In-facility HIV peer-based rehabilitation programs' role in linkage to care among persons transitioning from correctional to community-based HIV care in South Africa.

Abstract

This analysis aims to examine the role of pre-release, HIV-related, peer-based rehabilitation program attendance on post-release linkage to community-based HIV care in South Africa. During a post-release linkage-to-care prospective study, participants from six correctional facilities who had an HIV-positive diagnosis and were taking anti-retroviral medications at release (N = 351) self-reported rehabilitation program participation. Linkage-to-care status 90 days post-release was verified by medical chart review. In a binomial regression model, HIV-related, peer-based rehabilitation program attendance was insignificant (relative risk [RR] 1.1, 95% confidence interval [CI] [0.8, 1.4], p-value = 0.7), but short-/long-term incarceration site (RR 1.5, 95% CI [1.0, 2.1], p-value = 0.04) and relationship status pre-incarceration (RR 1.9, 95% CI [1.0, 3.6], p-value = 0.05) were significantly associated with linkage to HIV care post-release. Rehabilitation and peer-based HIV programs have had demonstrated benefit in other settings. Assessment of current programs may identify opportunities for improvement.