TechMPower: Advancing HIV/SUD Care and Service Delivery for People Involved in the Criminal Legal System - HIV prevalence in correctional facilities in the US is about five times greater than in the general population. About 14% of people living with HIV (PLWH) experience incarceration every year, and 15% of those incarcerated do not know their HIV status. Over 50,000 people are incarcerated in New York state and 1-2% are estimated to be PLWH. An estimated 70-80% of US jail detainees have a substance use disorders (SUD) and are at high risk of relapse, overdose and HIV infection post-release. Intervening during incarceration provides an opportunity to address HIV care in hard-to-reach individuals, though more robust HIV and SUD interventions are needed to improve care continuity. Increasing point-of-care rapid testing would maximize HIV detection and results receipt among people in jails and prepare them with essential knowledge and skills on SUD and HIV services post-release. TechMPower is a Regional Research Hub (RRH) and 2-phase, Hybrid Type II effectiveness/implementation study to evaluate the effectiveness of an intervention that bundles implementation strategies to increase delivery of HIV and SUD targeted evidence-based practices (EBPs) to prevent adverse HIV-related (new infection, untreated HIV) and SUD-related outcomes (fatal and non-fatal overdose) among a sample of individuals (n=1200 ) in six county jails in New York and New Jersey. In the first phase of this TechMPower study, we completed a pilot study to prepare for the phase two (R33) trial, informed by the PRISM/RE-AIM framework. Here, we successfully recruited 41 detained people in one NYS county jail and established and engaged a HEALing Communities Study coalition to implement the selected EBPs that act to increase: 1) HIV screening/testing via self-testing; 2) SUD screening, brief interview and referral to treatment (SBIRT); and 3) access to and uptake of biomedical HIV and SUD prevention and treatment (PrEP/PEP/ART); overdose education/naloxone distribution [OEND], opioid use disorder medication [MOUD]) delivered through 4) hybrid linkage (telehealth, face-to-face) to services via Navigation Enhanced Case Management (NCM). To optimize EBP delivery, TechMPower applies key implementation strategies including: a) data driven, multidisciplinary community coalitions and designated CLS workgroup; b) implementation teams led by champions; c) training in person-centered approaches for optimal service providers/organizations; and d) tech-mediated and hybrid trainings and service delivery. This study capitalizes on the investigators’ extensive expertise in conducting community-driven implementation studies, designing EBPs, and person-centered approaches to provide evidence for tech-mediated HIV and SUD service delivery integration in jails with linkages to community-based care.
