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

• Type of Material: Article
• Authors: Redonna Chandler, National Institutes of Health; Micheal S. Gordon, Friends Research Institute; Bridget Kruszka, University of Washington; Lauren N. Strand, University of Washington; Frederick L. Altice, Yale School of Medicine; Curt G. Beckwith, Brown University; Mary L. Biggs, University of Washington; William Cunningham, University of California at Los Angeles; J.A. Chris Delaney, University of Washington; Patrick M. Flynn, Texas Christian University; Carol E. Golin, University of North Carolina, Chapel Hill; Kevin Knight, Texas Christian University; Alex H. Kral, RTI International; Irene Kuo, George Washington University; Jennifer Lorvick, RTI International; Robin M. Nance, University of Washington; Lawrence J. Ouellet, University of Illinois at Chicago; Josiah D. Rich, Brown University; Stanley Sacks, National Development & Research Institutes; David Seal, Tulane University School of Public Health and Tropical Medicine; Anne Spaulding, Emory University; Sandra A. Springer, Yale School of Medicine; Faye Taxman, George Mason University; David Wohl, University of North Carolina, Chapel Hill; Jeremy D. Young, University of Illinois at Chicago; Rebekah Young, University of Washington; Heidi M. Crane, University of Washington
• Language: English
• Date: 2017-05-16
• Publisher: BioMed Central
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s). 2017
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s13011-017-0107-4
• Title of Journal or Parent Work: Substance Abuse Treatment, Prevention, and Policy
• ISSN: 1747-597X
• Volume: 12
• Issue: 1
• Start Page: 24
• End Page: 24
• Grant/Funding Information: Additional support was provided by NIAID AI027757.; Primary data collection for STTR studies was supported by grants 5R01DA030768, 5R01DA030747, 5R01DA030781, 5R01DA030771, 5R01MH094090, 5R01DA030778, 1R01DA030766, 7R01DA030770, 5R01DA030762, 5R01DA030776, 5R01DA030793, 1R01DA032059, 1R01DA032083, 1R01DA032106, 1R01DA032061, 1R01DA032110, 1R01DA032080, 1R01DA032082, 5R01DA032057, 1R01DA032098, 1R34DA035728 and 1R01DA032100.; Research presented in this paper is the result of secondary data analysis and was supported by 5U01DA037702 from the National Institute on Drug Abuse (NIDA).
• Keywords: Criminal justice; Data harmonization.; HIV
• Research Categories: Biology, Biostatistics; Health Sciences, Epidemiology; Health Sciences, Public Health

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.