“I don’t have to do this all by myself”: Systems Navigation to Ensure Continuity of HIV Care for Persons Leaving Prison

  • Shannon M. Fuller
  • Kimberly A. Koester
  • Andres Maiorana
  • Wayne T. Steward
  • Michelle R. Broaddus
  • Katie Lass
  • Sophia Zamudio-Haas
  • Evelyn Byrd Quinlivan
  • Janet J. Myers
Original Paper


Ensuring continuity of and retention in care after release from prison is critical for optimizing health outcomes among people living with HIV. As part of a large federal initiative, we conducted qualitative interviews (n = 24) with individuals living with HIV and recently released from prison in four states to understand their experiences in different navigation interventions to improve access to HIV care post-release. Interventions were delivered only in prison, only in the community, or in both settings. While the interventions varied by design, overall, participants appreciated the breadth of support received from interventionists, including health system navigation, case management and social support. Even when individuals leaving prison were returning to clinics that they were familiar with, systems navigation supported continuity of care. Our findings elucidate why navigational support was instrumental, and underscore the value of a variety of types of navigation programs in facilitating continuity of care and reintegration post-prison.


HIV Incarceration HIV care continuum Navigation Qualitative research 



This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U90HA22702 for the Systems Linkages and Access to Care for Populations at High Risk for HIV Infection Initiative Evaluation and Technical Assistance Center. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures involving human participants were in accordance with the ethical standards for the institutional review board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study. No personal identifying information is included in the manuscript.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Shannon M. Fuller
    • 1
  • Kimberly A. Koester
    • 1
  • Andres Maiorana
    • 1
  • Wayne T. Steward
    • 1
  • Michelle R. Broaddus
    • 2
  • Katie Lass
    • 3
  • Sophia Zamudio-Haas
    • 1
  • Evelyn Byrd Quinlivan
    • 4
  • Janet J. Myers
    • 1
  1. 1.Center for AIDS Prevention StudiesUniversity of California, San FranciscoSan FranciscoUSA
  2. 2.Center for AIDS Intervention ResearchMedical College of WisconsinMilwaukeeUSA
  3. 3.The Policy and Research GroupNew OrleansUSA
  4. 4.Institute for Global Health and Infectious DiseasesUniversity of North Carolina at Chapel HillChapel HillUSA

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