Transitional Care Coordination: From Jail Intake to Community HIV Primary Care

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A watch tower with barbed wire and hurricane fencing, overlaid by the word Jails and a drawing of a handshake.

This transitional care coordination intervention has been informed and adapted from the best practice findings of a past SPNS initiative that yielded successful HIV care continuum outcomes among client participants.

85% of incarcerated individuals pass solely through jails.

Replication resources

These evidence-informed intervention resources were developed to support interested sites in replicating this intervention and the necessary implementation processes.

Training to Implement

Additional Information

About this intervention

What is it?

An evidence-informed intervention for strengthening connections between community health centers and jail health care systems.

Why is it needed?

Without transitional assistance, people with HIV who are released from jail are at risk of: unstable housing; lack of access to health insurance and medication; overdose due to period of detoxification; exacerbation of mental health conditions; and lack of social supports when exposed to the same high-risk communities from which they were incarcerated.

Who can deliver it?

Organizations, agencies, clinics, health departments and jails.

How do I use these resources?

These resources are meant to support replication of the intervention. Manuals outline replication processes and curricula support training activities. Additional resources help provide insight from grant recipients or from other areas of the project.

Background

Jails concentrate marginalized individuals with a range of social and health problems into one place. Jails offer a window of opportunity to intervene and connect with this otherwise hard-to-reach population. Collaborations between public health agencies, community-based organizations, and jail health services have implications for public health and safety efforts and have been proven to facilitate linkage to care after incarceration.

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