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Helping Formerly Incarcerated People Living with HIV Stay in Care: Good for Them, Good for the Community

According to a recent study published in The Lancet by Johns Hopkins University researchers,* HIV prevalence is roughly three times higher in incarcerated individuals than in the general U.S. population. While cases of HIV transmission in jail and prison have been reported, studies suggest that most prisoners living with HIV acquired their infection prior to their incarceration. While access to treatment and viral suppression are generally good during the period of incarceration, retention in care after release continues to be a challenge for many people.

The time after incarceration is one of increased vulnerability and formerly incarcerated people may be particularly susceptible to drug overdose, suicide, re-arrest,** and interruptions in HIV medical care.* HIV medical care is essential in helping people returning to the community improve and maintain their own health. In addition, individuals living with HIV who are on consistent antiretroviral therapy and have an undetectable viral load are 96% less likely to transmit HIV to a sexual partner.

The ALIVE study reported on by Johns Hopkins researchers demonstrated that the risk of HIV transmission increases, rather than decreases, on release from prison. In fact, among newly diagnosed African American women who acquired HIV through heterosexual sex, the primary risk factor was having sex with a partner who had a history of incarceration.***

In order to address this challenge, correctional linkage-to-care programs support and assist incarcerated individuals living with HIV who are at increased risk for poor retention in care upon release. These programs provide comprehensive discharge planning prior to release and linkage support post-release, thereby minimizing drop-off rates along each stage of the HIV care continuum.

A successful re-entry linkage-to-care intervention can provide the “link” between the correctional facility and community medical care, thereby maintaining or improving clinical health status, including viral suppression. When successful, these interventions can decrease HIV transmission, reduce recidivism, improve quality of life for individuals and, ultimately, for communities.

Securing the Link: A Guide to Support Individuals Transitioning Back Into the Community from Jail

Action Wellness (formerly ActionAIDS), in Philadelphia, PA, is among a number of organizations in the U.S. with a program designed specifically to support people living with HIV who are transitioning from jail back into the community. Their Philadelphia Linkage Program uses an intensive Care Coach model to link formerly incarcerated people living with HIV medical care and help them remain in care. Action Wellness, in partnership with AIDS United, has recently released Securing the Link: A Guide to Support Individuals Transitioning Back into the Community.

This guide offers considerations and step-by-step program procedures for organizations looking to develop a linkage-to-care program with individuals transitioning out of correctional facilities and back into local communities. As the Johns Hopkins University researchers concluded, “The prison setting presents not only challenges, but also opportunities, for the prevention and treatment of HIV.”

* Dolan K, Wirtz AL, Moazen B, et al. Global burden of HIV, viral hepatitis, and tuberculosis in prisoners and detainees. Retrieved August 1, 2016 from
** Binswanger IA, Stern MF, Deyo RA, et al. Release from Prison—A High Risk of Death for Former Inmates. N Engl J Med. 2007.356(2): 157–165. Retrieved August 1, 2016 from
*** Centers for Disease Control and Prevention. “Prevention Benefits of HIV Treatment.” Retrieved May 5, 2016, from

Posted By: Melissa Werner, Senior Program Manager - Wednesday, September 07, 2016

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