“I don’t have to do this all by myself”: Systems Navigation to Ensure Continuity of HIV Care for Persons Leaving Prison

• Published in: AIDS and behavior Vol. 23; no. Suppl 1; pp. 14 - 24
• Main Authors: Fuller, Shannon M., Koester, Kimberly A., Maiorana, Andres, Steward, Wayne T., Broaddus, Michelle R., Lass, Katie, Zamudio-Haas, Sophia, Quinlivan, Evelyn Byrd, Myers, Janet J.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-01-2019; Springer Nature B.V
• Subjects: Access; Acquired immune deficiency syndrome; Adult; AIDS; Attrition; Case management; Continuity; Continuity of care; Continuity of Patient Care - organization & administration; Delivery of Health Care - organization & administration; Female; Health problems; Health Psychology; Health services; Health Services Research; HIV; HIV Infections - drug therapy; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Infectious Diseases; Intervention; Male; Medicine; Medicine & Public Health; Middle Aged; Original Paper; Patient Navigation - organization & administration; Prisoners; Prisons; Prisons - organization & administration; Public Health; Qualitative research; Social interactions; Social Support; United States - epidemiology; United States; Qualitative research; HIV care continuum; Navigation; Incarceration; HIV
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-018-2050-4

Ensuring continuity of and retention in care after release from prison is critical for optimizing health outcomes among people living with HIV. As part of a large federal initiative, we conducted qualitative interviews (
n
 = 24) with individuals living with HIV and recently released from prison in four states to understand their experiences in different navigation interventions to improve access to HIV care post-release. Interventions were delivered only in prison, only in the community, or in both settings. While the interventions varied by design, overall, participants appreciated the breadth of support received from interventionists, including health system navigation, case management and social support. Even when individuals leaving prison were returning to clinics that they were familiar with, systems navigation supported continuity of care. Our findings elucidate why navigational support was instrumental, and underscore the value of a variety of types of navigation programs in facilitating continuity of care and reintegration post-prison.