When Diana Harris was released from a Texas prison over a decade ago, she wasn't given any information on how to continue her regime of HIV medication. When the ten-day supply of meds the prison had issued her ran out, she basically ignored the problem for the next two years.

"I didn't want to tell my family the 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 correct the problems in continuity of care for newly-released Texas prisoners who have HIV infections. She is a peer advocate at the AIDS Outreach Center in Forth Worth. As such, she meets with releasees in Tarrant County and helps them understand the free world medical system.

"Navigating a hospital system is daunting if you have been incarcerated since 19 and never had to deal with it," said 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."

The system is vastly improved compared to what was in place when Harris was released.

"We can get same-day approval" for a new releasee's HIV meds, said Austin HIV medication program worker Herndon Johnson. "They have it working so, when the client comes in , we get the process rolling as quickly as possible."

All of this is good news for those prisoners being released to Austin, Fort Worth or other Texas cities with releasee support systems in place. Why then did a recent study headed by University of Texas Health Medical Branch at Galveston (UTMB) physician Dr. Jacques Baillargeon report that only 18% of 1,750 HIV+ prisoners who were released from Texas prisons between January 2004 and December 2007 receive HIV medications within 30 days of release? Sams prison health officials put the blame squarely oon the releasees' shoulders.

"Once they leave prison, we no longer have any control over what they do," according to Owen Murray, vice president for prisoner health services at UTMB, the state entity that provides about 80% of prisoner health care in Texas. "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."

Of course, treating newly-released prisoners like they were still in prison won't work. That approach wouldn't work with people who have never been to prison either. What might meet with more success would be email and phone reminders of appointments, offers of rides to the clinic and help filling out paperwork and dealing with the health care bureaucracy.

Thankfully, Murray's opinion is not the only one. Janina Davis is the re-entry coordinator for the Texas HIV Medication Program, which has a $90 million annual budget and a mission to provide HIV medication to low-income Texans. She said that state officials recently met to discuss the continuity of HIV medication problem. They decided to pursue several strategies to help connect prison medical services with the medical services available from various community organizations. While not as effective as the state providing the medications, it is a good way to make efficient use of the resources available. And that is surely a good thing.

"Prisoners receive such good [medicine] regimes in prison that most are released with undetectable viral loads," Daves said. "If they lapse, that is such a waste of what was expensive medication."

 Source: Fort Worth Star-Telegram

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