# A Community-Clinic Collaboration to Improve Outcomes in HIV+ Substance Users Released from Jail

> **NIH NIH R34** · UT SOUTHWESTERN MEDICAL CENTER · 2020 · $243,000

## Abstract

Project summary/abstract:
One of the largest challenges in HIV/AIDS treatment in the current era is that the majority of HIV-infected
individuals are not retained in care and therefore not receiving the full benefits of antiretroviral therapy (ART).
Health disparities persist, with certain groups at higher risk for poor outcomes, including minorities, youth,
substance users and those living in the South. The criminal justice system, where these groups are over-
represented, is a critical area of focus to improve HIV outcomes and reduce health disparities. We propose an
intervention aimed at improving re-engagement in HIV care after release from jail, which can promote ongoing
ART and decrease an individual's HIV viral load, thereby reducing the risk of HIV transmission to others. HIV-
infected substance users incarcerated at the Dallas County Jail will be randomized to a community-clinic
collaborative intervention versus treatment as usual. Participants randomized to the intervention will undergo a
detailed risk and needs assessment from an innovative organization focused on community re-entry after
incarceration, called Unlocking DOORS. This organization will provide participants with a personalized re-entry
plan, taking into account legal requirements from the court and probation systems, with referrals to an
extensive interconnected network of partners and providers in Dallas, including housing, food banks, mental
health counseling, substance abuse treatment, job training and transportation. In addition, a formerly-
incarcerated community health worker will help the participant navigate needed social and health services,
including attending visits at the outpatient HIV clinic, and will function as an integral community extension of
the HIV medical team. The primary outcomes of this study will be HIV viral load and substance use at 6
months after randomization, chosen due to its rigor in predicting both individual HIV outcomes and HIV
transmission risk. Monitoring of service delivery (referrals made, services utilized, visits with community health
worker) and secondary outcomes (re-incarceration, emergency room visits, hospitalizations) will allow for
measurement of intervention dose and important related potential impact of the intervention. We will also
measure 12-month HIV viral load and retention in care to assess the durability of the intervention.
Stakeholders, including HIV clinic patients, HIV community service organizations, and members of the
Unlocking DOORS partner/provider network, will be engaged and involved throughout the planning, execution
and analysis process of the project. Overall, this multi-sector approach to improving clinical and substance use
outcomes in HIV-infected individuals released from jail has the potential to advance the National HIV/AIDS
Strategy by improving access to HIV care for an underserved population (substance users involved in the
criminal justice system), reducing health disparities and decreasing th...

## Key facts

- **NIH application ID:** 9878102
- **Project number:** 5R34DA045592-03
- **Recipient organization:** UT SOUTHWESTERN MEDICAL CENTER
- **Principal Investigator:** Ank Elisabeth Nijhawan
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $243,000
- **Award type:** 5
- **Project period:** 2018-04-01 → 2022-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9878102

## Citation

> US National Institutes of Health, RePORTER application 9878102, A Community-Clinic Collaboration to Improve Outcomes in HIV+ Substance Users Released from Jail (5R34DA045592-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9878102. Licensed CC0.

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