News & Updates

New Project Launch: THRASHER

February 2025

Substance use disorder (SUD) disproportionately affects incarcerated people and increases HIV transmission risk among infected and at-risk populations. In contrast to other regions, the majority of substance use associated with HIV transmission in Atlanta does not include injected opioids. Prior to the current project, we developed an intervention for linkage to/retention in care after jail via case management & peer navigation known as SUCCESS-E. The foremost aim of THRASHER is to conduct a pilot test of this intervention by delivering it to 60-100 persons with SUD in Fulton County Jail, in an HIV status-neutral manner. During the first 2 years of this project, we plan to link persons with HIV (PWH) to HIV care and persons at high risk of seroconversion (PHRS) to PrEP care in combination with SUD treatment post-release. In a randomized trial, we will compare linkage using SUCCESS-E versus treatment as usual and gather cost data. Additionally, we will be conducting interviews with stakeholders in Fulton County for feedback on the implementation of the intervention while forming partnerships with jails/community stakeholders in neighboring counties to prepare for scale-up testing of the intervention in subsequent years. Using the RE-AIM framework for evaluation, we will be assessing the effectiveness of the SUCCESS-E intervention in terms of the primary outcome, linkage/retention in SUD & medical care, and related care outcomes.

Eligibility for the study is as follows:

• Currently residing in jail (or was in jail within the past 6 weeks)
• Living with HIV or uninfected
• Past or present use of alcohol and/or drugs
• Available for two 30-60 minute interview sessions, at least 3 months apart
• Able to give informed consent
• Age 18 years or older

Institutions involved with THRASHER include Emory University, Morehouse School of Medicine, and Rhode Island Hospital.

The THRASHER team will be led by co-PIs, Dr. Anne Spaulding and Dr. Rhonda Holliday. Their professional collaborations date back over two decades, when Dr. Spaulding was a CDC project officer on a Fulton County Jail study and Dr. Holliday was an Emory post-doctoral fellow evaluating the study. Additional information on Dr. Spaulding and Dr. Holliday’s professional backgrounds can be found here and the Morehouse School of Medicine site, respectively. THRASHER was made possible via a $5.6M award (allocated over the next 5 years) from the NIH. Please contact Anne Spaulding, MD, MPH, with any questions related to study partnerships or other details!

Learn about other projects with CHIP

The 1st African Conference on Health in Detention

July 3, 2024 - July 5, 2024

This past July, Team Spaulding & our partners from National Penitentiary Service Mozambique (SERNAP) had the privilege of attending and participating in a poster session at the 1st African Conference on Health in Detention, organized by the International Committee of the Red Cross (ICRC). The inaugural conference took place in Nairobi, Kenya, and centered around African solutions to improving health in detention. Alongside health practitioners and managers from several African countries, we learned about effective prison health policies/practices and share our own experiences researching TB care in Mozambique.