Link2CARE: Health and justice -
a continuum of care for HIV and Substance use for justice-involved youth
National Institute on Drug Abuse (NIDA)
Brooklyn, New York, USA
Justice-involved youth 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 justice-involved youth'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 justice-involved youth are needed that addresses youth as well as justice and health/behavioral health system-level barriers.
This project aims to embed HIV testing outreach workers from a youth focused medical and HIV treatment program into an alternative sentencing program (Brooklyn Justice Initiatives) to deliver a new service delivery model (Link2CARE) that integrates evidence-based protocols for justice-involved youth 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. We are conducting a 2-phase study. In Phase 1: Adaptation for Link2CARE, we are adapting the intervention components for use among justice involved youth (Phase 1a) and we will pilot the resulting protocols with justice-involved youth, finalizing the resulting Link2CARE intervention (Phase 1b). In Phase 2: Link2CARE Efficacy Trial and Implementation Evaluation, we will test Link2CARE among N=450 justice-involved youth enrolled at the alternative sentencing program (Phase 2a) and conduct process evaluations with healthcare staff and alternative sentence program staff (Phase 2b).