Research Projects

This application seeks to develop a strategy for implementing the Transitions Clinic Network (TCN) model in Miami to serve people with chronic health conditions that are returning to the community from the Miami Dade county jail. TCN is an evidenced-based model that was developed by Dr. Shira Shavit (UCSF) in collaboration with formerly incarcerated patients to provide a community-based primary care home for people leaving prison. The TCN model of care is associated with fewer acute care visits, higher rates of primary care, and retention in HIV care. Our goals are to (1) build trust and engagement among team members and collaborators and build sustainable and meaningful partnerships with government and community partners; (2) identify strategies to enhance the adaptation, adoption, and sustainment of the TCN model in Miami; and (3) develop an application for funding to conduct a hybrid type-2 clinic trial examining clinical, service, and implementation outcomes of the adapted TCN compared to treatment as usual.

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.

Preexposure prophylaxis (PrEP) for HIV prevention is practically 100% effective in keeping HIV negative people exposed to HIV from acquiring the virus and is an important tool for ending the HIV epidemic worldwide. By 2020, it was estimated that just less than 1 million people had initiated oral PrEP, far less than the 2020 UNAIDS target of 3 million, with the USA accounting for approximately one fifth of total PrEP initiations. Despite high HIV transmission rates relative to other Latin American countries, PrEP use in Mexico remains low. Therefore, we are conducting preliminary research on PrEP uptake and barriers and facilitators to PrEP use in Mexico City. The specific research objectives are to (1) document the clinical characteristics of a cohort of PrEP patients at Mexico’s largest HIV clinic through chart review, and (2) conduct formative qualitative interviews with PrEP patients about their initiation and uptake of PrEP, perceptions of HIV risk, and perceived barriers and facilitators to PrEP sustainment in Mexico City. This is an international collaboration with Clinica Especializada Condesa that is funded by the University of Miami Institute for the Advanced Study of the Americas.

Identification documents like passports, ID cards, and birth certificates are a cornerstone of citizenship. Trans and non-binary people face extensive barriers to changing their identification documents. Without gender-affirming identification, trans and non-binary people struggle to access their citizenship and face discrimination from prospective employers, landlords, healthcare providers, and police. Trans and non-binary activists have started organizations to help others complete the process of changing their identification documents. However, despite the importance of gender affirming identification for millions of trans and non-binary people, very little research has studied the process or the effects of having affirming documentation. In collaboration with TransSOCIAL, a Trans-led organization serving our TLGBQ+ community in Florida, we are piloting a study to track the document name change process and evaluate the impacts of gender-affirming identification on trans and non-binary people in Florida. This project is lead by Dr. Calla Hummel in the UM Department of Political Science and TransSOCIAL, with Associate Dean Charlton Copeland in the UM School of Law, and is funded by the University of Miami’s ULINK initiative.

The COVID Prison Project (CPP) grew out of the critical health crisis occurring in incarcerated settings during the COVID pandemic in early 2020.  Incarcerated populations face especially high risk for transmission of infectious diseases due to close living conditions that make social distancing impossible, as well as limited access to soap, hand sanitizer, and personal protective equipment (PPE).  COVID-19 has been particularly devastating to incarcerated populations given their high prevalence of certain chronic health conditions such as diabetes, heart disease, and respiratory illness, which can exacerbate the severity of symptom presentation. This has made stark racial and ethnic health disparities all the more apparent and a call to action all the more urgent.