Enhancing HIV care linkages for women in jail: A gender-responsive case management approach
Lawrence Ouellet, PhD
COIP - Epidemiology/Biostatistics (MC 923)
University of Illinois at Chicago
School of Public Health
1603 W. Taylor Street
Chicago, IL 60612
Phone: 312-355-0145 Fax: 312-996-1450
1. Summary of Intervention
The proposed project will address primary care and service needs of women who are living with HIV in jail and upon returning to the community, with an emphasis on building effective community linkages specific to the needs of women. During Year 1, we will address the organizational, data, and evaluation requirements necessary to collaborate with the Evaluation Center. During Years 2-4, the proposed gender-responsive case management intervention will:
1) streamline existing HIV counseling and testing in Cook County Jail (CCJ)
2) initiate baseline needs assessment and discharge planning for women with HIV in the jail, and 3) link them to community-based primary care and social services after release.
2. Target Population
The proposed intervention targets incarcerated women in CCJ, the largest single-site county jail in the US. While the HIV prevalence rates are consistently higher for the incarcerated population than for the general public, continuity of HIV primary care and related services for this population needs improvement. Female inmates are more likely than males to fail to keep their appointments, and challenges that female inmates experience are different from those of males. The majority of incarcerated women are racial/ethnic minorities living in poverty, who may have limited access to quality care. Many are illicit drug users and engage in risky sexual activities including exchanging sex for drugs or survival needs. High rates of childhood abuse experiences in these women also pose risks of depression and other psychosocial troubles.
3. Goals and Objectives
To enhance continuity of quality care and services for incarcerated women with HIV, interventions need to be planned before their release, and continue to mitigate barriers to obtaining care and services in their communities. The interdisciplinary project team of clinicians providing women's health and HIV care in CCJ, community based public health researchers at the University of Illinois at Chicago who also provide primary care and multiple HIV prevention services, and a long-standing community-based organization that provides HIV related services to African Americans is poised to carry out the proposed project. The goals and objectives are:
Goal 1: To reduce barriers to access for primary care and support services.
Objectives are: 1) establish linkages between incarcerated women and services, 2) improve rates of adherence to
care, and 3) achieve better access to needed services.
Goal 2: To improve quality of life and reduce recidivism.
Objectives include: 1) achieve reductions in problems identified in case management sessions, 2) reduce the number of ‘lost to
follow-up' cases, and 3) reduce incarceration at 6-months post-release.
Goal 3: To reduce risks of HIV transmission.
Objectives are: 1) achieve high attendance at case management and group empowerment sessions, 2) reduce HIV risk behaviors, and 3) reduce new STD infections.