AEGiS-14IAC: Strategies to support treatment adherence in newly release HIV-positive prisoners.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Strategies to support treatment adherence in newly release HIV-positive prisoners.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. LbPeF9055)

Cloutier M, Vandenberg G
Springboard and Homebase Programs, Continuum HIV Day Services, San Francisco, United States

ISSUES: HIV-positive prison- and jail- inmates who have been receiving HAART while incarcerated face a number of challenges upon their release. Access and adherence to anti-retroviral therapy will often take a back seat to finding shelter, nutrition, income, drugs for those who are addicted, and re-establishing family connections.

DESCRIPTION: Two transitional programs attempt to construct a compliance strategy that fits developmentally with the clients needs. The following interventions were implemented to ensure access to therapy and promote adherence: - Direct linkages were established between correctional medical providers and community based primary care providers who would provide care in our transitional program after discharge - All clients were enrolled in the AIDS Drug Assistance Program (ADAP), and/or re-enrolled in California's MediCal insurance for medically indigent clients to eliminate cost and access barriers - Relationships were established with specialty pharmacies who deliver medications to clients private and/or communal residences - The transitional program offer temporary housing, primary medical care, nursing care, adherence counseling, case management, psychiatric services, referral to drug abuse treatment and on site Medi-Set filling.

ISSUES: We were able to ensure that all clients served in these programs, who, did not get lost for follow-up (i.e.: absconded) immediately upon release, received prescriptions and nurse case manager support of specific behavioral strategies. Despite these interventions, many clients still did not take their medications as prescribed.

RECOMMENDATIONS: The psychological and behavioral impact of the change from receiving directly observed therapy in the correctional setting to self-administration in a moderately structured program focused on treatment compliance deserves further research.

Keywords: AEGIS, Prisoners, HIV Infections, Prisons, HIV Seropositivity, Case Management, Counseling, Health Services Needs and Demand, Thinking, Patient Discharge, Antiretroviral Therapy, Highly Active, Pharmacies, Substance-Related Disorders, California, Human, therapy, drug therapy

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