Online Program

291565
Prison releasees' linkage to community HIV care: Provider, correctional health, and policy perspectives on critical components of the linkage process in two states


Monday, November 4, 2013

Sara M.A. Donahue, DrPH, MPH, U.S. Health Division, Public Health and Epidemiology, Abt Associates, Cambridge, MA
Cristina Booker, MPH, U.S. Health Division, Public Health and Epidemiology, Abt Associates, Cambridge, MA
Alice Lee, U.S. Health Division, Public Health and Epidemiology, Abt Associates, Cambridge, MA
Alejandra Mijares, MPH, U.S. Health Division, Public Health and Epidemiology, Abt Associates, Atlanta, GA
Lynn Shaull, MA, U.S. Health Division, Public Health and Epidemiology, Abt Associates, Bethesda, MD
Josiah Rich, MD, MPH, Medicine and Community Health, Brown Medical School, Providence, RI
Lisa J. LeRoy, PhD, MBA, U.S. Health Division, Public Health and Epidemiology, Abt Associates, Cambridge, MA
Background: HIV-positive prisoners face unique barriers and may not link to medical and supportive services in a timely manner upon release. This NIDA-funded multi-site study is identifying and analyzing elements of successful linkage of HIV-positive releasees to community HIV care to develop recommendations for local, state, and national prevention initiatives. Methods: We conducted semi-structured interviews with healthcare providers, correctional staff, and policymakers in North Carolina and Rhode Island to compare characteristics of discharge planning, reentry activities, and post-release community services. Data from 20 interviews were analyzed to identify critical policy and programmatic elements of the linkage to community HIV care process. Further analyses will incorporate additional interviews in these and other states. Results: Interviewees identified features of successful linkage to community HIV care, including early initiation of comprehensive, tailored discharge and reentry planning; provision of medication for the initial post-release period; and timely communication between prison and community providers. Key systems- and policy-related features of the linkage process included service and public benefits availability and accessibility. In North Carolina, in-prison HIV disease management education was highlighted as an important component of successful linkage; Rhode Island interviewees emphasized the role of robust prison and community collaborations. Conclusions: Comprehensive and timely discharge planning and reentry services are critical components of HIV-positive offenders' successful linkages to community care. Findings can inform state and local programs as they strengthen services and policies that improve releasees' access to community HIV care. Results will also help support implementation of HIV prevention and treatment initiatives.

Learning Areas:

Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Describe the features of processes to link HIV-positive prisoners to community-based care upon release from incarceration. Identify important provider, correctional health, and political factors that support successful and timely linkage of recently released, HIV-positive prisoners to community-based health and supportive services following release.

Keyword(s): HIV/AIDS, Correctional Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I led the analysis and interpretation of the data. I am a researcher and evaluator at Abt Associates, and direct or participate in a number of public health studies.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.