Integrating Jail and Community Health Practices by Neighborhood- Evidence from HIV Care

As part of an invited panel, we present a nationally recognized model program to address community health disparities through multidisciplinary integration of community and jail health practices to impact the disparities and healthography in a medium-sized urban area.  For the past 2 decades, care of chronic and sub-acute health conditions has been organized by neighborhood health centers with health team members based in both health center and jail. Inclusion of intensive case management, dually-based physicians, continuity of mental health care including substance use disorders have been assessed.  Evidence includes satisfaction with, barriers to, facilitators of and engagement in care, HIV medication treatment and HIV viral suppression.  Recently, a modified Assertive Community Treatment (ACT) team approach for treating mental illness, was evaluated for 70 HIV+ jail detainees from incarceration through six-month post-release via interviews and medical records extraction.   Correlates and outcomes related to total number of contacts a client received from the team were analyzed to explore whether combining ACT with HIV services appears to improve access to treatment for those reintegrating into the community and, ultimately, whether it improves mental illness symptomology and viral suppression six months out. These approaches suggest improved clinical outcomes including community viral load suppression and the public health model for correctional health has been replicated in other jurisdictions with similar outcomes.