Client-centered case management strategies for connecting HIV-positive female detainees to HIV care and social services

Issues: Correctional facilities represent key settings for interventions to prevent, diagnose, and treat HIV disease. Linking HIV-positive individuals to care upon release is a critical component of the care continuum and in reducing HIV prevalence in communities to which releasees return. This presentation reports on strategies used in a client-centered case management (CM) program designed to connect HIV-positive women leaving jail to HIV care and social services. Description: Data come from the Chicago site of the HRSA-funded Special Projects of National Significance Program, “Enhancing Linkages to HIV Primary Care and Services in Jail Settings Initiative.” We examine baseline behavioral data, client service utilization data and case management notes to provide a comprehensive look at the health and behavioral profiles of women served by the program, their health and social service needs, and the process and strategies for meeting women's needs. Lessons Learned: The needs of HIV-positive female jail releasees are extensive, and successful linkages to care depend on multiple factors, including characteristics of the case manager, the client and her circumstances, and the CM-client relationship. Motivation and readiness for change vary among women, and substance use and mental health issues are significant challenges in keeping women engaged in care. Linkage to Ryan White CMs should be an important project goal. Recommendations: Post-release care of HIV-positive jail detainees presents challenges on multiple levels. A model that uses transition case managers to link HIV-positive persons to Ryan White case managers may prove most efficient and effective in achieving and maintaining care linkages.