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Ensuring continuity of and retention in care after release from prison is critical for optimizing health outcomes among people living with HIV. As part of a large federal initiative, we conducted qualitative interviews (n = 24) with individuals living with HIV and recently released from prison in four states to understand their experiences in different navigation interventions to improve access to HIV care post-release. Interventions were delivered only in prison, only in the community, or in both settings. While the interventions varied by design, overall, participants appreciated the breadth of support received from interventionists, including health system navigation, case management and social support. Even when individuals leaving prison were returning to clinics that they were familiar with, systems navigation supported continuity of care. Our findings elucidate why navigational support was instrumental, and underscore the value of a variety of types of navigation programs in facilitating continuity of care and reintegration post-prison.

Criminally involved adolescents engage in high levels of risky sexual behavior and alcohol use, and alcohol use may contribute to lack of condom use. Detained adolescents (n = 484) were randomized to (1) a theory-based sexual risk reduction intervention (GPI), (2) the GPI condition with a group-based alcohol risk reduction motivational enhancement therapy component (GPI + GMET), or (3) an information-only control (INFO). All interventions were presented in same-sex groups in single sessions lasting from 2 to 4 hr. Changes to putative theoretical mediators (attitudes, perceived norms, self-efficacy, and intentions) were measured immediately following intervention administration. The primary outcomes were risky sexual behavior and sexual behavior while drinking measured 3 months later (65.1% retention). The GPI + GMET intervention demonstrated superiority over both other conditions in influencing theoretical mediators and over the INFO control in reducing risky sexual behavior. Self-efficacy and intentions were significant mediators between condition and later risky sexual behavior. This study contributes to an understanding of harm reduction among high-risk adolescents and has implications for understanding circumstances in which the inclusion of GMET components may be effective. (Contains 2 figures, 2 tables and 4 footnotes.)

Patient-centered medical homes (PCMH) are a key component in addressing the comprehensive physical and psychosocial needs of persons living with HIV. The AIDS Resource Center of Wisconsin (ARCW) is a PCMH that has become a nationally recognized leader in addressing barriers to HIV retention in care. Recently, ARCW has become interested in the use of short message services (SMS), as SMS have been found to have positive impacts on treatment adherence, CD4+ counts, viral load, and appointment attendance. The purpose of this research was to evaluate patient acceptability of receiving SMS from an HIV specific PCMH, in addition to evaluating patient privacy concerns and practical details of incorporating SMS into clinical care. These constructs were evaluated through a survey of 180 ARCW patients recruited from several ARCW waiting rooms. Patients were most interested in receiving SMS from medical, dental, and pharmacy services and message content regarding appointment and medication refill reminders. Participants did not indicate the presence of significant privacy concerns and were divided nearly in half over whether ARCW should refer to itself as "ARCW" or "Your medical/dental clinic." Prior to implementation of SMS at ARCW, further evaluation into the optimization of language into concise and easy to understand messages that maximize confidentiality and minimize patient anxiety is needed. [ABSTRACT FROM AUTHOR]

Interventions to decrease acquisition and transmission of sexually transmitted diseases among African American women using text messages versus small-group delivery modalities pose distinct research risks and benefits. Determining the relative risk–benefit ratio of studies using these different modalities has relied on the expertise of investigators and their institutional review boards. In this study, African American women participated in focus groups and surveys to elicit and compare risks and benefits inherent in these two intervention delivery modalities, focusing on issues such as convenience, privacy, and stigma of participation. Some risk/benefit variables were implicated in willingness to participate the two intervention modalities. [ABSTRACT FROM PUBLISHER]