Study: Jails Provide Opportunity for Effective Linkage to HIV Care

CAMBRIDGE, Mass, Oct. 1, 2013 /PRNewswire/ -- A program to identify HIV-positive jail detainees and provide them with care and services following their release from jail was effective in linking people who are living with HIV into care, and in some cases helped to lower their viral load, a study published in a special supplement of the journal AIDS and Behavior found.

People who are incarcerated are a vulnerable population, with high rates of HIV. The Health Resources and Services Administration (HRSA) HIV/AIDS Bureau, Special Projects of National Significance funded the Enhancing Linkages to HIV Primary Care in Jail Settings Initiative to help identify HIV-positive jail detainees and link them into ongoing care following release.  Under the initiative, organizations and jail facilities in 10 cities implemented and evaluated models for linking people living with HIV who were leaving jails to healthcare and other needed services.

Abt Associates and colleagues at Emory University examined whether people who had been in jail received HIV care within 30 days of release. This included meeting with an HIV care provider or other outpatient health care provider after release, getting a viral load or CD4 cell count test, or getting a prescription for HIV/AIDS medicine within 30 days of release from jail.

In a sample of 1,021 HIV-infected people at 10 sites who were released from jail and were enrolled in the program, 79 percent received care within 30 days of post-release.  Researchers also found that for participants who had jail and community viral load assessments available, there was an increase in the number of people with a suppressed viral load, meaning that the severity of the HIV infection was lessened.

"Given the enormous impact of HIV among people who are incarcerated, ensuring that they get the care they need once they leave jail and enter the community is critical," said Cristina Booker, a researcher at Abt Associates and the study's lead author. "This study shows that jail systems offer opportunities to engage detainees, provide HIV testing and treatment, and successfully link them into care."

In addition, researchers found strong associations between case management services and linkage to care, which included having a discharge plan completed at release and receiving HIV or medication education while in jail.

"Over the course of the EnhanceLink project, nearly a million people were admitted to the 20 participating jails. We showed the feasibility of providing voluntary testing for detainees for HIV and linking them to community care post-release. The challenge now is to transfer the lessons to thousands of other jails throughout the U.S," said Dr. Anne Spaulding of the School of Medicine at Emory University.

The study is part of a special journal supplement on Enhancing Linkages to HIV Primary Care in Jail Settings Initiative and was supported by a grant from the Department of Health and Human Services, Health Resources and Services Administration, HIV/AIDS Bureau, Special Projects of National Significance.

Abt Associates co-authors include Christopher Flygare, Liza Solomon, Sarah Ball, Meredith Pustell and Ryan Kling. The study was also co-authored by Lauri Bazerman of the Miriam Hospital in Providence, RI; Dominique Simon-Levine of Allies in Recovery, Paul Teixeira and Jacqueline Cruzado-Quinones of the New York City Department of Health and Mental Hygiene and Paula M. Frew and Anne Spaulding of the School of Medicine at Emory University.

For a copy of the study, visit: http://link.springer.com/article/10.1007%2Fs10461-012-0354-3

About Abt Associates

Abt Associates is a mission-driven, global leader in research and program implementation in the fields of health, social and environmental policy, and international development. Known for its rigorous approach to solving complex challenges, Abt Associates is regularly ranked as one of the top 20 global research firms and one of the top 40 international development innovators.  The company has multiple offices in the U.S. and program offices in nearly 40 countries. www.abtassociates.com

SOURCE Abt Associates