HIV Services and Treatment Implementation in Corrections (HIV-STIC): Main Findings and Lessons Learned from a Randomized Implementation Research Experiment

• In Event: NIDA’s Criminal Justice Drug Abuse Treatment Studies (CJDATS): Findings and Lessons Learned from Implementation Research

Abstract

Many factors hinder effective HIV testing, prevention, and treatment for inmates at risk for or infected with HIV. HIV prevalence rates among inmates are 3-4 times the general population, and they have high rates of HIV risk behaviors. Organizational and structural barriers create numerous gaps in the provision of services. HIV testing does not adhere to CDC guidelines, access to evidence-based prevention is limited, and gaps exist in identification of HIV-positive inmates and provision of antiretroviral medications to HIV-positive inmates that continue following release to the community, undermining public health. HIV stigma and discrimination, among correctional staff and inmates, also must be overcome. We present findings from a multisite cluster randomized trial to test the efficacy of a local change team process improvement intervention to improve delivery of inmate HIV services. The findings from 14 matched pairs of correctional facilities in 9 states indicated positive impacts of the change team model compared to control sites: staff attitudes toward HIV services improved, more HIV services were provided, HIV testing rates increased, and inmates became more aware of HIV services. Organizational-level interventions improve HIV services access for inmates; specific examples of strategies developed by staff to improve HIV services are also presented.

Authors

• Daniel J. O'Connell, University of Delaware

• Steven Belenko, Temple University

• Christy Visher, University of Delaware

• Richard Dembo, University of South Florida

• Matthew Hiller, Temple University

• Jennifer Pankow, Texas Christian University

• Linda Frisman, University of Connecticut