Correctional facilities: An important site for engaging in the community network of HIV care

ISSUE: An estimated 30% of the PLWHA are out of care. Novel ways to engage the out of care population are needed so they may benefit from advances in HIV care that decrease morbidity/mortality as well as community transmission. With an estimated 14% of the population of PLWHA passing through the corrections setting annually, local jails may be efficient sites for re-engagement to care. Description: The ATLAS Program is one of 10 HRSA SPNS demonstration sites “Enhancing Linkages to HIV Primary Care and Services in Jail Settings Initiative”. ATLAS provides case management to detainees on site throughout their stay. Staff meets with a detainee shortly after incarceration and regularly throughout his/her stay to identify medical, social and supportive needs, facilitate re-engagement to care while in jail and create linkages to community based providers for continuity of care upon release. Lessons Learned: More than 380 HIV+ inmates were incarcerated in 28 months, 15 of which were newly diagnosed in jail. Two thirds of HIV+ inmates remained more than 7 days. 122 participated in ATLAS. 61% of participants reported using illicit drugs in last 30 days. 82% reported recent mental health concerns. 88% reported having an HIV care provider yet only 33% had standard monitoring of T cells/ viral load in the 6 mo prior to incarceration. Mean jail stay was 50 days. Recommendations: Providing HIV supportive care services within a jail setting is highly encouraged as it reaches a high risk and primarily out of care population.