Connecting Corrections and HIV Care: Building a Care Coordination Program for Recently Incarcerated Persons Living with HIV in Virginia

Interventions to Improve HIV Care Continuum Outcomes Among Individuals Released From Prison or Jail: Systematic Literature Review

BACKGROUND

HIV care continuum outcomes deteriorate among people returning from incarceration. Interventions to improve care outcomes postincarceration have been characterized by substantial heterogeneity in approach, outcome metrics, and results. A large number of recently published interventions have not been systematically reviewed.

METHODS

We searched peer reviewed and scholarly databases for published and gray literature describing interventions to improve HIV care continuum outcomes among individuals released from prison or jail. We systematically screened quantitative and qualitative intervention reports published through 2018, then extracted and analyzed study data using a classification scheme that we developed for categorizing intervention levels and strategies.

RESULTS

We included 23 reports from the peer-reviewed literature, 2 from gray literature, and 2 from conference abstracts (27 total). Seventeen studies were classified as individual level, 3 as biomedical level, 2 as organizational level, and 5 as multilevel. Nine studies were randomized controlled trials, 4 of which reported power calculations. Fifteen studies were quasiexperimental; one was a case study. Eleven studies were conducted in prisons, 7 in jails, and 9 in both prisons and jails. Of 11 studies reporting hypothesis tests, 5 found statistically significant effect sizes on primary outcomes.

CONCLUSIONS

Interventions that demonstrate postrelease improvements in clinic attendance and viral suppression include patient navigation strategies, especially involving peer support, and substance use treatment strategies.

Lessons Learned from Applying a Modified Learning Collaborative Model to Promote Change in Regional and Statewide HIV Care Systems

The Health Resources and Services Administration Special Projects of National Significance launched the Systems Linkage and Access to Care for Populations at High Risk of HIV Infection Initiative in 2011. Six state departments of health were funded to utilize a modified Learning Collaborative model to develop and/or adapt HIV testing, linkage to care and retention in care system-level interventions. More than 60 Learning Sessions were held over the course of the Learning Collaborative. A total of 22 unique interventions were tested with 18 interventions selected and scaled up. All interventions were created to impact services at a systems level, with standardized protocols developed to ensure fidelity. Our findings provide key lessons and present considerations for replication for use of a modified Learning Collaborative to achieve state-level systems change.