The grants will be distributed over a five-year period to 12 research teams, which will conduct studies in locations that include the Los Angeles County Jail; the jail system in Cook County, Illinois; Rikers Island in New York; prisons in North Carolina, Illinois, Texas, Wisconsin and Rhode Island; and jails in the District of Columbia.
“These important and wide reaching research grants will focus on identifying individuals with HIV within the criminal justice system and linking them to highly active antiretroviral therapy (HAART) during periods of incarceration and after community re-entry,” stated NIDA Director Dr. Nora D. Volkow. “We hope this effort will lead to decreased HIV/AIDS-related illness and death among those in the criminal justice system, as well as decrease HIV transmission in the community at-large, making an important impact on public health.”
Illinois will receive $7 million in grants. Researchers from the University of Illinois at Chicago will focus on prisoners in the Cook County Jail and more than two dozen state prisons.
The researchers plan three phases. The first will allocate money to implement HIV testing for all prisoners upon their entry into the prison system, unless they refuse. That policy change conforms to recommended guidelines from the Centers for Disease Control and Prevention, and will hopefully reduce the number of prisoners who are unaware of their HIV status.
Researchers will also examine whether linking prisoners to HIV care via telemedicine results in better treatment. “Prisoners have typically been managed by prison physicians who are generalists, not sub-specialists, so they don’t really have access to specialist care,” said Dr. Jeremy Young, one of the lead researchers. Telemedicine will connect prisoners with medical specialists and save the cost of having doctors drive across the state to see HIV+ prisoners.
While telemedicine may be better than no medical treatment, it should be noted that patients in the freeworld, under the community standard of care, see doctors in person and not via long-distance telemedicine video.
The third part of the NIDA-funded project in Illinois will track HIV+ prisoners after they are released. “In the past, prisoners have gotten two weeks of meds and an appointment [for follow-up care] in the city,” said Dr. Young. “The problem is, when prisoners go out into the community, many of them start taking drugs and hanging out with old friends, and they don’t show up for appointments and get lost in the follow-up.”
Additional case managers will be hired with the NIDA grant; they will contact newly-released prisoners and connect them with mental health services, drug counseling and the state’s AIDS Drug Assistance Program.
Researchers at the University of North Carolina will use the grant funding to study whether prisoners contract HIV while incarcerated or if they mainly enter the prison system with pre-existing infections. “I think HIV spreading in prison is so blown out of proportion,” stated UNC School of Medicine professor David Wohl.
It is estimated that one in seven people who are HIV+ passes through the criminal justice system each year, which presents an opportunity for interdiction and treatment. Approximately 2 percent of prisoners have HIV – which is around six times higher than the infection rate in the general population. [See: PLN, July 2010, pp.28, 43].
Sources: Sun Times, www.nih.gov, www.dailytarheel.com
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