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Hybrid implementation-effectiveness study to optimize HIV testing and PrEP in a southern jail (HOTSPOT)

Award Number: R01MH129185
ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 04/05/2022
PERIOD OF PERFORMANCE END DATE: 01/31/2027
AWARD TERMINATION DATE: 04/24/2025

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Hybrid implementation-effectiveness study to optimize HIV testing and PrEP in a southern jail (HOTSPOT) - Modified Project Summary/Abstract Section Over half of all new HIV infections in the US in 2017 occurred in 48 high-incidence counties and rural states known as HIV “hotspots”, indicating a need to intensify HIV prevention efforts in these regions. Preexposure prophylaxis (PrEP) can reduce new HIV infections by 99%, but PrEP use is limited in hotspots in the South where HIV incidence is highest. The carceral system is a prime location to engage persons in PrEP, as many people who pass through jails and prisons have risk factors for acquiring HIV. Implementing PrEP in jails, where people at risk are often temporarily detained, can have a high public health impact given rapid turnover back to the community. Because virtually no jails in the South offer PrEP due to resource constraints and competing priorities, there is a critical need for strategies to implement PrEP in this setting. Our central hypothesis is that a rigorously-developed PrEP implementation strategy can improve linkage to community PrEP care for persons released from southern jails. The objective of this proposal is to develop, implement and evaluate a multicomponent PrEP implementation strategy for the Dallas County Jail, the 8th largest jail in the nation and located in an HIV hotspot. We will leverage our robust partnerships with stakeholders in the jail, public health department, and community as we follow a well-established EPIS (exploration, preparation, implementation, sustainment) framework. The implementation strategy will include locally-adapted, evidence-based tools for identifying candidates for PrEP, engaging them in shared decision-making about PrEP, and navigating them to PrEP care at community reentry. We will rigorously evaluate our implementation strategy using a type 3 effectiveness-implementation hybrid study, which prioritizes implementation outcomes while also collecting clinical outcomes. Our specific aims are to: 1) Assess facilitators and impediments to PrEP evaluations in jail and linkage to PrEP at jail release; 2) Refine a multicomponent PrEP implementation strategy for the Dallas County Jail; and 3) Implement and evaluate the PrEP implementation strategy. We will use mixed-methods to evaluate implementation processes (feasibility, acceptability, penetration and sustainment) and clinical outcomes for PrEP evaluations and linkage, and an interrupted time series to measure changes in HIV/STI testing and diagnoses. Our study team includes experts in HIV, PrEP, implementation science, qualitative research, and clinical care for incarcerated populations. This project is significant in its potential to impact HIV incidence in a highly affected population in an HIV hotspot. The work is innovative in using implementation science to improve PrEP for incarcerated populations and is directly responsive to NOT-MH-20-024, “Implementation Science to Advance the United States HIV Prevention and Treatment Goals.” Our strategy is scalable and with guidance from Dissemination Consultants, can serve as a model for future public health initiatives in other carceral settings, directing PrEP in a patient-centered manner to those most likely to benefit in order to maximize impact on HIV incidence.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $659,566 )
2026	2026	THE UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER	5323 HARRY HINES BLVD	DALLAS	TX	75390	DALLAS	USA	Mental Health Research Grants	000	5	2/12/2026	NON-COMPETING CONTINUATION	$659,566
														Subtotal = $659,566

Issue Date FY: 2025 ( Subtotal = $562,838 )
2025	2025	THE UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER	5323 HARRY HINES BLVD	DALLAS	TX	75390	DALLAS	USA	Mental Health Research Grants	000	4	2/14/2025	NON-COMPETING CONTINUATION	$562,838
2025	2025	THE UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER	5323 HARRY HINES BLVD	DALLAS	TX	75390	DALLAS	USA	Mental Health Research Grants	002	4	4/23/2025	NON-COMPETING CONTINUATION	$0
2025	2024	THE UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER	5323 HARRY HINES BLVD	DALLAS	TX	75390	DALLAS	USA	Mental Health Research Grants	001	3	4/23/2025	TERMINATION	$0
														Subtotal = $562,838

Issue Date FY: 2024 ( Subtotal = $812,614 )
2024	2024	THE UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER	5323 HARRY HINES BLVD	DALLAS	TX	75390	DALLAS	USA	Mental Health Research Grants	002	3	8/12/2024	NON-COMPETING CONTINUATION	$66,379
2024	2024	UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER, THE	5323 HARRY HINES BLVD	DALLAS	TX	75390	DALLAS	USA	Mental Health Research Grants	000	3	1/11/2024	NON-COMPETING CONTINUATION	$597,405
2024	2024	THE UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER	5323 HARRY HINES BLVD	DALLAS	TX	75390	DALLAS	USA	Mental Health Research Grants	001	3	4/18/2024	SUPPLEMENT FOR EXPANSION	$148,830
														Subtotal = $812,614

Issue Date FY: 2023 ( Subtotal = $561,913 )
2023	2023	UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER, THE	5323 HARRY HINES BLVD	DALLAS	TX	75390	DALLAS	USA	Mental Health Research Grants	000	2	2/1/2023	NON-COMPETING CONTINUATION	$561,913
														Subtotal = $561,913

Issue Date FY: 2022 ( Subtotal = $639,117 )
2022	2022	UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER, THE	5323 HARRY HINES BLVD	DALLAS	TX	75390	DALLAS	USA	Mental Health Research Grants	000	1	4/5/2022	NEW	$639,117
														Subtotal = $639,117

Grand Total All Awards = $3,236,048

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Hybrid implementation-effectiveness study to optimize HIV testing and PrEP in a southern jail (HOTSPOT)

Award Number: R01MH129185

ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 04/05/2022

PERIOD OF PERFORMANCE END DATE: 01/31/2027

AWARD TERMINATION DATE: 04/24/2025

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