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THP 87 Bridging the Gap: Transitioning HIV-Positive Inmates from Prison to Community HIV Care

Thursday, September 22, 2016
Galleria Exhibit Hall
Victoria Mobley, MD MPH, Communicable Disease Branch, North Carolina Division of Public Health, Raleigh, NC, Jenna Donovan, MPH, Department of Health and Human Services, NC Division of Public Health/Communicable Disease Branch, Raleigh, NC, Kimberly Sutton, BA, Department of Health and Human Services, NC Division of Public Health/Communicable Disease Branch, Charlotte, NC, Dee Simmons, BS, North Carolina Department of Health and Human Services, Centers for Disease Control and Prevention, Raleigh, NC and Constance Jones, MA, CPM, Department of Health and Human Services, NC Division of Public Health/Communicable Disease Branch, Fayetteville, NC

Background: HIV-positive inmates face structural barriers to continued care engagement following release from prison. The North Carolina (NC) State Bridge Counselor (SBC) program helps to facilitate inmates’ transition from prison to community HIV care. We compared demographics and care engagement between inmates who received and declined SBC services. We also attempted to identify predictors of successful care engagement among inmates who received SBC services.

Methods:Analysis was limited to HIV-positive inmates released from a NC prison in 2014. All inmates referred to the SBCs were stratified into two groups: received services (RS) and declined services (DS). HIV viral load (VL) suppression 180 days after referral was the marker of successful care engagement. Demographics and VL were compared between the two groups as well as demographic predictors of VL suppression among the RS group.  Data was extracted from NC’s Electronic Disease Surveillance System and from CAREWare.   

Results: There were 139 HIV-positive inmates referred for SBC services in 2014; 68% ≥40 years old, 93% were male, 81% were black/African-American and 20 (14%) were not locatable. DS (N=44) and RS (N=75) inmates were similar in age, gender and race/ethnicity. The DS group was more likely than the RS group to be virally suppressed (84% vs. 64%, P<0.05). Among the RS group, VL suppression was more common among inmates who were ≥40 years old (40% vs. 24%), white (79% vs. 61%), female (80% vs. 63%) and report heterosexual HIV-risk (79% vs. 55%). 

Conclusions: SBC services were not necessary for all HIV-positive prison inmates to successfully engage in care upon release. Inmates who refused SBC services likely had less structural barriers or more resources to continued care engagement following discharge. Among inmates who received SBC services, there may be a subset that requires more intensive assistance to successfully transition them into care following prison release.

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