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Subst Abuse Treat Prev Policy. 2017 May 16;12(1):24. doi: 10.1186/s13011-017-0107-4.

Cohort profile: seek, test, treat and retain United States criminal justice cohort.

Author information

1
Division of Clinical Innovation, National Center for Advancing Translational Sciences, National Institutes of Health, Washington, DC, USA.
2
Friends Research Institute, Baltimore, MD, USA.
3
Department of Biostatistics, University of Washington, Seattle, WA, USA.
4
Medicine and Epidemiology, Yale School of Medicine, New Haven, CT, USA.
5
Division of Infectious Diseases, Alpert Medical School of Brown University, Providence, RI, USA.
6
Department of Health Policy and Management, Medicine, General Internal Medicine, University of California at Los Angeles, Los Angeles, CA, USA.
7
Department of Epidemiology, University of Washington, Seattle, WA, USA.
8
Texas Christian University, Fort Worth, TX, USA.
9
Departments of Health Behavior and Medicine, University of North Carolina, Chapel Hill, NC, USA.
10
Institute of Behavior Research, Texas Christian University, Fort Worth, TX, USA.
11
Urban Health Program, RTI International, Research Triangle Park, NC, USA.
12
Department of Epidemiology and Biostatistics, The George Washington University, Washington, DC, USA.
13
Department of Medicine, University of Washington, Seattle, WA, USA.
14
Department of Epidemiology, University of Illinois at Chicago, Chicago, IL, USA.
15
Medicine and Epidemiology, Brown University, Center for Prisoner Health and Human Rights, The Miriam Hospital, Providence, RI, USA.
16
Center for the Integration of Research & Practice (CIRP), National Development & Research Institutes, Inc. (NDRI), New York, NY, USA.
17
Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
18
Department of Epidemiology, Emory University, Atlanta, GA, USA.
19
Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
20
Department of Criminology, Law and Society, George Mason University, Fairfax, VA, USA.
21
School of Medicine, University of North Carolina, Chapel Hill, NC, USA.
22
Infectious Disease Fellowship Program, University of Illinois at Chicago, Chicago, USA.
23
School of Medicine, University of Washington, Seattle, WA, USA. hcrane@uw.edu.

Abstract

BACKGROUND:

The STTR treatment cascade provides a framework for research aimed at improving the delivery of services, care and outcomes of PLWH. The development of effective approaches to increase HIV diagnoses and engage PLWH in subsequent steps of the treatment cascade could lead to earlier and sustained ART treatment resulting in viral suppression. There is an unmet need for research applying the treatment cascade to improve outcomes for those with criminal justice involvement.

METHODS:

The Seek, Test, Treat, and Retain (STTR) criminal justice (CJ) cohort combines data from 11 studies across the HIV treatment cascade that focused on persons involved in the criminal justice system, often but not exclusively for reasons related to substance use. The studies were conducted in a variety of CJ settings and collected information across 11 pre-selected domains: demographic characteristics, CJ involvement, HIV risk behaviors, HIV and/or Hepatitis C infections, laboratory measures of CD4 T-cell count (CD4) and HIV RNA viral load (VL), mental illness, health related quality of life (QoL), socioeconomic status, health care access, substance use, and social support.

RESULTS:

The STTR CJ cohort includes data on 11,070 individuals with and without HIV infection who range in age from 18 to 77 years, with a median age at baseline of 37 years. The cohort reflects racial, ethnic and gender distributions in the U.S. CJ system, and 64% of participants are African-American, 12% are Hispanic and 83% are men. Cohort members reported a wide range of HIV risk behaviors including history of injection drug use and, among those who reported on pre-incarceration sexual behaviors, the prevalence of unprotected sexual intercourse ranged across studies from 4% to 79%. Across all studies, 53% percent of the STTR CJ cohort reported recent polysubstance use.

CONCLUSIONS:

The STTR CJ cohort is comprised of participants from a wide range of CJ settings including jail, prison, and community supervision who report considerable diversity in their characteristics and behavioral practices. We have developed harmonized measures, where feasible, to improve the integration of these studies together to answer questions that cannot otherwise be addressed.

KEYWORDS:

Criminal justice; Data harmonization.; HIV

PMID:
28511680
PMCID:
PMC5433052
DOI:
10.1186/s13011-017-0107-4
[Indexed for MEDLINE]
Free PMC Article

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