California hub for HIV/STI/SUD prevention research with reentry populations - the period following release from incarceration is associated with increased risk for HIV and STI acquisition and…

California hub for HIV/STI/SUD prevention research with reentry populations - the period following release from incarceration is associated with increased risk for HIV and STI acquisition and transmission and fatal drug overdose. Implementation of effective programs for linkage to pre-exposure prophylaxis (prep) for HIV, screening for HIV/stis/ hepatitis c virus (HCV), and rapid SUD treatment and harm-reduction services in reentry populations is needed to counteract these harms. Scale up of such programs may help to address racial/ethnic differences in these outcomes given the overrepresentation of black and latino people, men who have SEX with men, and people who inject drugs in jails and prisons. The proposed research hub will study the implementation of a demonstrated-effective, 6-month intervention designed to increase prep use and HIV/STI/HCV testing following reentry, in three high-priority california counties. The mobile enhanced prevention support or meps intervention combines evidence-based strategies, including peer mentors, cash incentives, and a mobile application for facilitating access, goal tracking, and receipt of incentives. In the first (R61) phase of the project, we will adapt the meps implementation to practical realities of new agencies in new areas. In the second (R33) phase, we will conduct a type 3 hybrid implementation-effectiveness study using a randomized controlled trial to evaluate the adapted meps intervention in riverside and alameda counties. Our academic-community partnership will also provide infrastructure for robust stakeholder engagement and support of pilot studies related to prevention during reentry. Our study aims are to: 1) pilot the following aspects of the meps trial in one county: participant recruitment and enrollment; baseline needs assessment and client-centered planning sessions; retention and follow-up assessments; specimen collection for prep adherence monitoring; and peer mentor identification and training for the full intervention. 2A). Formalize partnerships with community agencies in each county and plans and adaptations for implementation of meps and the trial in their sites. 2B). Develop a set of common core measures with community and justice system partners and other components of the nida HIV/justice research network. 3) conduct a type 3 hybrid effectiveness trial, implementing the adapted meps intervention with the three agencies, with 300 participants. Use the RE-aim framework and proctor's implementation science outcomes with a subset of participants, agency staff, and stakeholders to examine meps' implementation and randomized design to assess intervention effectiveness for increasing prep uptake and adherence (via self-report and biomarkers), HIV testing, and SUD service utilization. 4) create and deploy a website as a community commons, with integrated research and communications utilities designed to meet the study coordination, community engagement, and implementation needs of hub partners in aims 1-3; disseminate findings related to meps intervention scale-up and other hub activities, (e.g., pilot studies); and support the sustainability and breadth of intervention adoption and knowledge production.