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Integration of Jail Booking and HIV Surveillance Data to Facilitate Care Coordination
Tigran Avoundjian1,2, Matthew R Golden1,2,3, Brandon L Guthrie2,4
1Department of Epidemiology, University of Washington, Seattle, Washington, USA.
Abstract:
Many people with HIV (PWH) in jail have not been well engaged in HIV treatment in the community. This study aimed to assess the impact of a data exchange paired with care coordination for PWH on HIV outcomes after jail release. We developed an automated process to match jail booking records with HIV surveillance data. Health department HIV relinkage specialists and jail release planners used the data in weekly case conferences to facilitate care coordination for PWH who were out of care (no CD4 or viral load [VL] reported in the past 12 months) or viremic (VL ≥ 200 copies/mL) before booking. We compared VL testing within 3 months after release and viral suppression (VL < 200 copies/mL) within 6 months after release in preintervention (October 1, 2016-October 1, 2017) versus postintervention (April 1, 2018-February 1, 2019) periods using Cox proportional hazard models. Comparing 153 bookings among PWH in the preintervention period to 80 in the postintervention period, VL testing after release did not differ (47% vs. 55%; adjusted hazard ratio [aHR]: 1.05, 95% confidence interval [CI]: 0.68-1.64) nor did viral suppression (35% vs. 44%; aHR: 1.28 [95% CI: 0.80-2.05]). Data exchange and care coordination are insufficient to improve postrelease outcomes among PWH without additional interventions in the jail and community.
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