Successful linkage of medical care and community services for HIV-positive offenders being released from prison |
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Authors: | Josiah D Rich Leah Holmes Christopher Salas Grace Macalino Deborah Davis James Ryczek Timothy Flanigan |
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Institution: | (1) Miriam Hospital and Brown University, 164 Summit Avenue, Providence, RI, 02906 Providence, Rhode Island |
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Abstract: | Human immunodeficiency virus (HIV) infection is more prevalent among the incarcerated than the general population. For many
offenders, incarceration is the only time that they may access primary care. Project Bridge is a federally funded demonstration
project that provides intensive case management for HIV-positive exoffenders being released from the Rhode Island state prison
to the community. The program is based on collaboration between colocated medical and social work staff. The primary goal
of the program is to increase continuity of medical care through social stabilization; it follows a harm reduction philosophy
in addressing substance use. Program participants are provided with assistance in accessing a variety of medical and social
services. The treatment plan may include the following: mental illness triage and referral, substance abuse assessment and
treatment, appointments for HIV and other medical conditions, and referral for assistance to community programs that address
basic survival needs. In the first 3 years of this program, 97 offenders were enrolled. Injection drug use was reported by
80% of those enrolled. There were 90% followed for 18 months, 7% moved out of state or died, and 3% were lost to follow-up.
Reincarceration happened to 48% at least once. Of those expressing a need, 75% were linked with specialty medical care in
the community, and 100% received HIV-related medical services. Of those expressing a need for substance abuse treatment, 67%
were successful in keeping appointments for substance abuse treatment within the community. Project Bridge has demonstrated
that it is possible to maintain HIV-positive ex-offenders in medical care through the provision of ongoing case management
services following prison release. Ex-offenders will access HIV-related health care after release when given adequate support.
The contents of this article are solely the responsibility of the authors and do not necessarily represent the official view
of the Health Resources and Services Administration, the Special Projects of National Significance program, or other sponsors. |
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Keywords: | AIDS Case Management HIV Incarceration Injection Drug Use Prison Prisoners |
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