Effectiveness of Peer Navigation to Link Released HIV+ Jail Inmates to HIV Care

The proposed study has two Primary Specific Aims:

1. To examine individual-level and structural-level barriers to HIV care after release
from jail, using formative semi-structured interviews with ex-inmates, case managers,
and HIV care providers; and to use the information we obtain to inform the adaptation
and tailoring of an intervention designed to improve linkage with and retention to HIV
care for HIV+ ex-inmates (Complete);

2. Using a two-group experimental RCT design, to test the adapted health navigation
intervention condition for HIV+ inmates upon release from jail compared to a usual care
condition, and to evaluate the intervention's effectiveness at improving linkage with
and retention in HIV care, self-reported ART adherence, and HIV RNA viral load
suppression;

We hypothesize that the intervention will result in more rapid linkage to care, a greater
proportion completing at least three HIV care visits per year, increased self-reported ART
adherence, and decreased levels of HIV RNA viral load compared to the usual care control
group.

Secondary Aims of the study include assessing the potential moderating effects of substance
abuse, the potential mediating effects of substance abuse treatment, and the program's
effects on recidivism, and costs.

We hypothesize that active substance abuse will moderate the effect of the intervention, so
the intervention will be less effective among participants who report substance use.

Inclusion Criteria:

1. Age: 18 years or older

2. Male or male-to-female transgender

3. Fluency in English

4. Residing in LA County upon release

Exclusion Criteria:

1. Inability to give informed consent

2. stays in jail <5 days

3. Lack of English fluency