Positive Transitions (POST): Evaluation of an HIV Prevention Intervention for HIV-Positive Persons Releasing from Correctional Facilities

Abstract

People with HIV who are released from custody frequently do not maintain the viral suppression and other health benefits achieved while incarcerated. This study was conducted to provide preliminary evidence of efficacy of an intervention to reduce HIV risk behaviors and increase use of HIV medical services following release from custody. People with HIV were recruited from San Francisco County jails, San Quentin State Prison and the California Medical Facility (Vacaville, CA), and randomly assigned to the "standard of care" or POST intervention. POST consisted of 4 sessions pre-release and 2 sessions post-release, focusing on HIV prevention and access to care. Behavioral data were obtained for the 3 months before incarceration and 3 months after release. Although POST participants reported a statistically significant increase in receiving health care at HIV clinics (62.5-84.4 %), there were no significant differences between the POST and control participants with respect to any primary outcomes.

Challenges in the Evaluation of Interventions to Improve Engagement Along the HIV Care Continuum in the United States: A Systematic Review

“…Gardner et al implemented an intervention for education and enhanced personal contact for a general HIV clinic population over 12 months and found that visit adherence (defined as proportion kept out of all scheduled primary care visits) increased from 67% to 73% [16]. By contrast, however, three other RCTs evaluating educationally focused interventions found no significant effect [17–19]. Lucas et al found that clinic-based substance abuse treatment modestly improved the number of clinic visits over the twelve month study period from 3 to 3.5 when comparing control to intervention arms [20].…”

Effects of integrated interventions on transmission risk and care continuum outcomes in persons living with HIV

“…Interventions targeted a variety of PLWH subgroups, including (not mutually exclusive) clinic patients [27-32], youth or young adults [31-33], persons who use/inject drugs [30, 33, 34], women [35, 36], inmates reentering the community [37, 38], women with histories of sexual abuse [36], persons who were homeless or at risk of homelessness [39] and other high-risk PLWH (e.g., persons who engaged in unprotected sex with HIV-negative/status unknown partners or had medication/visit adherence problems) [28, 31, 40]. …”

“…Regarding the intervention characteristics, nine studies addressed risk reduction and medication adherence [29-32, 35, 36, 38, 40, 41], four studies examined all three behaviors [33, 34, 37, 39], and two studies focused on HIV care engagement and medication adherence [27, 28]. Almost half of the interventions were tailored to an individual's needs by using less structured sessions [27-29, 31, 32, 35, 38].…”

“…Almost half of the interventions were tailored to an individual's needs by using less structured sessions [27-29, 31, 32, 35, 38]. The majority of the interventions were delivered oneon-one [27-29, 31-33, 37, 39, 40] and in settings where PLWH receive services or care (e.g., HIV outpatient clinics, community AIDS service centers, methadone treatment clinics) [27-32, 35, 40, 41]. Interventions were delivered by trained facilitators [27, 28, 34, 36, 37, 39-41] or by health care providers or counselors [30-33, 35, 38].…”

Can TasP Approaches Be Implemented in Correctional Settings?: A review of HIV testing and linkage to community HIV treatment programs

“…Positive Transitions (POST), a six-session (four pre and two post-release) intervention to decrease HIV risk and increase access to care for HIV-positive inmates, was evaluated using an RCT design 49 . Participants from jails and prisons were randomized prior to release to either the SOC condition, transitional case management (TCM), or POST, which also included TCM.…”