HIV; Reentry; Engagement in Care


In 2003, Michigan implemented a reentry service to assist HIV-infected people incarcerated in state prisons in linking to HIV medical care immediately upon their release. We examined whether formerly incarcerated people were linked to care successfully, remained in care, and were in good health 3 years after their date of release. In all, 190 people used the service over the 5 years following its inception. Only a minority of those who were alive and not reincarcerated at the time of the evaluation engaged consistently with medical care. Unsurprisingly given low rates of engagement in care, 3 years after their release only 27% had achieved viral suppression. Concerted efforts to support formerly incarcerated HIV-infected individuals’ engagement in care over the long term are urgently needed.

Author Bio

Robin Lin Miller is Professor of Ecological Community Psychology at Michigan State University and co-director of Michigan State University's Master's Degree and Certificate in Program Evaluation.

Danielle Chiaramonte is a PhD student in Ecological Community Psychology at Michigan State University.

Miles A. McNall is Director of the Community Evaluation and Research Collaborative at Michigan State University.

Jason C. Forney is senior evaluator at the Michigan Public Health Institute.

Patrick F. Janulis is assistant professor of Medical Social Sciences in the Feinberg School of Medicine at Northwestern University.

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Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.



Alexander, M. (2012). The new Jim Crow: Mass incarceration in the age of colorblindness. New York, NY: The New Press.

Altice, F. L., Mostashari, F., & Friedland, G. H. (2001). Trust and the acceptance of and adherence to antiretroviral therapy. Journal of Acquired Immune Deficiency Syndromes, 28, 47-58.

Arriola, K. R., Braithwaite, R. L., Holmes, E., & Fortenberry, R. M. (2007). Post-release case management services and health-seeking behavior among HIV-infected ex-offenders. Journal of Health Care for the Poor and Underserved, 18, 665-674.

Avery, A., Ciomica, R., Gierlach, M., & Machekano, R. (2018). Jail-based case management improves retention in HIV care 12 months post release. AIDS and Behavior, in press.

Baillargeon, J., Giordano, T. P., Harzke, A. J., Spaulding, A. C., Wu, Z. H., Grady, J. J., … Paar, D. P. (2010). Predictors of reincarceration and disease progression among released HIV-infected inmates. AIDS Patient Care and STDs, 24, 389–394.

Baillargeon, J., Giordano, T., Rich, J., Wu, Z., Wells, K., Pollock, B., & Paar, D. P. (2009). Accessing antiretroviral therapy following release from prison. Journal of the American Medical Association, 301, 848-857.

Bakken, S., Holzemer, W. L., Brown, M. A., Powell-Cope, G. M., Turner, J. G., Inouye, J., Nokes, K.M….Corless, I. B. (2000). Relationships between perception of engagement with health care provider and demographic characteristics, health status, and adherence to therapeutic regimen in persons with HIV/AIDS. AIDS Patient Care and STDs, 14, 189-197.

Barrera, M. (1981). Social support in the adjustment of pregnant adolescents: Assessment issues. Social Networks and Social Support, 4, 69-96.

Centers for Disease Control and Prevention. (n.d.). Mortality slide series. Retrieved from http://www.cdc.gov/hiv/pdf/statistics_surveillance_statistics_slides_HIV_mortality.pdf.

Centers for Disease Control and Prevention. (2014). Annual Report 2014: Closing the Gaps in HIV Prevention and Care. Retreived from https://www.cdc.gov/hiv/pdf/policies/cdc-hiv-2014-dhap-annual-report.pdf

Centers for Disease Control and Prevention. (2015). HIV/AIDS. Retrieved from http://www.cdc.gov/hiv/

Centers for Disease Control and Prevention. (2017). HIV/AIDS. Retrieved from http://www.cdc.gov/hiv/

Cheever, L.W. (2007). Engaging HIV-infected patients in care: Their lives depend on it. Clinical Infectious Diseases, 4(11), 1500-1502.

Clements-Nolle, K., Marx, R., Pendo, M., Loughran, E., Estes, M., & Katz, M. (2008). Highly active antiretroviral therapy use and HIV transmission risk behaviors among individuals who are HIV infected and were recently released from jail. American Journal of Public Health, 98, 661-666.

Dennis, A. C., Barrington, C., Hino, S., Gould, M., Wohl, D., & Golin, C. E. (2015). You’re in a world of chaos: Experiences accessing HIV care and adhering to medications after incarceration. Journal of the Association of Nurses in AIDS Care, 26(5), 542–555.

Dhami, M. K., Mandel, D. R., Loewenstein, G., & Ayton, P. (2006). Prisoners’ positive illusions of their post-release success. Law and Human Behavior, 30, 631–647.

Fisher, J. D., Fisher, W. A., Amico, K. R., & Harman, J. J. (2006). An information-motivation-behavioral skills model of adherence to antiretroviral therapy. Health Psychology, 25, 462-473.

Fishbein, M., & Coutinho, R. (1997). NIMH multisite HIV prevention trial. AIDS, 11, S13–S19.

Fontana, L., & Beckerman, A. (2007). Recently released with HIV/AIDS: Primary care treatment needs and experiences. Journal of Health Care for the Poor and Underserved, 18, 699-714.

Gardner, E. M., McLees, M. P., Steiner, J. F., Del Rio, C., & Burman, W. J. (2011). The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clinical Infectious Diseases, 52, 793–800.

Gardner, L. I., Metsch, L. R., Anderson-Mahoney, P., Loughlin, A. M., Del Rio, C., Strathdee, S…. Holmberg, S.D. (2005). Efficacy of a brief case management intervention to link recently diagnosed HIV-infected persons to care. AIDS, 19, 423-431.

Giordano, T.P., Gifford, A. L., White, A. C., Suarez-Almazor, M. E., Rabeneck, L., Hartman, C…..Morgan, R. O. (2007). Retention in care: a challenge to survival with HIV infection. Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America, 44(11), 1493–1499.

Glaze, L. E., & James, D. J. (2006). Mental health problems of prison and jail inmates. Washington, DC: U.S. Department of Justice.

Greene, J. C. (2007). Mixed methods in social inquiry. San Francisco, CA: Jossey-Bass.

Greene, J. C. & Caracelli, V. J. (1997). Advances in mixed-method evaluation: The challenges and benefits of integrating diverse paradigms. New Directions for Evaluation Number, no. 74. San Francisco, CA: Jossey-Bass.

Greenfeld, L. A. & Snell, T. L. (2000). Women offenders. Washington, DC: U.S. Department of Justice.

Iroh, P. A., Mayo, H., & Nijhawan, A. E. (2015). The HIV care cascade before, during, and after incarceration: a systematic review and data synthesis. American Journal of Public Health, 105, e5-e16.

Luther, J. B., Reichert, E. S., Holloway, E.D., Roth, A. M., & Aalsma, M. C. (2011). An exploration of community reentry needs and services for prisoners: A focus on care to limit return to high-risk behavior. AIDS Patient Care and STDS, 25, 475-481.

Maruschak, L. M., & Beavers, R. (2009). Bureau of justice statistics: HIV in prisons, 2007-2008. U.S. Department of Justice: Bureau of Justice Statistics.

Meyer, J.P., Cepeda, J., Wu, J., Trestman, R.L., Altice, F.L., & Springer, S.A. (2014). Optimization of human immunodeficiency virus treatment during incarceration: Viral suppression suppression at the prison gate. JAMA Internal Medicine, 174, 721–729.

Mugavero, M. J. (2008). Improving engagement in HIV care: what can we do? Topics in HIV Medicine : A Publication of the International AIDS Society, 16, 156–161.

Mugavero, M. J., Davila, J. A., Nevin, C. R., & Giordano, T. P. (2010). From access to engagement: Measuring retention in outpatient HIV clinical care. AIDS Patient Care and STDs, 24, 607-613.

Mugavero, M. J., Norton, W. E., & Saag, M. S. (2011). Health care system and policy factors influencing engagement in HIV medical care: Piecing together the fragments of a fractured health care delivery system. Clinical Infectious Diseases, 52(S2), S238-2246.

Murphree, J., Batey, D. D., Kay, E. S., Westfall, A. O., Mugavero, M. J. (2018). Suboptimal retention in care among recently released prisoners: Implications for social workers in HIV primary care. AIDS and Behavior, in press.

National Minority AIDS Council and Housing Works. (2013). Mass Incarceration, Housing Instability and HIV/AIDS: Research Findings and Policy Recommendations. Retreived from: http://nmac.org/wp-content/uploads/2013/02/Incarceration-Report-FINAL_2-6-13.pdf

Pakenham, K., & Rinaldis, M. (2002). Development of the HIV/AIDS stress scale. Psychology and Health, 17, 203-219.

Palepu, A., Tyndall, M. W., Chan, K., Wood, E., Montaner, J. S. G., & Hogg, R. S. (2004). Initiating highly active antiretroviral therapy and continuity of HIV care: the impact of incarceration and prison release on adherence and HIV treatment outcomes. Antiviral Therapy, 9(5), 713–719.

Petersilia, J. (2003). When prisoners come home: Parole and prisoner reentry. London: Oxford University Press.

Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement,1, 385-401.

Rodger A. J., Cambiano, V., Bruun, T., Vernazza, P., Collins, S., Corbelli, G. M., Degen, O., Estrada, V., Geretti, A.M., Beloukas, A & Phillips, A.N. (2018). Risk of HIV transmission through condomless sex in MSM couples with suppressive ART: The PARTNER2 Study extended results in gay men. Journal of the International AIDS Society, 21, 163.

Rodger, A. J., Cambiano, V., Bruun, T., Vernazzo, P. Collins, S., Lunzen, J., Corbelli, G. M., Estrada, V., Geretti, A.M., Beloukas, A. & Asboe, D. (2016). Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. Journal of the American Medical Association, 316(2),1-11.

Simoni, J. M., Kurth, A. E., Pearson, C. R., Pantalone, D. W., Merrill, J. O., & Frick, P. A. (2006). Self-report measures of antiretroviral therapy adherence: a review with recommendations for HIV research and clinical management. AIDS and Behavior, 10, 227-245.

Springer, S. A., Friedland, G., Doros, G., Pesanti, E., & Altice, F. (2007). Antiretroviral treatment regimen outcomes among HIV-infected prisoners. HIV Clinical Trials, 8, 205–212.

Springer, S., Pesanti, E., Hodges, J., Macura, T., Doros, G., & Altice, F. (2004). Effectiveness of antiretroviral therapy among HIV-infected prisoners: reincarceration and the lack of sustained benefit after release to the community. Clinical Infectious Diseases, 38, 1754-1760.

Stephenson, B. L., Wohl, D. a, Golin, C. E., Tien, H.-C., Stewart, P., & Kaplan, A. H. (2005). Effect of release from prison and re-incarceration on the viral loads of HIV-infected individuals. Public Health Reports, 120(1), 84–88.

Thompson, M. A., Mugavero, M. J., Amico, K. R., Cargill, V. A., Chang, L. W., Gross, R….Beckwith, C.G. (2012). Guidelines for improving entry into and retention in care and antiretroviral adherence for persons with HIV: Evidence-based recommendations from an International Association of Physicians in AIDS Care panel. Annals of Internal Medicine, 156, 817-833.

Travis, J. C. (2005). But they all come back: facing the challenges of prisoner reentry. Urban Institute Press, 391.

United States Department of Health and Human Services. HIV core indicators. Available at: http://blog.aids.gov/2012/08/secretary-sebelius- approves-indicators-for-monitoring-hhs-funded-hiv-services.html.

Visher, C. (2010). Life after prison: Tracking the experiences of male prisoners returning to Chicago, Cleveland, and Houston. Washington, DC: The Urban Institute. Retrieved from http://www.urban.org/publications/412100.html.

Visher, C., Debus, S., & Yahner, J. (2008). Employment after prison: A longitudinal study of releasees in three states. Washington, DC: The Urban Institute. Retreived from http://www. urban. org/publications/411778. html.

Visher, C., La Vigne, N., & Travis, J. (2004). Returning home: Understanding the challenges of prisoner reentry. Urban Institute. http://doi.org/10.1037/e720382011-001

Walsh, J. C., Mandalia, S., & Gazzard, B. G. (2002). Responses to a 1-month self-report on adherence to antiretroviral therapy are consistent with electronic data and virological treatment outcome. AIDS, 16, 269-277.

Winters, K., Zenilman, J., & Co-Chairs, C. P. (1994). Simple screening instruments for outreach for alcohol and other drug abuse and infectious diseases. Treatment Improvement Protocol (TIP) Series, Vol. 11. Washington, DC: Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment.

Wohl, D., Scheyett, A., Golin, C., White, B., Matuszewski, J., Bowling, M., Smith, P…Earp, J. (2011). Intensive case management before and after prison release is no more effective than comprehensive pre-release discharge planning in linking HIV-infected prisoners to care: A randomized trial. AIDS and Behavior, 15, 356-364.

Wu, A., Revicki, D., Jacobson, D., & Malitz, F. (1997). Evidence for reliability, validity and usefulness of the Medical Outcomes Study HIV Health Survey (MOS-HIV). Quality of Life Research, 6, 481-493.

Zaller, N. D., Holmes, L., Dyl, A. C., Mitty, J. A., Beckwith, C. G., Flanigan, T. P., & Rich, J. D. (2008). Linkage to treatment and supportive services among HIV-positive ex-offenders in Project Bridge. Journal of Health Care for the Poor and Underserved, 19, 522-531.