Research Projects

Sex trafficking, opioid crisis, and HIV epidemic are intersecting public health emergencies. Given the high rates of injection drug use and HIV among women with experiences of sex trafficking, we propose that syringe service programs are a novel site for engaging women histories of and vulnerability to sex trafficking into HIV, substance use, and other health and social services. Decades of research has highlighted the effectiveness of SSPs in HIV prevention. In this R34 application, we will develop and test novel and innovative peer-delivered brief intervention–Healthcare Empowerment and Advocacy for Recovery from Trafficking (HEART)–to engage women with experiences of sex trafficking and women vulnerable to sex trafficking into comprehensive care services, including HIV, SUD, and other health (e.g., mental) and social (e.g., legal) services by (1) providing low barrier access to care in a non-stigmatizing setting (SSPs); (2) using peer delivery with techniques of motivational interviewing to increase self-efficacy and empowerment; (3) offering trauma-informed and gender-sensitive integrated harm reduction and addiction services (e.g., PrEP, MOUD, naloxone); (4) providing education and safety planning for sex trafficking and commercial sex work from a harm reduction perspective; (5) and offering women-specific reproductive health services (e.g., contraception). This research is funded by the National Institute on Drug Abuse R34DA063047 and is being conducted in partnership with IDEA Miami and the THRIVE Clinic.

We propose an implementation science research study designed to ensure biomedical and behavioral treatment strategies increase retention and engagement in HIV care and achieve maintenance of viral suppression. Specifically, we will use community engaged implementation science methodology to adapt a CDC evidence-based intervention (EBI) jail linkage program (LINK LA) for people with HIV (PWH) in Miami-Dade County. Our team has documented a fragmented reentry service system, often resulting in confusion and frustration among PWH returning to the community post-release (P30MH116867 [pilot]). Multiple jail admissions, social and financial difficulties related to jail stays, and even short-term stays in jail are significant obstacles for continuity of care after release for PWH. Accordingly, all stages of the HIV care cascade are lower for people post-release from prison and jail compared to PWH living in the community. Our goal is to adapt and optimize the LINK LA intervention for implementation in the Miami context to increase timely linkage to HIV care, retention, and viral suppression following release from jail. We will accomplish this by identifying and addressing the barriers and facilitators to timely linkage, retention, and viral suppression. This study is being conducted in partnership with Empowerment Zone Reentry Initiative. This study is funded by an EHE supplement through Miami CFAR (3P30AI073961-17S1).

The objective of this study is to empower women involved in the criminal justice system by producing formative research for implementation of an HIV prevention intervention for women who use drugs who are at-risk for unplanned pregnancy, are pregnant, or are recently pregnant. This research will lead to the development of an equity-focused approach to HIV prevention and the advancement of reproductive justice and wellbeing for structurally marginalized women. Women who use drugs that are involved in the criminal justice system constitute a population of particular importance to ending the HIV epidemic because so many of these women are structurally marginalized, live in poverty, and are often forced to move between low-wage care/service work and sex work for economic survival, placing them at high risk for HIV. Additionally, women’s pathway to incarceration is characterized by criminalizing behaviors associated with gender-based violence, including drug use and sex work, and therefore infectious disease risk. This study is being completed in partnership with Leap for Ladies, Justice Impact Alliance, IDEA Exchange, and CHARM. This study is funded by the NIH 3P30MH116867-04S2.