Given the number of HIV-positive individuals who pass through jails, this linkage work has important public health implications. For people who are aware of their serostatus, many face incredible barriers to health care, both individual and systemic. We know that the biggest “cliff” in the care continuum occurs between linkage to and retention in care, representing more than 300,000 people living with HIV/AIDS who are lost between those stages,48 which is why efforts such as jail linkage programs are so imperative.
Jail linkage work aligns with the National HIV/AIDS Strategy. In addition, the Affordable Care Act calls for improved care coordination—something this work helps achieve. The CDC recommends testing in jail facilities, and the EnhanceLink study demonstrated that linkage services can improve health outcomes and ARV adherence among a highly transient and difficult-to-reach population. Jails are an extension of the community. Helping address HIV among releasees has important implications not only on jail releasees’ health but also on community viral loads.