# Health and Justice:  A Continuum of Care for HIV and SU for Justice-involved Youth

> **NIH NIH R01** · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · 2020 · $155,148

## Abstract

Justice-involved youth (JIY) aged 18-24 are at significant risk for HIV but are unlikely to know their HIV status.
Rates of HIV in justice populations are 2-5 times higher than the general population, yet despite this risk, HIV
testing in justice settings, particularly community supervision programs, is not universal. Even after
identification, data also suggest that linkage to community HIV care in justice populations is much lower
compared to general population rates, due to system/organization-, staff-, and individual-level factors,
particularly youth substance use (SU). Overcoming barriers to SU screening and enrollment in SU care is,
therefore, central to decreasing JIY’s negative HIV-related outcomes. Intensive efforts to increase screening
and improve linkage to HIV (including PrEP for HIV– youth who are behaviorally eligible) and SU services for
JIY are needed that address youth as well as justice and health/behavioral health system-level barriers. This
project proposes to embed HIV testing outreach workers from a youth focused medical and HIV treatment
program into and alternative sentencing program (ASP) to deliver a new service delivery model (Link2CARE)
that integrates evidenced-based protocols for JIY to a) promote HIV and STI testing, HIV and SU risk
screening and b) provide onsite intervention and c) cross-system linkage to HIV, STI and SU care. This is a
first R01 proposal from proposed Principal Investigator with significant experience working within justice
settings and supported by a strong multi-disciplinary team of senior researchers to achieve study aims. Guided
by CFIR and Andersen’s Behavioral Model of Health Services Use, our Specific Aims are: 1) Among 450 JIY
(18-24 y.o.), randomized to either Link2CARE or standard of care (SOC), to determine the efficacy of
Link2CARE delivered by health staff embedded within the ASP, on (a) HIV outcomes: uptake of HIV testing
/repeat testing; HIV risk behaviors; (b) STI outcomes: uptake of STI testing/repeat testing, linkage to care of
JIY with STIs; (c) SU outcomes: SU screening, SU, and linkage to care of SU JIY; and (d) (exploratory) linkage
to care of HIV+ JIY and HIV– JIY who are behaviorally eligible for PrEP; 2) to determine the influence of
theoretically-based intervention mechanisms of change (e.g., predisposing characteristics, enabling resources,
perceived need, organizational climate; staff attitudes) on the proposed HIV and SU outcomes; and 3) To
describe Link2CARE implementation and elucidate the system/organizational-, staff-, and youth-level
factors that influence implementation (i.e. acceptability, sustainability, feasibility) of Link2CARE in an
ASP to develop a plan for dissemination and scale-up of Link2CARE in New York City. We propose a 2-phase
study. In Phase 1: Adaptation for Link2CARE, we will adapt the intervention components for use among JIY and
pilot the resulting protocols with n=8 JIY; and finalize the resulting Link2CARE intervention. In Phase 2:
Link2CAR...

## Key facts

- **NIH application ID:** 10171051
- **Project number:** 3R01DA043122-05S1
- **Recipient organization:** NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
- **Principal Investigator:** KATHERINE S ELKINGTON
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $155,148
- **Award type:** 3
- **Project period:** 2016-08-15 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10171051

## Citation

> US National Institutes of Health, RePORTER application 10171051, Health and Justice:  A Continuum of Care for HIV and SU for Justice-involved Youth (3R01DA043122-05S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10171051. Licensed CC0.

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