The goal of this clinical study in one NY county is to pilot and refine implementation strategies aimed at improving delivery and uptake of evidence-based practices (EBPs) for HIV prevention/treatment and substance use disorder (SUD) care among incarcerated individuals approaching release with or at risk for HIV and SUD. The main questions it aims to answer are: 1. How feasible and acceptable are the TechMPower implementation strategies (community coalition workgroups, multidisciplinary implementation team with champion, and tech-mediated training/service delivery with peer navigation) in real-world carceral and reentry settings? 2. To what extent do these strategies improve delivery and uptake of HIV testing with self-testing (HST), pre-exposure prophylaxis (PrEP)/antiretroviral treatment (ART), medications for opioids use disorder (MOUD), and overdose education and naloxone distribution (OEND)? 3. What are the preliminary cost estimates for the implementation strategies and EBPs to inform the larger trial to follow in NY and NJ? 4. What are the preliminary impacts on individual-level outcomes such as HIV testing, linkage to care, and SUD treatment initiation? Our specific aims for the Phase I protocol presented here is conducted in one county (Ulster County) with a sample (n=50) of detained (prisoners) in their county jail are presented here: * R61 \| Aim 1: Evaluate \\ preliminary effectiveness of TechMPower, using mixed methods and a pre-/post-evaluation design, on increasing reach of the EBPs resulting in the following outcomes: (1) SUD and HIV screenings (pre-/post-release); and (2) linkage to SUD prevention/care (MOUD, OEND); and (3) linkage to HIV prevention/care (applying a status-neutral approach) with community service providers post-release. (Effectiveness). * R61 \| Aim 2: Identify how adoption/feasibility, implementation/fidelity and sustainability/maintenance of TechMPower may impact effectiveness of TechMPower outcomes as described in Aim 1 in one (Ulster County) jail using surveys of Implementation Team, jail staff and other key stakeholders. (Implementation) * R61 \| Aim 3: Use implementation mapping to adapt implementation strategies for R33 phase. (Implementation)
Age range
18 Years
Sex
ALL
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Number of people incarcerated who have received an HIV test
Timeframe: Baseline and 3 months follow-up
Number of people detained screened for SBIRT
Timeframe: Baseline and 3 months follow-up
HIV care access & utilization/ART Use/adherence/viral load/CD4 count
Timeframe: 3-month following pos test result, pre- post release
Average PrEP oral daily/injectable/episodic PrEP captured in records/chart review; ACASI self-report
Timeframe: Baseline and 3 months follow-up
PEP uptake rate
Timeframe: Baseline and 3 months follow-up