The Effect of Patient Navigation on the Likelihood of Engagement in Clinical Care for HIV-Infected Individuals Leaving Jail

Abstract

Patient navigation supports maintaining engagement in care and can mitigate health disparities, and should become the standard of care for HIV-infected individuals leaving jail.

Using the barriers and facilitators to linkage to HIV care to inform hepatitis C virus (HCV) linkage to care strategies for people released from prison: Findings from a systematic review

“…Conversely, Booker et al found that inmates with stable housing 30 days post‐release were over four times more likely to be linked to HIV care . Thirteen studies examining the role of substance use on linkage to care found that either drug or alcohol use following release were associated with decreased linkage to care in the community . Conversely, treatment for substance use or alcohol abstinence during incarceration was each associated with a fourfold greater likelihood of linkage to HIV care post‐release .…”

“…Thirteen studies examining the role of substance use on linkage to care found that either drug or alcohol use following release were associated with decreased linkage to care in the community . Conversely, treatment for substance use or alcohol abstinence during incarceration was each associated with a fourfold greater likelihood of linkage to HIV care post‐release . Similarly, a history of untreated mental illness was associated with up to a fourfold decreased likelihood of linkage to care, while treated mental illness increased post‐release linkage to care by 1.5‐fold .…”

“…Similarly, a history of untreated mental illness was associated with up to a fourfold decreased likelihood of linkage to care, while treated mental illness increased post‐release linkage to care by 1.5‐fold . There were mixed results regarding the role of sex and ethnicity on linkage to care; however, increasing age was found to be an independent predictor of linkage to HIV care . Released inmates aged 30‐49 (odds ratio (OR) = 1.9, 95% confidence interval (CI): 1.2‐2.9) and >50 (OR 2.1, 95% CI: 1.3‐3.6) were more likely to be linked to HIV care, whereas inmates aged <30 years were threefold less likely to link to care .…”

“…We identified several system‐level factors that affect linkage to HIV care post‐release. The main facilitators to linkage included the provision of case management, discharge planning, transportation assistance, housing support and peer navigation. The chief barriers to linkage to HIV care were the lack of either transportation assistance or post‐release reintegration assistance with housing, employment, addiction and other services, health insurance, etc, as well as prison transfers …”

Continuum of Hepatitis C Care Cascade in Prison and Following Release in the Direct-acting Antivirals Era

“…To date, studies on linkage to care from incarceration have been mainly focused on people with HIV infection, and a variety of strategies, including case management and patient navigation, have been introduced to facilitate the transition period for these patients (15,20). Although developing effective care models require knowledge on the gaps in continuity of care and potential solutions (11), evidence lack around feasibility and e ciency of such interventions among HCV patients (21,22). Community reintegration and post-release continuity of care are current areas of priority for prison healthcare research (23).…”