Background:

Correctional systems have an opportunity to provide coordinated prevention and treatment interventions for inmates with infectious diseases in concert with local public health officials and community-based organizations. Many people released from jails have serious, unmanaged infectious diseases and mental illnesses. Public health and safety could be improved through greater collaboration among correctional facilities, public health agencies, and community-based organizations. Ideally, proven interventions would be initiated with inmates and coordinated upon their release.  

The Initiative:

The Enhancing Linkages to HIV Primary Care and Services in Jail Settings Initiative is funded by the Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB), Special Projects of National Significance (SPNS) Program.

This SPNS Initiative is a multisite demonstration and evaluation of HIV service delivery interventions. Demonstration projects will develop innovative methods for providing care and treatment to HIV positive individuals in jail settings who are returning to their communities. Specifically, they will identify HIV-infected individuals in jails and provide appropriate assistance with transitioning to the community for HIV primary care and social support services.  Grantees will evaluate the demonstrations locally as well as part of a multi-site study.

In September 2007, this funding initiative awarded 10 grants to demonstration sites to design, implement and evaluate innovative methods for linking persons living with HIV/AIDS (PLWHA) who are in jail settings or have been recently released from local jail facilities to primary medical care and ancillary services. 

In September 2006, the Rollins School of Public Health of Emory University in Atlanta, Georgia and Abt Associates Inc. in Cambridge, Massachusetts were funded as the Evaluation and Support Center to coordinate the multi-site evaluation of the initiative.

Interventions Include: 

Jail-Based Services

HIV testing

• Traditional and rapid tests
• Coordination of notification of test results for inmates released early
• Partner notification
• Coordination of HIV treatment
• Coordination of HIV medication at release
• Coordination of other health and social services

HIV prevention education

Pre-release discharge planning

• Development of service plans for post-release HIV care and other services
• Mental health assessment
• Mental health treatment
• Coordination of mental health medication at release
• Substance abuse assessment
• Substance abuse treatment

Community-Based Services

Post-release case management (short- and long-term)

Linkage to and provision of HIV care in the community (provided directly by grantee or through referrals to HIV clinics)

 Linkage to and provision of substance abuse assessment and treatment

• Assessment
• Alternatives to Incarceration (ATI) programs
• Residential and out-patient treatment
• Office-based opioid treatment
• Relapse prevention
• Family counseling and support

Linkage to and provision of mental health assessment and treatment

• Assessment
• Triage
• Post-release treatment
• Referral to community mental health providers

Linkage to and provision of other services:

• Housing
• Benefits
• Transportation services and vouchers
• Basic needs (e.g., food, clothing)

Coordination with courts, probation and parole to provide services

Target Populations:

• HIV-infected inmates
• Female inmates
• Inmates with a history of substance use
• Inmates with mental health diagnoses
• Inmates without mental health diagnoses
• Inmates with short lengths of stay in jail
• Sentenced jail inmates