A randomized controlled study of intervention to improve continuity care engagement among HIV-infected persons after release from jails

ABSTRACT

Short-term stay, multiple jail admissions and social and financial difficulties are significant obstacles for continuity care engagement (CCE) after release among HIV-infected jail detainees. However, data existing on interventions or strategies to increase post-release CCE among this population are limited. We conducted a randomized controlled study among HIV-infected detainees at Cook County Jail during 2011–2014. The intervention group received telephone contact within 2–4 days of release by a continuity clinic coordinator, who scheduled and informed the ex-detainees of their appointment date within 6 weeks post-release plus standard of care, while the control group received standard of care. The standard of care included comprehensive discharge planning, offering substance abuse treatment and provision of information on how to self-schedule an appointment with the chosen clinics. Of the 166 detainees enrolled, 56 were excluded due to being sent to prison or re-incarcerated within 6 weeks. The final cohort included 55 detainees in each of the groups. The rate of CCE within 6 weeks after release was significantly higher in the intervention group compared to the control group (58% vs. 33%; P = .007). In multivariable logistic regression analysis, being in the control group was the only factor associated with no CCE within 6 weeks (adjusted odds ratio 2.66; 95% confidence interval 1.18–6.00; P = .02). The study findings suggest that the simple telephone contact intervention significantly improved CCE among HIV-infected jail detainees.

KEYWORDS:

• Intervention
• continuity care engagement
• human immunodeficiency virus
• jail detainees
• randomized controlled study

Acknowledgement

The salary of the investigator (T.K.) was partially funded by the Mark Weiss Memorial Fund, Rush University Medical Center.

Disclosure statement

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article. At the time of the conceptualization, design and implementation of this study, Harold Kessler, M.D. was a full-time employee of Rush University Medical Center in Chicago. He is currently an employee of ViiV Healthcare, Research Triangle Park, NC.

Disclosure statement

No potential conflict of interest was reported by the authors.