Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Department of Medicine, Johns Hopkins University, Baltimore, MD; and.
J Acquir Immune Defic Syndr. 2021 Mar 1;86(3):271-285. doi: 10.1097/QAI.0000000000002523.
HIV care continuum outcomes deteriorate among people returning from incarceration. Interventions to improve care outcomes postincarceration have been characterized by substantial heterogeneity in approach, outcome metrics, and results. A large number of recently published interventions have not been systematically reviewed.
We searched peer reviewed and scholarly databases for published and gray literature describing interventions to improve HIV care continuum outcomes among individuals released from prison or jail. We systematically screened quantitative and qualitative intervention reports published through 2018, then extracted and analyzed study data using a classification scheme that we developed for categorizing intervention levels and strategies.
We included 23 reports from the peer-reviewed literature, 2 from gray literature, and 2 from conference abstracts (27 total). Seventeen studies were classified as individual level, 3 as biomedical level, 2 as organizational level, and 5 as multilevel. Nine studies were randomized controlled trials, 4 of which reported power calculations. Fifteen studies were quasiexperimental; one was a case study. Eleven studies were conducted in prisons, 7 in jails, and 9 in both prisons and jails. Of 11 studies reporting hypothesis tests, 5 found statistically significant effect sizes on primary outcomes.
Interventions that demonstrate postrelease improvements in clinic attendance and viral suppression include patient navigation strategies, especially involving peer support, and substance use treatment strategies.
从监禁中返回的人，其艾滋病毒护理连续体的结果会恶化。为了改善监禁后的护理结果，已经采取了各种不同的方法来实施干预措施，包括方法、结果衡量标准和结果。最近发表的许多干预措施都没有经过系统审查。
我们在同行评议和学术数据库中搜索了描述旨在改善从监狱或看守所获释的个人的艾滋病毒护理连续体结果的干预措施的已发表和灰色文献。我们系统地筛选了 2018 年之前发表的定量和定性干预报告，然后使用我们为分类干预水平和策略而开发的分类方案来提取和分析研究数据。
我们纳入了来自同行评议文献的 23 份报告、灰色文献的 2 份报告和会议摘要的 2 份报告（共 27 份报告）。17 项研究被归类为个体层面，3 项为生物医学层面，2 项为组织层面，5 项为多层次。9 项研究为随机对照试验，其中 4 项报告了功效计算。15 项为准实验研究；1 项为案例研究。11 项研究在监狱进行，7 项在看守所进行，9 项在监狱和看守所都进行。在报告假设检验的 11 项研究中，有 5 项研究发现对主要结果有统计学显著的效应大小。
表明在就诊和病毒抑制方面有改善的干预措施包括患者导航策略，特别是涉及同伴支持和药物使用治疗策略。
