Project Bridge: Linking Recently Released Prisoners with HIV/AIDS to Primary Care

Project Bridge is an ongoing, federally funded demonstration project that was started in 1997 to provide intensive case management for HIV-positive ex-offenders being released from the Rhode Island state prison to the community. Human immunodeficiency virus (HIV) infection is significantly more prevalent among the incarcerated than the general population. For many prisoners, incarceration has, in the past, been the only time that they may have access primary care.

Project Bridge is based on collaboration between co-located medical and social work staff. The primary goal of the program is to increase continuity of medical care through social stabilization; it follows a harm reduction philosophy in addressing substance use. Program participants are provided with assistance in accessing a variety of medical and social services. The treatment plan may include the following: mental illness triage and referral, substance abuse assessment and treatment, appointments for HIV and other medical conditions, and referral for assistance to community programs that address basic survival needs.

Through 2001, 97 offenders were enrolled. Injection drug use was reported by 80% of those enrolled. There were 90% followed for 18 months, 7% moved out of state or died, and 3% were lost to follow-up. Re-incarceration happened to 48% at least once. Of those expressing a need, 75% were linked with specialty medical care in the community, and 100% received HIV-related medical services. Of those expressing a need for substance abuse treatment, 67% were successful in keeping appointments for substance abuse treatment within the community.

Project Bridge has demonstrated that it is possible to maintain HIV-positive ex-offenders in medical care through the provision of ongoing case management services following prison release. Ex-offenders will access HIV-related health care after release when given adequate support.

Selected Publications:

1. Rich, J.D., et al., Successful linkage of medical care and community services for HIV-positive offenders being released from prison. J Urban Health, 2001. 78(2): p. 279-89.