessing identified services, and a trained Peer Mentor.
Participants in the control arm will continue to receive services they would normally receive consistent with the setting in which they were recruited. This includes substance use treatment in jail, substance use treatment at a residential recovery facility, and/or supportive housing services. The study will provide referrals customized to their needs and preferences.
God's Property
Los Angeles, California, United States
Los Angeles County Men's Central Jail
Los Angeles, California, United States
Los Angeles Center for Alcohol and Drug Abuse
Santa Fe Springs, California, United States
Number of Participants Establishing a Primary Care Provider Who Can Prescribe PrEP (Pre-exposure Prophylaxis)
Defined as the participant identifying and completing an appointment with a primary care provider who is willing and able to prescribe HIV pre-exposure prophylaxis.
Time frame: 9 months
Number of Participants Who Initiate PrEP Regimen
Defined as the participant obtaining a prescription for PrEP, providing documentation, reporting taking the medication
Time frame: 9 months
Number of Participants Who Demonstrate Minimal Adherence to PrEP
Defined as the participant self-reporting taking prescribed PrEP at least 4 days per week at first instance of reporting taking PrEP
Time frame: 3, 6, or 9 months
Number of Participants Who Remain on PrEP for at Least 3 Months.
The outcomes is defined by self-reported PrEP use for 3 or more months
Time frame: 9 months
Number of Participants Who Report an HIV Test Within 3 Months of a Follow-up
Defined as the participant self-reporting having obtained HIV testing within 3 months of the follow-up
Time frame: 3, 6, and 9 months
Number of Participants Who Undergo a Test for Gonorrhea, Syphilis, and Chlamydia Within 6 Months of a Follow-up
Defined by the participant self-reporting having obtained testing for these sexually transmitted diseases (STDs) within the 6 months prior to a follow-up over the 9 month follow-up period
Time frame: 6 and 9 months
Number of Participants Who Undergo a Test for Hepatitis C
Defined by the participant self-reporting having obtained at least one test for Hepatitis C
Time frame: 9 months
Number of Participants Obtaining Treatment for Substance Use Disorders (SUDs) in the Community
Defined by the participant self-report of completing SUD appointments within the 3 months following enrollment
Time frame: 3 months
Number of Participants Who Remain Engaged in Treatment for Substance Use Disorders (SUDs) in the Community,
Defined by the participant self-reporting remaining engaged in treatment (i.e., continuing to attend meetings, counseling or other treatment activities) in the 3 months prior to the final follow-up interview.
Time frame: 9 months
Number of Participants in Each Arm Receiving Care and Treatment for Newly Diagnosed HIV or HCV Infections.
Self-report of whether or not participants received follow-up care and treatment for HIV or hepatitis C infections diagnosed during study follow-up (n=200)
Time frame: 3, 6, or 9 months
Number of Participants Who Recidivate
Measure the comparative effectiveness of each intervention arm on reducing recidivism (n=200), quantified as the number of respondents who are reincarcerated.
Time frame: 9 months
Number of Reincarcerations Among Those Who Recidivate
Measure the comparative effectiveness of the intervention reducing recidivism (n=200), quantified as total number of reincarcerations over the study period among those who recidivate.
Time frame: 9 months
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