JMIR Publications

ABSTRACT

Background:

Introduction: Men who have sex with men (MSM) and transgender women (TW), particularly those who have experienced criminal justice involvement (CJI), have particularly high HIV burdens; MSM and TW experience elevated rates of incarceration. The period following community reentry from incarceration is critical for addressing potential risks of HIV/STI acquisition and negative sequelae of substance use. Further, the impact experienced by one’s social and sexual networks experienced at the time of detention and release have important health implications for MSM and TW.

Objective:

The purpose of this study is to test a new intervention (called Mobile Enhanced Prevention Support or MEPS) that involves a GPS-based mobile app (called GeoPass), incentives, and peer support for promoting the use of HIV prevention, substance use treatment, and related services.

Methods:

A two-arm, randomized, controlled trial will seek to enroll 300 HIV-negative, MSM/TW aged 18-44 with substance use disorders (SUDs) who are either in jail or have recently left jail. We will randomize and compare those assigned to the MEPS intervention to those assigned to a control group that receives customized referrals and substance use-focused case management to the intervention group that receives customized referrals in addition to the GeoPass app, cash incentives, and the support of a trained Peer Mentor (PM) for six months. All participants will complete a baseline survey as well as follow-up surveys at 3-, 6-, and 9-months post enrollment. The primary outcomes include establishing a primary care provider, being prescribed and adhering to pre-exposure prophylaxis (PrEP) for HIV, HIV, STI, and Hepatitis C virus (HCV) screening and treatment, and engagement in recommended treatment for SUDs. Secondary outcomes include obtaining treatment for any identified infections and avoiding recidivism.

Results:

Enrollment will begin in November 2019, with study completion in 2023. Discussion: This study will advance our knowledge base on patient navigation and peer interventions. Peer navigation services have been studied for treatment of HIV and STIs , but less often in the context of HIV/STI prevention among sexual and gender minority populations experiencing reentry to the community from incarceration. The MEPS study will examine the acceptability and feasibility of combining PM services with a mobile application to facilitate service utilization and participant-PM communication. MEPS will assess patterns of PrEP uptake and utilization in MSM and TW leaving jail, and will provide here-to-fore unavailable data on post-incarcerated persons’ HIV, STI, PreP, substance abuse treatment, and service utilization patterns and experiences, including geocoded data for those in the intervention arm. Clinical Trial: The study has been registered with ClinicalTrials.gov, trial number NCT04036396. Keywords: