262429 Linked Into Care Study (LINCS): Released HIV-positive offenders' linkage into Ryan White HIV/AIDS Program services

Monday, October 29, 2012

Traci Green, PhD , Department of General Internal Medicine, Rhode Island Hospital, Providence, RI
Michael Costa , Domestic Health, Abt Associates Inc., Cambridge, MA
Brian Montague, DO MS MPH , Infectious Diseases, Brown University/Miriam Hospital, Providence, RI
Background

LINCS has designed and is implementing a monitoring strategy in four states for evaluating follow-up HIV medical care in the community after release from incarceration. This study tests the clinical and epidemiological utility of the monitoring strategy in distinguishing areas with high success in linkage to care from those with low success. Recent studies have shown that HIV-positive released offenders often do not make successful connections to comprehensive medical services in a timely manner post-release from prison. This leads to negative health outcomes, as well as increased viral load in communities into which they re-enter.

Methods

This cohort study uses demographic data from the sites' Department of Corrections release records to create an encrypted Unique Client Identifier –eUCI- for persons released from corrections. These eUCI's are used to match to the eUCI's in the RSR data provided by participating Ryan white grantees. The RSR provides the client-level clinical service data necessary to determine the rate of enrollment in Ryan White outpatient HIV care.

Results

Linkage to care was demonstrated for 77.5 percent of HIV infected persons leaving corrections with African Americans demonstrating lower rates of linkage relative to Caucasians; 76.6 percent vs 87.5 percent.

Conclusions

This innovative new monitoring system will provide important data that informs our understanding of released HIV-positive prisoner's linkage to care when they reenter the community. This information can be used to inform community health linkage interventions that seek to improve releasee health outcomes and reduce community viral load.

Learning Areas:
Provision of health care to the public
Public health or related public policy
Public health or related research

Learning Objectives:
Demonstrate the benefit of analyzing Ryan White services data in combination with prisoner release records to assess HIV-positive offenders' linkage to HIV care in the community after release.

Keywords: HIV/AIDS, Ryan White

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I supervised and led the analyses for the validation of the eUCI method for this study. I have served as a biostatistician and statistical consultant for more than 12 years and am currently Co-Investigator on the LINCS project. My research focuses on drug abuse and HIV epidemiology.
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.

Back to: 3284.0: Intersecting the Justice System with HIV/AIDS Prevention, Care and Treatment