Continuity of health care among the formerly incarcerated is an emerging public health challenge. We used data from the San Francisco County Jail to determine whether discharge planning improves access to care on release. Inmates who were HIV positive and received discharge planning were 6 times more likely to have a regular source of care in the community compared with inmates with other chronic medical conditions, and they were as likely to have a regular source of care compared with the general San Francisco population.
This study aims to investigate age differences in rates of mental health/substance abuse and behavioral health treatment in HIV-positive adults. One-hundred and nine HIV-positive adults (21-88 years old) were recruited from the University of Pennsylvania Center for AIDS Research (CFAR) infectious disease clinics. Each subject participated in a 3-hour comprehensive behavioral/psychosocial interview. Over half of the sample displayed significant mental health and substance abuse symptoms, of which approximately a third were actively participating in behavioral health care. Major depression and illicit drug use appeared to be the most prevalent syndromes. However, individuals with mania and psychosis were most likely to be participating in behavioral health treatment, while individuals with at-risk drinking and illicit drug use were least likely to be participating in treatment. Furthermore, older-aged adults were less likely to be receiving behavioral health care when there was evidence of need. The findings of this investigation generally concluded that HIV-positive adults, especially older-aged adults, are in need of improved behavioral health management for mental health/substance abuse.
Directly observed therapy (DOT) of antiretroviral (ARV) medications has beneficial effects on HIV treatment for incarcerated inmates but has been associated with limited continuation after release and inadvertent disclosure of HIV status. Guided self-administered therapy (g-SAT) may be a preferred method of ARV delivery and may encourage medication-taking behavior. We surveyed the preference of 102 HIV-positive jailed inmates at the San Francisco City and County Jails regarding receiving ARVs via DOT versus g-SAT while incarcerated. Participants overwhelmingly preferred g-SAT over DOT.
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