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Two Yale School of Medicine physicians have been awarded a $4.1 million research grant from the National Institutes of Health (NIH) to study a new pharmacological treatment for newly released HIV-positive inmates with alcohol dependence who are transitioning back into the community.

The U.S. prison population is disproportionately impacted by HIV and by alcohol and drug abuse. A majority of HIV-positive inmates also have substance abuse disorders. Though many are treated successfully for both HIV and substance abuse while incarcerated, they face enormous challenges when released.

“Released HIV-positive inmates who relapse to alcohol and drug use are less likely to adhere to HIV treatment, including antiretroviral drugs, and more likely to engage in high-risk behavior,” according to Frederick L. Altice, M.D., professor at Yale School of Medicine, director of clinical and community research at the Yale AIDS Program and one of the two principal investigators.

The prestigious NIH grant is the first of its stature for Sandra Springer, M.D., assistant professor of medicine and co-principal investigator - a junior investigator whose career has already benefited from a career development award from the NIH. In the clinical trial led by Springer and Altice, 125 HIV-positive prisoners with alcohol dependence who are transitioning back into society will receive subcutaneous (depot) injections of naltrexone. Though the medication has been previously shown to benefit those with alcohol dependence, HIV-infected individuals were never previously included in clinical trials.

All subjects in the trial, whether getting naltrexone or the placebo, will receive comprehensive case-management services and 24 weeks of counseling. “This is the first time that depot naltrexone will be formally tested in HIV-infected patients,” says Springer. She adds, “We hope to learn whether a medication known to benefit those with alcohol problems will also help assist with HIV treatment and prevent a relapse to high-risk behaviors. Our study could confirm that treating one disease, alcohol dependence, can actually fight two life-threatening conditions.”

Source
Yale University

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