Effectiveness of Peer Navigation to Link Released HIV+ Jail Inmates to HIV Care (LINK LA)

This study is currently recruiting participants.
Verified January 2013 by University of California, Los Angeles
Sponsor:
Collaborator:
Los Angeles County Department of Public Health
Information provided by (Responsible Party):
William Cunningham, University of California, Los Angeles
ClinicalTrials.gov Identifier:
NCT01406626
First received: July 28, 2011
Last updated: January 4, 2013
Last verified: January 2013

July 28, 2011
January 4, 2013
December 2012
January 2014   (final data collection date for primary outcome measure)
  • Linkage to HIV Care [ Time Frame: 12 months (baseline, 2, 6, and 12 month follow ups) ] [ Designated as safety issue: No ]
    Linking HIV+ ex jail inmates to HIV care
  • Retention in Treatment [ Time Frame: 12 months total (baseline, 2, 6, and 12 month follow ups) ] [ Designated as safety issue: No ]
    This assesses whether or not the HIV+ ex jail inmates were retained in their HIV care after first accessing care.
  • Adherence to Treatment [ Time Frame: 12 months (baseline, 2, 6, and 12 month follow ups) ] [ Designated as safety issue: No ]
    This measures how adherent the HIV+ ex jail inmates are to their treatment regiment.
  • Viral Load [ Time Frame: 12 months total (Baseline, 2 and 12 month follow ups) ] [ Designated as safety issue: No ]
    This measures the HIV+ ex jail inmates' viral load to see how effective their treatment adherence has been.
  • Linkage to HIV Care [ Time Frame: 14 months (baseline, 2, 6, 10, and 14 month follow ups) ] [ Designated as safety issue: No ]
    Linking HIV+ ex jail inmates to HIV care
  • Retention in Treatment [ Time Frame: 14 months total (baseline, 2, 6, 10, and 14 month follow ups) ] [ Designated as safety issue: No ]
    This assesses whether or not the HIV+ ex jail inmates were retained in their HIV care after first accessing care.
  • Adherence to Treatment [ Time Frame: 14 months (baseline, 2, 6, 10, and 14 month follow ups) ] [ Designated as safety issue: No ]
    This measures how adherent the HIV+ ex jail inmates are to their treatment regiment.
  • Viral Load [ Time Frame: 14 months total (Baseline, 6, and 14 month follow ups) ] [ Designated as safety issue: No ]
    This measures the HIV+ ex jail inmates' viral load to see how effective their treatment has been.
Complete list of historical versions of study NCT01406626 on ClinicalTrials.gov Archive Site
Costs [ Time Frame: Assessed at one point only toward the end of the study period ] [ Designated as safety issue: No ]
To examine whether the costs of the intervention and HIV care are offset by reductions in healthcare and recidivism costs from the perspective of LA County.
Costs [ Time Frame: 14 months (only assessed at the end of the 14 month follow up) ] [ Designated as safety issue: No ]
To examine whether the costs of the intervention and HIV care are offset by reductions in healthcare and recidivism costs from the perspective of LA County.
Not Provided
Not Provided
 
Effectiveness of Peer Navigation to Link Released HIV+ Jail Inmates to HIV Care
Effectiveness of Peer Navigation to Link Released HIV+ Jail Inmates to HIV Care

This study will implement a health navigation intervention to improve linkage to and retention in HIV care for inmates released from L.A. county jail into the community.

The proposed study has two Primary Specific Aims:

  1. To examine individual-level and structural-level barriers to HIV care after release from jail, using formative semi-structured interviews with ex-inmates, case managers, and HIV care providers; and to use the information we obtain to inform the adaptation and tailoring of an intervention designed to improve linkage with and retention to HIV care for HIV+ ex-inmates (Complete);
  2. Using a two-group experimental RCT design, to test the adapted health navigation intervention condition for HIV+ inmates upon release from jail compared to a usual care condition, and to evaluate the intervention's effectiveness at improving linkage with and retention in HIV care, self-reported ART adherence, and HIV RNA viral load suppression;

We hypothesize that the intervention will result in more rapid linkage to care, a greater proportion completing at least three HIV care visits per year, increased self-reported ART adherence, and decreased levels of HIV RNA viral load compared to the usual care control group.

Secondary Aims of the study include assessing the potential moderating effects of substance abuse, the potential mediating effects of substance abuse treatment, and the program's effects on recidivism, and costs.

We hypothesize that active substance abuse will moderate the effect of the intervention, so the intervention will be less effective among participants who report substance use.

Interventional
Not Provided
Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
HIV-infection/Aids
Behavioral: Health Navigator
Health navigation intervention to improve linkage to and retention in HIV care and suppress viral load for underserved HIV+ persons in Los Angeles
  • Experimental: Health Navigation Intervention Arm

    Subjects will receive the following health navigation services:

    1) 10 Navigator meetings: Navigators will meet with participants in person to teach linkage/retention skills and knowledge

    2a) 2 Navigator accompaniment sessions: the health navigator will accompany participants to HIV care appointment. Before and after the appointment, participants and navigators will review linkage and retention skills/knowledge things that make it hard or easy for him to get regular HIV care

    2b) Optional health navigator accompaniment sessions: If the participant requests, the health navigator will provide accompaniment to supportive HIV care appointments (one per month max)

    3) 14 Health navigator care calls: During these calls, navigators and participants will talk about any problems that could make it difficult to get regular HIV care.

    Intervention: Behavioral: Health Navigator
  • No Intervention: Usual Care
    Participants assigned to the control arm will receive the transitional case management (TCM) services that are currently offered at the jail
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
360
January 2016
January 2014   (final data collection date for primary outcome measure)

Inclusion Criteria:

  1. Age: 18 years or older
  2. Male or male-to-female transgender
  3. Fluency in English
  4. Residing in LA County upon release

Exclusion Criteria:

  1. Inability to give informed consent
  2. stays in jail <5 days
  3. Lack of English fluency
Male
18 Years and older
No
Contact: William E Cunningham, MD, MPH 310.794.0314 wcunningham@mednet.ucla.edu
United States
 
NCT01406626
R01DA030781
Yes
William Cunningham, University of California, Los Angeles
University of California, Los Angeles
Los Angeles County Department of Public Health
Principal Investigator: William E Cunningham, MD, MPH University of California, Los Angeles
Principal Investigator: Trista Bingham, MS, MPH, PHD LA County Department of Health
University of California, Los Angeles
January 2013

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP