Health outcomes for HIV-positive inmates released from NYC jails

Title: Health outcomes for HIV-positive inmates released from NYC jails.

Issue: While HIV positive individuals held in New York City jails receive standard of care and are offered anti-retroviral therapy (ARV), challenges exist to continued engagement with the health care system upon release. The New York City Department of Health and Mental Hygiene (DOHMH) offers transitional care coordination and discharge planning services to all known HIV positive inmates. Although many inmates on ARV achieve viral suppression while incarcerated, little is known of their disease progression post-release. It is particularly important that those taking ARV remain in care in order to avoid gaps in treatment and to monitor drug effectiveness.

Description: DOHMH's office of Transitional Health Care Coordination took part in the Enhancing Linkages Project, a multi-site study of HIV-positive jail inmates. Baseline surveys and clinical reviews were conducted on 555 people held in NYC jails, 52% had 6-month clinical reviews, and 45% also completed a 6-month interview and survey. We found that at 6-months post-release CD4 and viral load counts had improved, a greater number were on ARV therapy, and fewer reported being homeless or visiting an emergency room in the prior 6-month period. These improvements benefit not only the individual, but the communities these inmates return to when released from jail.

Lessons Learned: Appropriate care in jails and comprehensive discharge planning services are critical to the care of HIV-positive jail detainees and to public health in general.

Recommendations: Correctional health and local health departments should work together to care for HIV-infected inmates as this benefits the broader community.