Transmission of the COVID-19 virus (SARS-CoV-2) is magnified in correctional settings due to restricted access to sanitizing supplies and personal protective equipment, close congregant living conditions, and exposure to correctional staff who unknowingly transmit the infection from the community. These populations are also more likely to experience severe and life-threatening symptoms of COVID-19, due to higher rates of underlying medical conditions. Therefore, there is an urgent need for the development and implementation of long-term testing strategies targeting incarcerated populations and correctional staff. RADx-UP (Rapid Acceleration of Diagnostics for Underserved Populations) is a short-term funding mechanism that is designed to capitalize on the existing infrastructure and networks of funded projects to quickly engage historically at-risk and under-served populations in significant COVID-19 testing efforts.
We are conducting formative research to establish a Miami Transitions Clinic at the University of Miami based on the Transitions Clinic Network (TCN) model. The TCN is an evidence-based program designed in partnership with formerly incarcerated individuals, with locations within safety-net community health centers in neighborhoods most impacted by incarceration. Each TCN clinic provides linkages with correctional partners to provide continuity of care; easy access to comprehensive primary care; culturally competent, patient-centered medical services; community health workers with a history of incarceration as part of an integrated medical team; and close partnerships with local reentry organizations and other agencies to address social determinants of health (e.g., housing, education). We are conducting a community needs and resource assessment study with the following aims: (1) identify the primary health needs and existing service gaps in reentry from the perspective of people who are formerly incarcerated and professionals working directly with people who are formerly incarcerated; (2) document, map, and assess community assets (e.g., agencies, organizations, institutions) that can be mobilized to support the Miami Transitions Clinic. This study is funded by the University of Miami Office of the Provost.
Check out the Miami Reentry Resource Map here. And see the main findings published here.
Justice involvement is syndemic with infection with HIV, mental illness, substance use, and exposure to violence; and mass incarceration is both a cause and consequence of US racial health disparities. The post-release period following confinement in prison or jail is a particularly vulnerable period for people who are formerly incarcerated. Thus, the justice-involved population living with HIV is a key priority population for HIV care and treatment interventions. We are using a qualitative life history calendar study design to interview 30 people. The objective of this study is to provide foundational knowledge on syndemic pathways and risk subjectivities for suboptimal HIV care among justice-involved persons living with HIV and the social and structural contextual factors that shape these pathways. This study is funded by Center for HIV and Research in Mental Health (CHARM).
Data collection for Proyecto SALTO concluded in 2020. This study was funded by the National Institute on Drug Abuse and directed by Drs. Alice Cepeda and Avelardo Valdez at the University of Southern California. The purpose of this study was to identify and determine how distinct drug use and intimate partner violence victimization trajectories that emerge in adolescence through young adulthood contribute to physical and mental health outcomes among Mexican American women within the context of a highly disadvantaged community. Survey and biomarker data collection was completed with 225 women, along with nested qualitative interviews (n=37). Papers that have been published from this project can be found here.
As a follow up, we are conducting a solicited diary study with a subsample of Latina women who have sex with women and men. These women occupy multiple, intersecting stigmatized statuses, which result in unique stressors and health risk. The minority stress model posits that members of highly stigmatized groups experience chronically high levels of stress resulting from discrimination (e.g., overt, internalized), disproportionate exposure to stressful life events (e.g., violent victimization, criminal justice involvement), and low socioeconomic status. These factors are predicted to increase psychological distress and, subsequently, high-risk substance use, but can be buffered by protective factors such as social support (e.g., chosen family, family of origin). We use an intersectional approach to apply this model and elucidate these complex processes over the life course. This study is funded by Center for Latino Health Research Opportunities (CLaRO) at Florida International University and University of Miami.
The primary objectives of this study were to generate population estimates for admission screening of HIV, and other infectious diseases and comorbid conditions, as well as the use of HIV prevention measures (e.g., Pre-Exposure Prophylaxis (PrEP) for HIV prevention, and medication assisted therapy (MAT) for opioid addiction). The study was funded by the Miami Center for AIDS Research (CFAR) and The Lifespan/Brown Criminal Justice Research Training Program with additional in-kind support from the American Jail Association, and concluded in 2020. The final report is available for download. See the published manuscripts here.