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Texas: Helping HIV+ Prisoners Receive Post-Release Meds
When Diana Harris was released from a Texas prison more than a decade ago, she received no information on how to continue her regimen of HIV medication. The prison issued her a 10-day supply of meds and when that ran out she basically ignored the problem for the next two years.
“I didn’t want to tell my family that I [was HIV+], so I couldn’t ask them for help,” said Harris. “I was on my own and didn’t really know where I should go to keep myself healthy.”
Harris now works to address problems with continuity of care for newly-released Texas prisoners who are HIV+. She is a peer advocate with the AIDS Outreach Center in Fort Worth, and meets with releasees in Tarrant County to help them understand the medical system in the free world.
“Navigating a hospital system is daunting if you have been incarcerated since 19 and never had to deal with it,” noted Shannon Hilgart, associate executive director of the AIDS Outreach Center. “Getting into a clinic, getting through the paperwork.... It’s a whole new learning process.”
Fortunately, the system is vastly improved compared to what was in place when Harris was released from prison.
“We can get same-day approval” for a releasee’s HIV meds, said Austin HIV medication program worker Brenda Herndon Johnston. “They have it working without delays so, when the client comes in, we get the process rolling as quickly as possible.”
That is good news for prisoners who are released to Austin, Fort Worth and other Texas cities with HIV medication support systems in place. Why, then, did a 2009 study headed by Dr. Jacques Baillargeon at the University of Texas Medical Branch at Galveston (UTMB) find that only 17.7 percent of 2,115 HIV+ prisoners had received post-release medication within 30 days of their release from Texas prisons between January 2004 and December 2007? Some medical officials place the blame squarely on the prisoners.
“Once they leave prison, we no longer have any control over what they do,” stated Owen Murray, vice president for prisoner health services at UTMB, which provides about 80% of the medical care in Texas’ prison system. “We can’t drive to their houses and make sure they go to the clinic. I really think the state is doing everything it can.”
Instead of criticism, however, what newly-released HIV+ prisoners need is practical help with obtaining their medication – such as reminders about medical appointments, help with transportation to clinics, and assistance in filling out paperwork and dealing with the health care system bureaucracy.
Janina Davis is the re-entry coordinator for the Texas HIV Medication Program, which provides HIV meds to low-income Texans. She said state officials held a summit to discuss the problem of continuity of HIV medication for released prisoners, and decided to pursue several strategies to connect prison health care services with services available from various community organizations. While not as effective as the state providing HIV medication to releasees directly, it is a way to make efficient use of existing resources.
“Prisoners receive such good [HIV medicine] regimens in prison that most are released with undetectable viral loads,” said Davis. “If they lapse, that is such a waste of what was expensive medication.”
Which is all the more reason for prison officials to ensure that HIV+ prisoners receive the resources and support they need to continue their meds once they are released.
Sources: Fort Worth Star-Telegram, www.thebody.com, www.jama.com
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