Summary
Using a client-focused, personalized, Incremental Risk Reduction approach, the Project START intervention improves linkage and retention in care among people with HIV who are leaving correctional facilities to return to the community.
Implementation Resources
Intervention Outcomes
- Clients were nearly twice as likely to be linked to care within 30 days of their release.
- Clients were almost twice as likely to be retained in care across the year of the project.
- Clients who received treatment for substance use disorders were 4 times as likely to be linked to care upon release.
Intervention Components
- Recruit staff who are familiar with HIV, STI, and viral hepatitis prevention activities and who are familiar with the specific needs of people being released from correctional settings.
- Use assessment and documentation tools to provide a structured program.
- Conduct enrollment and schedule two pre-release sessions within 2 months before a client’s release from a correctional setting.
- Schedule four post-release sessions. Hold the first session as soon as possible, ideally within 48 hours of release. The next three sessions should be spaced out over 3 months after release.
- Ensure the same staff member conducts both pre-release and post-release sessions with clients.
- Provide condoms at each post-release session.
- Actively maintain contact with clients, using individual-based outreach and program flexibility to determine the best time and place to meet with them.
Cost Analysis
The Project START intervention cost analysis is not currently available. However, you can also use the CIE Cost Analysis Calculator to create an estimate for implementing the intervention at your organization.
Supplementary Resources
Publications
- Janet J. Myers, Mi-Suk Kang Dufour, Kimberly A. Koester, Mark Morewitz, Rebecca Packard, Kate Monico Klein, Milton Estes, Brie Williams, Alissa Riker, and Jacqueline Tulsky, 2018: The Effect of Patient Navigation on the Likelihood of Engagement in Clinical Care for HIV-Infected Individuals Leaving Jail. American Journal of Public Health 108, 385_392, https://doi.org/10.2105/AJPH.2017.304250
- Richard J. Wolitski and and the Project START Writing Group, 2006: Relative Efficacy of a Multisession Sexual Risk–Reduction Intervention for Young Men Released From Prisons in 4 States. American Journal of Public Health 96, 1854_1861, https://doi.org/10.2105/AJPH.2004.056044
