The Navigator Project

Navigator-Enhanced Case Management for HIV-Infected Jail Inmates Reentering the Community

Each year, there are over 600 unduplicated HIV-infected persons incarcerated in the San Francisco jail. Two thirds of those released with HIV-focused discharge planning are reincarcerated within one year. More than half of HIV-infected jail inmates are diagnosed with mental health conditions severe enough to require medication and a similar proportion report substance use disorders at the time of detention. While some community-based services exist, there remains a critical need to improve linkages to care and adherence to care plans for HIV-infected adults as they move between community and jail. The Navigator Project is a five-year randomized study that will test the effectiveness of an intensive enhanced case management intervention to reduce sex and drug-related HIV transmission risk; increase HIV medication adherence; reduce drug dependence; and reduce reincarceration.

Inclusion Criteria:

• Detention in the San Francisco jail system
• Confirmed HIV infection
• Lifetime history of ever having met standardized criteria for drug or alcohol addiction
• Likely release back into San Francisco without transfer to another facility
• Agreement to work with Forensic AIDS Project to plan post-release care
• Able and willing to provide informed consent
• Not scheduled for release within 36 hours

Exclusion Criteria:

• Undocumented HIV status
• Inability to speak English or Spanish
• Unable or unwilling to provide informed consent
• Not under routine level of jail security