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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Lyndee Knox, PhD, Department of Family Medicine, University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90089, William D. King, MD, JD, Robert Wood Johnson Clinical Scholars Program, University of California at Los Angeles, 911 Broxton Ave suite 317, Westwood, CA 90024, 310 794 3703, Knox@hsc.usc.edu, and Pamela Diamond, PhD, College of Criminal Justice, Sam Houston State University, 1803 Ave I, Huntsville, TX 77341-2296.
Improving health services in correctional facilities has proven to be difficult. Litigation alone has had limited effect.
In 1998, CorrectHelp, a community based legal advocacy organization, began working with the LA County Jail system to improve access to care for its HIV positive inmates. The organization used a legal advocacy-educational intervention model to introduce changes into the jail’s health services system. We evaluated the effects of the 2 year intervention on HIV services using qualitative and quantitative methods.
Key-informant interviews and field observations were conducted and analyzed for content and theme. Facility documents related to the care and treatment of HIV in the jail were reviewed. A time series analysis was conducted on pharmacy purchase records to examine changes in the amount and type of HIV medication purchased during and immediately following the intervention period.
Outcomes included an increase in resources available for early identification of HIV positive inmates, increased access for HIV positive inmates to HIV-related pharmaceuticals, improved ability for inmates to adhere to medication regimes, training and educating medical and field staff in HIV care, and an increase in transition planning for inmates being released into the community.
Factors that contributed to these changes include: targeted legal advocacy; the timing of the intervention to coincide with system concerns with other health care services; effective leadership in both the jail system and the community organization; the community organization’s orientation toward collaboration and resource brokering rather than litigation; and federal resources to support training and purchases of HIV-related medications.
Learning Objectives:
Keywords: Correctional Health Care, Public Health Advocacy
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.