NCT04296331

Brief Summary

"Enhancing a universal testing and treatment strategy in jail to promote viral load suppression among justice-involved people living with HIV" is an observational research study led by Dr. Matthew Akiyama, MSc of Albert Einstein College of Medicine and Montefiore Medical Center and Dr. Anne Spaulding, MPH of Emory University's Rollins School of Public Health. Due to the high rates of undiagnosed Human Immunodeficiency Virus (HIV) in the correctional setting and the short length of stay in jails, this study aims to evaluate whether care coordination within the D.C. Central Detention Facility (DC DOC) and upon release, including testing procedures and antiretroviral therapy (ART) initiation, can improve the connection of adults (age 18 and over) living with HIV to care in the community. The researchers will retrospectively look at the aggregate-level de-identified data of roughly 3,000 individuals admitted to the DC DOC over a 6-month period to determine the most effective HIV diagnostic test for routine opt-out testing in the correctional setting. Over the course of these 6 months, the correctional facility will transition from using POC only to POC + antigen/antibody (Ag/Ab), to solely using Ag/Ab, each for a 2-month duration. Individuals from this time period who are identified by corrections staff as HIV-positive either through testing upon admission, their electronic medical record (EMR) or self-report, and have a known release date will be considered eligible for the follow-up study to assess if care coordination is effective in linking others with HIV leaving the DC DOC to care. This follow-up will enroll 100 of these individuals who have consented to participate following their release from the DC DOC, and will consist of a chart review of their DC DOC EMRs and those from their community healthcare provider for up to two years after their release.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
6,613

participants targeted

Target at P75+ for all trials

Timeline
Completed

Started Oct 2019

Typical duration for all trials

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

October 14, 2019

Completed
5 months until next milestone

First Submitted

Initial submission to the registry

March 3, 2020

Completed
2 days until next milestone

First Posted

Study publicly available on registry

March 5, 2020

Completed
1.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 3, 2021

Completed
1.7 years until next milestone

Study Completion

Last participant's last visit for all outcomes

April 30, 2023

Completed
Last Updated

May 22, 2023

Status Verified

May 1, 2023

Enrollment Period

1.9 years

First QC Date

March 3, 2020

Last Update Submit

May 18, 2023

Conditions

Keywords

Correctional settingsHIV/AIDSpoint-of-care testingrapid Universal Testing and Treatment

Outcome Measures

Primary Outcomes (1)

  • HIV diagnostic test effectiveness

    To determine the most effective HIV diagnostic test for routine opt-out testing in the correctional setting

    6 months

Secondary Outcomes (2)

  • Linkage to care

    6 months

  • Cost-effectiveness

    6 months

Study Arms (3)

POC only

Participants who enter the DC Department of Corrections within the first 2 months of the study will be offered opt-out Point-of-Care (POC) rapid testing

Diagnostic Test: POC

POC + Ag/Ab

Participants who enter the DC Department of Corrections within the third and fourth months of the study will be offered opt-out POC and 4th generation laboratory-based antigen/antibody testing (Ag/Ab)

Diagnostic Test: POC + Ag/Ab

Ag/Ab only

Participants who enter the DC Department of Corrections within the fifth and sixth months of the study will be offered Ag/Ab testing.

Diagnostic Test: Ag/Ab

Interventions

POCDIAGNOSTIC_TEST

DC DOC's current testing practice offers opt-out POC testing with the INSTI® finger stick test at entry

Also known as: INSTI® rapid test
POC only
Ag/AbDIAGNOSTIC_TEST

The DC DOC will transition from offering their current POC testing upon entry to offering opt-out HIV testing with Ag/Ab: ARCHITECT® laboratory-based test.

Also known as: Ag/Ab: ARCHITECT® laboratory-based test
Ag/Ab only
POC + Ag/AbDIAGNOSTIC_TEST

As the DC DOC transitions to utilizing the Ag/Ab: ARCHITECT® laboratory-based test from their current POC testing, jail nurses will offer new entrants op-out testing with the two methods

Also known as: INSTI® rapid test and ARCHITECT® laboratory-based test
POC + Ag/Ab

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Individuals admitted to DC DOC between October 14th, 2019 and October 31st, 2020

You may qualify if:

  • Admitted to DC DOC between October 14th, 2019 and October 31st, 2020
  • Has initiated ART by time of release
  • Being HIV-positive: confirmed either through HIV testing upon entry, was known to be HIV-positive through the EMR, or self-reported being HIV-positive

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Emory University

Atlanta, Georgia, 30322, United States

Location

Related Links

MeSH Terms

Conditions

Acquired Immunodeficiency Syndrome

Condition Hierarchy (Ancestors)

HIV InfectionsBlood-Borne InfectionsCommunicable DiseasesInfectionsSexually Transmitted Diseases, ViralSexually Transmitted DiseasesLentivirus InfectionsRetroviridae InfectionsRNA Virus InfectionsVirus DiseasesSlow Virus DiseasesGenital DiseasesUrogenital DiseasesImmunologic Deficiency SyndromesImmune System Diseases

Study Officials

  • Matthew J Akiyama, MD, MSc

    Montefiore Medical Center

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
OTHER
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Assistant Professor of Medicine

Study Record Dates

First Submitted

March 3, 2020

First Posted

March 5, 2020

Study Start

October 14, 2019

Primary Completion

September 3, 2021

Study Completion

April 30, 2023

Last Updated

May 22, 2023

Record last verified: 2023-05

Data Sharing

IPD Sharing
Will not share

Locations