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document
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 . Imprisonment provides opportunities for the diagnosis and successful treatment of HIV , however , the benefits of antiretroviral therapy are frequently lost following release due to suboptimal access and utilization of health care and services . In response , some have advocated for development of intensive case-management interventions spanning incarceration and release to support treatment adherence and community re-entry for HIV-infected releasees . We conducted a randomized controlled trial of a motivational Strengths Model bridging case management intervention ( BCM ) beginning approximately 3 months prior to and continuing 6 months after release versus a standard of care prison-administered discharge planning program ( SOC ) for HIV-infected state prison inmates . The primary outcome variable was self-reported access to post-release medical care . Of the 104 inmates enrolled , 89 had at least 1 post-release study visit . Of these , 65.1 % of BCM and 54.4 % of SOC assigned participants attended a routine medical appointment within 4 weeks of release ( P > 0.3 ) . By week 12 post-release , 88.4 % of the BCM arm and 78.3 % of the SOC arm had at attended at least one medical appointment ( P = 0.2 ) , increasing in both arms at week 24-90.7 % with BCM and 89.1 % with SOC ( P > 0.5 ) . No participant without a routine medical visit by week 24 attended an appointment from weeks 24 to 48 . The mean number of clinic visits during the 48 weeks post release was 5.23 ( SD = 3.14 ) for BCM and 4.07 ( SD = 3.20 ) for SOC ( P > 0.5 ) . There were no significant differences between arms in social service utilization and re-incarceration rates were also similar . We found that a case management intervention bridging incarceration and release was no more effective than a less intensive pre-release discharge planning program in supporting health and social service utilization for HIV-infected individuals released from prison .
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Intervention_Physical
Intensive case management
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Intervention_Physical
comprehensive pre-release discharge planning
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Intervention_Physical
antiretroviral therapy
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Intervention_Educational
motivational Strengths Model bridging case management intervention ( BCM )
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Outcome_Other
self-reported access to post-release medical care
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Outcome_Other
routine medical appointment
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Outcome_Other
least one medical appointment
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Participant_Condition
HIV-infected prisoners
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Participant_Condition
HIV-infected releasees .