Revista de SIDA e investigación clínica

An Evaluation of Post-Incarceration Linkage to Care for HIV/Hepatitis C Infected Veterans in Los Angeles County

Abstract

Henry D Anaya, Jeffery Solomon and Hemen N Saifu

Objectives: This effort provides the first description of barriers and facilitators that Hepatitis C Virus (HCV) and/or Human Immunodeficiency Virus (HIV) -infected Veterans face in seeking medical care after community re-entry from Los Angeles County (LAC) jails.

Design: An evaluation of in-depth qualitative interviews with re-entry HCV and HIV-infected Veterans, and clinical and social service providers. The key variables in the analyses are HIV/HCV linkage to care, barriers/facilitators to linkage to care, and staff perspectives.

Setting: Qualitative data was collected in person at the VA hospital or by telephone interview within the year the study was conducted. Correctional institutions offer opportunities to identify Veterans with HCV and HIV, and for the US Department of Veterans Affairs (VA) to link them to medical care upon release.

Participants: Semi-structured interviews of two cohorts: 1) 16 clinical/non-clinical VA/LAC jail staff; 2) 9 postincarcerated Veterans with HIV and/or HCV. Main outcome measure: Feedback about barriers and facilitators to reduce gaps, strengthen and improve linkage to care efforts.

Results: Although some characterized efforts positively, barriers were highlighted. Veterans and staff described insufficient strategies for identifying Veterans, ineffective outreach, and inadequate staffing. Strategies for improving linkage, including routine in-take identification of Veteran status, greater program dissemination and increased staff were noted.

Conclusions: Results highlight existing gaps for Veterans transitioning to VA healthcare from LAC jails. Findings can guide future efforts to strengthen gaps between local and federal government