Texas: Inmate Advocates Work to Close Lapse in HIV Treatment After Discharge

Efforts are underway in Texas to ensure that inmates receiving HIV treatment do not fall out of care once they leave the correctional setting.

"Prisoners receive such good [medicine] regimens in prison that most are released with undetectable viral loads," said Janina Daves, re-entry coordinator for the Texas HIV Medication Program (THMP). "If they lapse, that is such a waste of what was expensive medication."

At a summit on the issue, state officials agreed on several strategies to link ex-inmates to services in the community. Officials are using medical discharge planners to help inmates complete applications for treatment programs before they are released, Daves said. Inmates are given contact information for AIDS services groups and phone numbers to call if they run into problems.

Myriad challenges face HIV-positive inmates leaving jail, experts say. Ex-inmates may have no home or family to return to, or they may be afraid to let relatives know they are infected. In studies, only 20 percent of inmates had enrolled at an HIV clinic within 30 days post-release, and only 28 percent did so in 90 days.

"Navigating a hospital system is daunting if you have been incarcerated since 19 and never had to deal with it," said Shannon Hilgart, associate executive director of the AIDS Outreach Center. Ex-prisoners coming home to Tarrant County often are referred to AOC, whose case workers see two to three such clients a month.

The changes enacted at the state level are having some success, officials say. Typically, the University of Texas Medical Branch sends former prisoners' paperwork along before they arrive, said Brenda Herndon Johnston, an AOC care and treatment manager. And one worker at THMP is dedicated to processing applications from ex-offenders. "They have it working without delays so, when the client comes in, we get the process rolling as quickly as possible," she said.

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