Linking HIV-positive Jail Inmates to Treatment, Care, and Social Services After Release: Results from a Qualitative Assessment of the COMPASS Program
Linking HIV-positive Jail Inmates to Treatment, Care, and Social Services After Release: Results from a Qualitative Assessment of the COMPASS Program
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DOI：
10.1007/s11524-010-9496-7
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发表时间：
2010-12-01
影响因子：
6.6
通讯作者：
Beckwith, Curt
中科院分区：
文献类型：
--
作者：
Nunn, Amy;Cornwall, Alexandra;Beckwith, Curt
每年约有17%的艾滋病毒/艾滋病感染者通过教养系统，监狱为获得医疗服务有限的高风险流动人口提供了诊断和治疗艾滋病毒感染的独特机会。美国卫生资源和服务管理局资助了一个名为“加强与监狱环境中艾滋病毒初级保健的联系”的多地点示范项目，该项目旨在改善对艾滋病毒阳性监狱被拘留者的诊断和治疗服务，并使他们在释放后获得基于社区的医疗保健和社会服务。我们对罗德岛州示范地点进行了评估，该示范地点名为“通过社区伙伴关系和支持艾滋病毒感染者出狱的服务”在对罗德岛州20名艾滋病毒阳性COMPASS参与者的深度定性访谈中，我们评估了COMPASS如何影响获得医疗保健和社会服务的利用，大多数人在登记时接受艾滋病毒治疗和护理服务，但COMPASS增强了大多数参与者与医疗保健的联系，并对艾滋病毒和其他并发症进行了随访。包括一名新诊断为艾滋病毒感染者和另一名感染艾滋病毒多年并能够开始高度积极的抗逆转录病毒治疗（HAART）的人。虽然许多人报告说，COMPASS的支持防止了药物滥用复发，但对一些参与者来说，持续的药物滥用仍然是一个挑战。大多数参与者由于COMPASS参加了一项或多项新的社会服务，包括医疗补助、补充安全收入、食品援助、COMPASS参与者未满足的主要需求是获得心理健康服务和稳定的住房。加强对艾滋病毒阳性监狱被拘留者的个案管理，增加获得医疗和社会支持服务的机会，并有助于防止药物滥用复发。扩大对最近释放的艾滋病毒阳性被拘留者的集中个案管理方案、公共住房和心理健康服务，应成为公共卫生方面的优先事项
Approximately 17% of individuals living with HIV/AIDS pass through the correctional system each year Jails provide a unique opportunity to diagnose and treat HIV infection among high risk, transient populations with limited access to medical services In 2007, the US Health Resources and Services Administration funded a multi-site demonstration project entitled Enhancing Linkages to HIV Primary Care in Jail Settings that aims to improve diagnosis and treatment services for HIV-positive jail detainees and link them to community based medical care and social services upon release We performed an evaluation of the Rhode Island demonstration site entitled Community Partnerships and Supportive Services for HIV Infected People Leaving Jail (COMPASS) Through in depth qualitative interviews among 20 HIV-positive COMPASS participants in Rhode Island, we assessed how COMPASS impacted access to health care and social services utilization Most individuals were receiving HIV treatment and care services upon enrollment, but COMPASS enhanced linkage to medical care and follow-up visits for HIV and other co morbidities for most participants Several participants were successfully linked to new medical services as a result of COMPASS, including one individual newly diagnosed with HIV and another who had been living with HIV for many years and was able to commence highly active antiretrovrral therapy (HAART) While many individuals reported that COMPASS support prevented substance abuse relapse, ongoing substance abuse nevertheless remained a challenge for several participants Most participants enrolled in one or more new social services as a result of COMPASS, including Medicaid, Supplemental Security Income, food assistance, and housing programs The primary unmet needs of COMPASS participants were access to mental health services and stable housing Intensive case management of HIV positive jail detainees enhances access to medical and social support services and helps prevent relapse to substance abuse Expanding intensive case management programs, public housing, and mental health services for recently released HIV-positive detainees should be public health priorities