A study protocol for a randomized controlled trial of a cross-systems service delivery model to improve identification and care for HIV, STIs and substance use among justice-involved young adults

Abstract

Background Justice-involved young adults (JIYA) aged 18–24 are at significant risk for HIV and problematic substance use (SU) but are unlikely to know their HIV status or be linked to HIV or SU treatment and care. Intensive efforts to increase screening and improve linkage to HIV and SU services for JIYA are needed that address youth as well as justice and health/behavioral health system-level barriers. Methods MoveUp is a four-session intervention that integrates evidence-based protocols to promote HIV and STI testing, HIV and SU behavioral risk reduction and engagement in treatment for JIYA. MoveUp is delivered onsite at an alternative sentencing program (ASP) by HIV testing outreach workers from a youth-focused medical and HIV treatment program. N = 450 youth are randomized following baseline assessment into two groups: MoveUp or standard of care. Youth are followed for 12 months following the intervention; unprotected sexual behavior, substance use, HIV and STI testing as well as treatment linkage will be assessed at 3, 6, 9 and 12-months. Discussion This study is one of the first to systematically test an integrated screen/testing, prevention intervention and linkage-to-care services program (MoveUp), using evidence-based approaches to address the overlapping HIV/STI and substance use epidemics in JIYA by providing on-site services to identify HIV/STI and SU risk and treatment need within justice-settings as well as linkage to services in the community. This approach, capitalizing on health and justice partnerships, represents an innovation that can capitalize on missed opportunities for engaging JIYA in health care.

Perceiving fairness in an unfair world: System justification and the mental health of girls in detention facilities

“…Some scholarly work suggests that the promotion of critical consciousness is associated with positive outcomes (e.g., vocational engagement, human immunodeficiency virus risk prevention; Diemer & Blustein, 2006; Elkington, O'Grady, et al, 2020; Harper et al, 2019). And, community psychologists have long called for increasing critical consciousness as a means of addressing internalized oppression and thereby promoting positive outcomes such as mental health and wellbeing (e.g., Watts, 2004; Watts et al, 1999).…”

Readiness to change among justice-involved young adults in an alternative sentencing program who screened positive for alcohol or drug risk

“…Data were drawn from the baseline assessment of a randomized controlled trial testing an intervention to promote substance use and STD/HIV service readiness and risk reduction ( Elkington et al, 2020 ). The study was conducted at an alternative sentencing program (ASP) in a criminal courthouse in the Brooklyn borough of New York City.…”

“…There is substantial prevalence of substance use disorder among frequently incarcerated justice-involved young adults (JIYA) ( Chan et al, 2020 ). Few interventions target JIYA and there is a lack of research that can provide information on how to tailor interventions to them ( Elkington et al, 2020 , McMurran, 2009 , Pederson et al, 2021 , Prendergast et al, 2017 , Tolou-Shams et al, 2021 ).…”