title: Jails, HIV testing, and linkage to care services: an overview of the EnhanceLink initiative.
abstract: Over 9 million persons in the United States (US) are admitted each year to jails. HIV prevalence among detainees is higher than the general population, which creates a public health need for linking HIV-infected detainees to services during jail and after release. The EnhanceLink initiative was funded as demonstration projects in 10 communities at 20 separate jails across the US. Grantees implemented and evaluated innovative models of HIV testing in jails and linkage of HIV-infected individuals to community services post release. In this paper, we describe services delivered with the EnhanceLink initiative. During 877,119 admission events, 210,267 inmates agreed to HIV testing and 822 new diagnoses of HIV were made. The majority of persons served with transitional services were previously diagnosed before the current incarceration. Cumulatively, 9,837 HIV+ persons were offered linkage and transitional services and 8,056 (82 %) accepted the offer. EnhanceLink demonstrated the feasibility of HIV testing in jail settings and provision of linkage services to enhance continuity of HIV care post-release.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA, aspauld@emory.edu.
authors.forename: Anne C
authors.initials: AC
authors.lastname: Spaulding
authors.forename: Cristina A
authors.initials: CA
authors.lastname: Booker
authors.forename: Shalonda H
authors.initials: SH
authors.lastname: Freeman
authors.forename: Sarah W
authors.initials: SW
authors.lastname: Ball
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Stein
authors.forename: Alison O
authors.initials: AO
authors.lastname: Jordan
authors.forename: Divya
authors.initials: D
authors.lastname: Ahuja
authors.forename: Liza
authors.initials: L
authors.lastname: Solomon
authors.forename: Paula M
authors.initials: PM
authors.lastname: Frew
mesh_terms: D000328:Adult; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015995:Prevalence; D011329:Prisoners; D011330:Prisons; D016730:Program Development; D015397:Program Evaluation; D014481:United States / Q000453:epidemiology; D055815:Young Adult