Annually, 1 in 7 persons with HIV in the US cycles through jail. Short stays in jail are associated with an eight-fold increase in the likelihod of HIV treatment disruption. An HIV+ person may have been linked to care before incarceration, but might not follow up in outpatient HIV care after release because even a few week stay in jail can lead to the loss of a job, resulting homelessness and other social stressors. The releasee often prioritizes tackling these issues above reestablishing medical care. Substance abuse could have precipitated his or her arrest and detainment;addressing addiction issues are frequently key to retention in HIV care. Since jail is a serious impediment to a national Seek-Test-Treat and Retain strategy for HIV care, we want to build evidence for an innovative intervention of intensive case management beginning in jail, and supplemented with cell phone technology post-discharge, that is acceptable and can promote retention in care for HIV+ jail releasees in the community. This proposed feasibility study, Planning for SUCCESS (Sustained, Unbroken Connections to Care, Entry Services, and Suppression), will test the logistics and acceptance of this intervention and its evaluation tools. Findings from this feasibility study of SUCCESS will inform the planning of a future randomized, controlled trial and cost study to examine long-term effectiveness of intensive Strengths- Based Case Management compared with usual care for this hard-to-treat population. Our feasibility study will ascertain: 1) the pac of recruitment, 2) what proportion of releasees receiving the intervention link to care after jail, and 3) what proportion are retained in care with two visits to an HIV provider within the first yea after release. At 12 months, we will also examine viral loads and linkage to substance abuse and mental health treatment.

Public Health Relevance

Many persons with HIV cycle in and out of jail, which disrupts their linkage to medical care if previously established. Other HIV+ jail detainees never were in care and need initial linkage to community care on release. We have developed a standardized intervention to enhance case management for jail releases. We are conducting a feasibility study that will assess recruitment, linkage and retention in HIV care, and linkage to substance abuse and mental health treatment when indicated.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Planning Grant (R34)
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Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section (BSPH)
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Jones, Dionne
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Emory University
Public Health & Prev Medicine
Schools of Public Health
United States
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