259487 Role of State and Community Programs on Prison Releasees' Linkage to HIV Care

Monday, October 29, 2012

Lisa J. LeRoy, PhD, MBA , U.S. Health Division, Public Health and Epidemiology, Abt Associates, Cambridge, MA
Sara M.A. Donahue, DrPH, MPH , U.S. Health Division, Public Health and Epidemiology, Abt Associates, Cambridge, MA
Alice Lee , U.S. Health Division, Public Health and Epidemiology, Abt Associates, Cambridge, MA
Liza Solomon, MHS, DrPH , U.S. Health, Public Health and Epidemiology, Abt Associates Inc., Bethesda, MD
Michael Costa , Domestic Health, Abt Associates Inc., Cambridge, MA
Josiah Rich, MD, MPH , Medicine and Community Health, Brown Medical School, Providence, RI
David Rosen, MD PhD , Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC
Background: HIV-positive offenders frequently do not make successful transitions to comprehensive medical services in a timely manner after release from prison. The purpose of this study was to explore community, institutional, and political factors that influence the extent to which HIV-infected prisoners engage in medical care upon release.

Methods: We used in-depth semi-structured qualitative interviews with providers, corrections staff, and policymakers in North Carolina and Rhode Island to learn about prison policies, administrative protocols, and political factors related to HIV care and social services inside and outside of prison and linkage to care from prison to the community.

Results: HIV care providers explained care delivery for HIV-positive releasees and local programs that may influence linkage to services. Corrections staff described prison-based HIV care and discharge planning and discussed collaborative activities necessary for successful linkage to care upon release. Policymakers, public servants, and community-based organization staff discussed the local political climate, funding constraints, and other factors that can influence releasees' access to care, including Medicaid policies, state HIV/AIDS programs, drug assistance eligibility, and characteristics of other medical and social service programs. Summary themes revealed the role of state and local programs, procedures, and political climate in supporting or hindering post-release linkage to care for HIV-positive offenders.

Conclusions: We will outline key programmatic and contextual features of successful linkages to care for HIV-positive individuals upon release from prison. Findings will help identify what criminal justice systems, HIV providers and communities need to have in place to improve releasees' access to HIV care.

Learning Areas:
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
1. Describe community, institutional, and political factors that influence HIV-infected prisoners' linkage to community primary care. 2. Demonstrate the importance of assessment of efforts to link persons with HIV newly released from corrections into community-based care.

Keywords: HIV/AIDS, Correctional Institutions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I oversee the project that collected the data presented in the abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.