title: Design and methods of a double blind randomized placebo-controlled trial of extended-release naltrexone for alcohol dependent and hazardous drinking prisoners with HIV who are transitioning to the community.
abstract: HIV-infected prisoners have a high prevalence of alcohol use disorders and commonly relapse to alcohol soon after release to the community which is linked to high morbidity, poor antiretroviral therapy (ART) adherence and increased sexual risk-taking behaviors. Extended-release naltrexone (XR-NTX) effectively reduces relapse to alcohol in alcohol dependent persons, yet it remains unexamined among criminal justice system (CJS) populations transitioning to the community.
  
  
  
  A randomized double-blind, placebo-controlled trial of XR-NTX to improve HIV treatment outcomes via reducing relapse to alcohol use after prison release for HIV-infected hazardous drinking and alcohol dependent prisoners is discussed.
  
  
  
  Acceptability of study participation is high with 86% of those referred who met eligibility criteria and 85% of those who were able to receive injections prior to release accepted injections, yet important implementation issues are identified and addressed during the study and are discussed in this paper.
  
  
  
  Medication-assisted therapies for prevention of relapse to alcohol use for CJS populations transitioning to the community, especially for HIV-infected patients, are urgently needed in order to reduce alcohol relapse after release and improve HIV treatment outcomes and contribute to improved individual and public health.
authors.affiliation: Yale University School of Medicine, Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, 135 College St., Suite 323, New Haven, CT 06510, United States. Electronic address: sandra.springer@yale.edu.
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Springer
authors.affiliation: Yale University School of Medicine, Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, 135 College St., Suite 323, New Haven, CT 06510, United States; Yale University School of Public Health, Division of Epidemiology of Microbial Diseases, 135 College St., Suite 323, New Haven, CT 06510, United States.
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Altice
authors.affiliation: Yale University School of Medicine, Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, 135 College St., Suite 323, New Haven, CT 06510, United States.
authors.forename: Maua
authors.initials: M
authors.lastname: Herme
authors.affiliation: Yale University School of Medicine, Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, 135 College St., Suite 323, New Haven, CT 06510, United States.
authors.forename: Angela
authors.initials: A
authors.lastname: Di Paola
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000188:drug therapy*; D044966:Anti-Retroviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003692:Delayed-Action Preparations; D004311:Double-Blind Method; D015658:HIV Infections / Q000188:drug therapy*; D006304:Health Status; D006801:Humans; D055118:Medication Adherence; D008603:Mental Health; D009271:Naltrexone / Q000008:administration & dosage / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D011329:Prisoners; D012107:Research Design; D012309:Risk-Taking; D055502:Secondary Prevention; D012959:Socioeconomic Factors
chemical_list: D044966:Anti-Retroviral Agents; D003692:Delayed-Action Preparations; D009292:Narcotic Antagonists; D009271:Naltrexone
keywords: Alcohol use disorder; Extended-release naltrexone; HIV; Hazardous drinking; Prisoners; Randomized controlled trial