Conference AbstroctsOr

Sth *r*t*rna*i*na*{ * n f * r * n { e s r lKNWXKKffiWffiWT&WWKKreW€K

59735 The Bridge Program: Building a MentalHealth Care Network for HIV* Inmates withMental lllness Recently Released from theVirginia Department of Corrections

MichaetRollisont (presenting), StevenBo ite,f , RachelRees 2

'Virginio Commonweolth University Medical Center, Richmond, VA,United Stotes2virginio Deportment of Heatth, Richmond, VA, United Stotes

Introduction: A recent American Public Health Associationstudy (Nov 2007) indicates >50% of HIV* inmates in the UShave mental illness (MD, with half undiagnosed.Pre-incarceration, inmates with MI have substantial unmetneeds and increased needs upon release. They demonstrate poorcapacity to cope with challenges related to accessing HIV andmental health (MH) care. A pilot program, was collaborativelydeveloped by the Virginia Department of Health and the VCUMedical Center's Infectious Disease Clinic (IDC), identifyingrecently released HIV+ persons returning to IDC for HIV care,assisting with care transition, providing MH evaluation,assessment, and treatment as indicated. Components of BridgeProgram (BP) services include neurological and psychologicalevaluative testing relevant to incarceration, HIV, depression,cognitive function, posthaumatic stress disorder, and bio-socialhistory. Other supportive MH services provided: psychiahicfollow-up, MH counseling, and intensive case management.

Projections: Approximately 50 HIV* Department ofCorrection (DOC) released annually that are then followed inthe IDC.

Description: Objectives are to (l) assist in HIV care transi-tion post DOC release and (2) offer and provide extensive MHevaluation, assessment, and treatment.

Objective Outcomes: Maintain or improve HIV healthparameters achieved during DOC incarceration, identiff andtreat MH conditions appropriately toward increasing compli-ance to and retention in medical care, and lastly reduce recidi-vism back to DOC.

Lessons Learned: By the end of the second quarter(October 2009),35% met Social Security criteria for disabilityrelated to MI (7120), while 80% (16120) were found with

Journal of the IntemationalAssociation of Physicians in AIDS Caree(4) 240-267@ The Author(s) 20 | 0Reprints and permission:sagepub.com/iournalsPermissions.navDOI: 10. | 177 | 15451097 10376486http://jiapac.sagepub.com

0sner

clinically diagnosable MI conditions deemed moderate tosevere. Only one BP client has been reincarcerated and two lostto care, indicating an 85To retention rate to HIV and MH care.

Recommendations: DOC release planning should includeidentifying HIV* inmates with MI, addressing this group'selevated needs upon release regarding intensive medical casemanagement, MH screening, and treatment to facilitate thesuccessful care transition into communitv HIV care sites.

51097 Structural Ecosystem Therapy for HIVMedication Adherence and Substance AbuseRelapse PreventionDaniel Feosterr (presenting), Victorio Mitroni2, MyronBurns3, Brian McCabe2, Ahnolee Brinckst, AllonRodriguezt , Deshrotn Asthonot , MichoelRobbins't_tJniversiry of Miomi, Miomi, FI- United Stotes'University of Miomi, Coral Gobles, Ff United Stotes'Nevodo Stote College, Henderso4 NV, United Stores

Background: Substance abuse is associated with adverseconsequences for women with HIV/AIDS. Structural Ecosys-tems Therapy (SET) seeks to encourage medication adherenceand prevent drug relapse among HIV+ women by shengthen-ing family' support. helping woman distance themselves fromdrug-using family' members. and developing a family plan torespond to dru-s relapse.

Methods: .{,n \lH-funded randomized trial tested theefficacy of SET relatir.e to a psycho-educational health group(HG) inten'ention in l16 HIV+ women in drug-abuserecoven'- The inren.entions lasted four months. Research assess-ments $'ere conducred for I I months. Women were assessed fordrug use and medicauon adherence at two-month intervals. CD4T-cell count and HI\- r iral load *'ere assessed at four-monthintervals. Famill mernbers rrere assessed on a range of psycho-social factors to eramine rhe family' mechanisms of SET.

Results: Lerels of drug use did not differ by condition.Women in SET \r'er€ rrore lrkelv to separate from drug usinghousehold rrmtss and ur-rea:e substance abuse services inresponse to relap:e than *crrrn rn HG. These changes explainedthe decline in drug use otr=rral *rrhin SET between 6 and 12

m(ifl

CIofani

shrontreithetiol

6 lRaDiArLotGal

2 \

torrec

'ch,Unil2Pu.,3ch,

Unitachi

Units u c i

Bhavrtize<tatiopercreseiconcple Iadhe

Minterracelfor smeaselecttlineacrimiself-rviduainterrwere

Rr

i*: