Linking people living with HIV to care after incarceration

Every month, the HIV health navigation team at San Francisco AIDS Foundation gets a handful of letters from people across the U.S. who are currently living in prison. The letters, all handwritten, are typically lengthy, detailed accounts of people’s experience living with HIV, questions about where to receive care after they’re released, and requests for up-to-date health information and referrals.

“People write to us because our team has years of experience working with and in the jail and prison systems, and word gets around,” said Julie Lifshay, MPH, PhD, director of HIV services at San Francisco AIDS Foundation. “We have gained people’s trust, and people know that we are a reliable source of information.”

In addition to regularly mailing people in prison and jail reading material and information about services, the team works one-on-one with people who are currently incarcerated—or who have just been released—to make sure they are able to access care, can make it to HIV health care appointments, and are able to access and take medications.

Marco Partida, an HIV services navigator for San Francisco AIDS Foundation, travels to local jails or communicates over the phone with prisons to help develop HIV care plans in collaboration with parole officers for people living with HIV who are set to be released.

Lifshay and Partida explained that release from a long-term jail or prison stay can be an extremely difficult time for a person living with HIV, and without adequate support a person may not be able to prioritize their HIV care.

“If they were getting HIV care inside, they may or may not be provided with HIV medications when they walk out the door,” said Lifshay. “And if they are provided with antiretrovirals to take with them, it will only be for a short period of time. They may get a week, or two weeks, or a month of medications.”

“People need a lot of connections when they are released,” said Partida. “They may be coming out into a totally new world. People have to worry about their housing, their food, reuniting with friends and family. They need someone who is going to be waiting for them to make sure they can get back into HIV care and get medications.”

This is precisely the type of linkage to care that Partida provides to clients. In the midst of a prison system that can be frustratingly short on empathy, trust, efficiency and fairness—he and the rest of the health navigation team work miracles for the people they reach.

In 2017, Partida advocated for three HIV-positive undocumented people who were being kept in a deportation center. Ultimately, he prevented their deportation back to countries where access to HIV medications and care can be difficult.

Recently, he was able to transfer a client’s parole to San Francisco from another region of California, which helped a client access the medical care they needed and connect with their family.

“Switching a person’s parole county can be really difficult, so this was a huge feat,” explained Lifshay. “People usually get paroled to the county where their crime was committed, which can create complications for some people. For instance if they don’t want to go back to an area where their former social group was when they committed the crime. Or, if people get stuck in an area outside of where their family or social support is.”

Working with people who are incarcerated can be extremely gratifying, said Partida and Lifshay. In December, they attended a World AIDS Day event at San Quentin State Prison with prison staff and people incarcerated there. Even though it has been several years since Partida and Lifshay had been to San Quentin, the people living there remembered them and expressed how much they appreciated the fact that they see them as human beings, deserving of care.

“We do this work because there is a high HIV incidence and prevalence among people who are incarcerated, but that is only half of it. There’s a humanity that you bring when you work with people who are currently incarcerated. They’re human beings. And they’re grateful to people who treat them that way,” said Lifshay.

“When we work inside, we work with people, not ‘criminals,’” said Partida. “They’re not people to be afraid of.”

—

For more information about San Francisco Bay Area services for people living with HIV who are currently incarcerated, call Marco Partida at 415-487-3054. Additional information about San Francisco AIDS Foundation services for people living with HIV can be found online.