Skip to main content

Advertisement

SpringerLink
Log in

Effect of Patient Navigation on Transitions of HIV Care After Release from Prison: A Retrospective Cohort Study

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Antiretroviral therapy is successfully administered to people living with HIV while they are incarcerated in most US prison systems, but interruptions in treatment are common after people are released. We undertook an observational cohort study designed to examine the clinical and psychosocial factors that influence linkage to HIV care and viral suppression after release from a single state prison system. In this report we describe baseline characteristics and 6-month post-incarceration HIV care outcomes for 170 individuals in Wisconsin. Overall, 114 (67%) individuals were linked to outpatient HIV care within 180 days of release from prison, and of these, 90 (79%) were observed to have HIV viral suppression when evaluated in the community. The strongest predictor of linkage to care in this study was participation in a patient navigation program: Those who received patient navigation were linked to care 84% of the time, compared to 60% of the individuals who received only standard release planning (adjusted OR 3.69, 95% CI 1.24, 10.96; P < 0.01). Findings from this study demonstrate that building and maintaining intensive patient navigation programs that support individuals releasing from prison is beneficial for improving transitions in HIV care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Dolan K, Wirtz AL, Moazen B, et al. Global burden of HIV, viral hepatitis, and tuberculosis in prisoners and detainees. Lancet. 2016;388(10049):1089–102.

    Article  Google Scholar 

  2. Altice FL, Azbel L, Stone J, et al. The perfect storm: incarceration and the high-risk environment perpetuating transmission of HIV, hepatitis C virus, and tuberculosis in Eastern Europe and Central Asia. Lancet. 2016;388(10050):1228–48.

    Article  Google Scholar 

  3. Maruschak LM. HIV in Prisons, 2001–2010. US Department of Justice, Washington, DC, Bureau of Justice Statistics, Report No: NCJ 238877. http://bjs.ojp.usdoj.gov/content/pub/pdf/hivp10.pdf. Accessed 9 Dec 2018.

  4. Springer SA, Friedland GH, Doros G, Pesanti E, Altice FL. Antiretroviral treatment regimen outcomes among HIV-infected prisoners. HIV Clin Trials. 2007;8(4):205–12.

    Article  Google Scholar 

  5. Meyer JP, Cepeda J, Wu J, Trestman RL, Altice FL, Springer SA. Optimization of human immunodeficiency virus treatment during incarceration: viral suppression at the prison gate. JAMA Intern Med. 2014;174(5):721–9.

    Article  Google Scholar 

  6. Westergaard RP, Kirk GD, Richesson DR, Galai N, Mehta SH. Incarceration predicts virologic failure for HIV-infected injection drug users receiving antiretroviral therapy. Clin Infect Dis. 2011;53(7):725–31.

    Article  Google Scholar 

  7. Baillargeon J, Giordano TP, Rich JD, et al. Accessing antiretroviral therapy following release from prison. JAMA. 2009;301(8):848–57.

    Article  CAS  Google Scholar 

  8. Milloy MJ, Kerr T, Buxton J, et al. Dose-response effect of incarceration events on nonadherence to HIV antiretroviral therapy among injection drug users. J Infect Dis. 2011;203(9):1215–21.

    Article  CAS  Google Scholar 

  9. Meyer JP, Cepeda J, Springer SA, Wu J, Trestman RL, Altice FL. HIV in people reincarcerated in Connecticut prisons and jails: an observational cohort study. Lancet HIV. 2014;1(2):e77–84.

    Article  Google Scholar 

  10. Oyugi JH, Byakika-Tusiime J, Ragland K, et al. Treatment interruptions predict resistance in HIV-positive individuals purchasing fixed-dose combination antiretroviral therapy in Kampala. Uganda AIDS. 2007;21(8):965–71.

    PubMed  CAS  Google Scholar 

  11. UNAIDS, 90-90-90: an ambitious treatment target to help end the AIDS epidemic. 2014, Joint United Nations Programme on HIV/AIDS. http://www.unaids.org/sites/default/files/media_asset/90-90-90_en_0.pdf. Accessed 26 Dec 2018.

  12. Flanigan TP. Jails: the new frontier. HIV testing, treatment, and linkage to care after release. AIDS Behav. 2013;17(Suppl 2):S83–5.

    Article  Google Scholar 

  13. Beyrer CA, Kamarulzaman A, McKee M. Prisoners, prisons, and HIV: time for reform. Lancet. 2016;388(10049):1033–5.

    Article  Google Scholar 

  14. Small W, Wood E, Betteridge G, Montaner J, Kerr T. The impact of incarceration upon adherence to HIV treatment among HIV-positive injection drug users: a qualitative study. AIDS Care. 2009;21(6):708–14.

    Article  Google Scholar 

  15. Brinkley-Rubinstein L. Incarceration as a catalyst for worsening health. Health Justice. 2013;1(1):3.

    Article  Google Scholar 

  16. Wisconsin Department of Health Services, D.o.P.H.A.H.P., Wisconsin HIV Surveillance Annual Review. 2018.

  17. Wisconsin Department of Health Services, D.o.P.H., AIDS/HIV Program. linkage to care specialist program manual: a patient navigation program for people living with HIV and AIDS. 2015. https://www.dhs.wisconsin.gov/publications/p01089.pdf.

  18. Pawasarat JQ, Lois M. Wisconsin’s mass incarceration of African American males. Summary: ETI Publications; 2014.

    Google Scholar 

  19. Wisconsin Department of Health Services, Division of Publi Health AIDS/HIV Program. Wisconsin HIV: integrated epidemiology profile 2010-2014. https://www.dhs.wisconsin.gov/publications/p01294.pdf. Accessed 26 Dec 2018.

  20. World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach. 2013. https://www.who.int/hiv/pub/guidelines/arv2013/en/ Accessed 27 Dec 2018.

  21. Schumann CL, Westergaard RP, Meier AE, Ruetten ML, Vergeront JM. Developing a patient navigation program to improve engagement in HIV medical care and viral suppression: a demonstration project protocol. AIDS Behav. 2017. https://doi.org/10.1007/s10461-017-1727-4.

    Article  Google Scholar 

  22. Sun S, Crooks N, Kemnitz R, Westergaard RP. Re-entry experiences of Black men living with HIV/AIDS after release from prison: intersectionality and implications for care. Soc Sci Med. 2018;211:78–86.

    Article  Google Scholar 

  23. Kemnitz R, Kuehl TC, Hochstatter KR. Manifestations of HIV stigma and their impact on retention in care for people transitioning from prisons to communities. Health & Justice. 2017;5(1):7–9.

    Article  Google Scholar 

  24. Iroh PA, Mayo H, Nijhawan AE. The HIV care cascade before, during, and after incarceration: a systematic review and data synthesis. Am J Public Health. 2015;105(7):e5–16.

    Article  Google Scholar 

  25. Chu C, Umanski G, Blank A, Meissner P, Grossberg R, Selwyn PA. Comorbidity-related treatment outcomes among HIV-infected adults in the Bronx, NY. J Urban Health. 2011;88(3):507–16.

    Article  Google Scholar 

  26. Rodriguez-Penney AT, Iudicello JE, Riggs PK, et al. Co-morbidities in persons infected with HIV: increased burden with older age and negative effects on health-related quality of life. AIDS Patient Care STDs. 2013;27(1):5–16.

    Article  Google Scholar 

  27. Gonzalez JS, Batchelder AW, Psaros C, Safren SA. Depression and HIV/AIDS treatment nonadherence: a review and meta-analysis. J Acquir Immune Defic Syndr. 2011;58(2):181–7.

    Article  Google Scholar 

  28. Greenberg GA, Rosenheck RA. Homelessness in the state and federal prison population. Crim Behav Ment Health. 2008;18(2):88–103.

    Article  Google Scholar 

  29. Kerker BD, Bainbridge J, Kennedy J, et al. A population-based assessment of the health of homeless families in New York City, 2001-2003. Am J Public Health. 2011;101(3):546–53.

    Article  Google Scholar 

  30. Robertson MJ, Clark RA, Charlebois ED, et al. HIV seroprevalence among homeless and marginally housed adults in San Francisco. Am J Public Health. 2004;94(7):1207–17.

    Article  Google Scholar 

  31. Milloy MJ, Marshall BD, Montaner J, Wood E. Housing status and the health of people living with HIV/AIDS. Curr HIV/AIDS Rep. 2012;9(4):364–74.

    Article  Google Scholar 

  32. Montague BT, John B, Sammartino C, et al. Use of viral load surveillance data to assess linkage to care for persons with HIV released from corrections. PLoS ONE. 2018;13(2):e0192074.

    Article  CAS  Google Scholar 

  33. Hochstatter KR, Hull SJ, Stockman LJ, et al. Using database linkages to monitor the continuum of care for hepatitis C virus among syringe exchange clients: experience from a pilot intervention. Int J Drug Policy. 2017;42:22–5.

    Article  Google Scholar 

  34. Harrigan PR, Whaley M, Montaner JS. Rate of HIV-1 RNA rebound upon stopping antiretroviral therapy. AIDS. 1999;13(8):F59–62.

    Article  CAS  Google Scholar 

Download references

Funding

This study was funded by the National Institute of Health/National Institute on Drug Abuse (K23DA032306). KRH receives support from the Lifespan/Brown Criminal Justice Research Program on Substance Use, HIV, and Comorbidities, funded by the National Institute of Health/National Institute on Drug Abuse (R25DA037190). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of this manuscript.

Author information

Authors and Affiliations

  1. Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Ryan P. Westergaard, Danielle Kahn, Alec E. Winzenried & James M. Sosman

  2. Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Karli R. Hochstatter, Paige N. Andrews, Ajay K. Sethi & Ronald E. Gangnon

  3. Wisconsin Division of Public Health AIDS/HIV Program, Madison, WI, USA

    Casey L. Schumann

  4. 1685 Highland Ave – 4th Floor, Madison, WI, 53705, USA

    Karli R. Hochstatter

Authors
  1. Ryan P. Westergaard
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Karli R. Hochstatter
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paige N. Andrews
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Danielle Kahn
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Casey L. Schumann
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Alec E. Winzenried
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ajay K. Sethi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ronald E. Gangnon
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. James M. Sosman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Karli R. Hochstatter.

Ethics declarations

Conflict of interest

All authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments.

Informed Consent

Participant data was collected for this study under a waiver of informed consent.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Westergaard, R.P., Hochstatter, K.R., Andrews, P.N. et al. Effect of Patient Navigation on Transitions of HIV Care After Release from Prison: A Retrospective Cohort Study. AIDS Behav 23, 2549–2557 (2019). https://doi.org/10.1007/s10461-019-02437-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-019-02437-4

Keywords

Search

Navigation