Effects of Peer Navigation Intervention on HIV Viral Suppression After Release From Jail

HIV viral load suppression
HIV viral load suppression
The effects of a peer navigation intervention on HIV viral suppression in previously incarcerated individuals were examined.

A peer navigation intervention prevented the decline in viral suppression in patients with HIV who have just been released from jail, according to results published in JAMA Internal Medicine.

The intervention used in the study, called Linking Inmates to Care in Los Angeles (LINK LA, ClinicalTrials.gov Identifier: NCT01406626), is a 12-week, 24-session peer navigation intervention in which trained peer navigators counsel patients on goal-setting and problem-solving around barriers to HIV care and adherence. The program starts while patients are still incarcerated. After patients are released from jail, the counselors then accompany them to 2 HIV care visits and facilitate communication with clinicians during those visits.

The study included 250 participants with HIV being released from Los Angeles County Jail between December 2012 and October 2016. Participants were randomly assigned to the peer navigation intervention (n=125) or standard transitional case management (n=125).  The primary outcome was change in HIV viral suppression (<75 RNA copies/mL) over a 12-month period.

At 12 months, 49.6% (62) of the intervention participants achieved viral suppression compared with 36.0% (45) in the control group.

The probability of viral suppression declined from 52% at baseline to 30% in control participants, while participants in the intervention group maintained a 49% rate of viral suppression from baseline to 12 months.

The researchers stressed the need for further studies to explore ways to strengthen the intervention to increase viral suppression.

Disclosure: Dr Shoptaw has received clinical supplies from MediciNova Inc for a different clinical trial. 

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Cunningham WE, Weiss RE, Nakazono T, et al. Effectiveness of a peer navigation intervention to sustain viral suppression among HIV-positive men and transgender women released from jail: the LINK LA randomized clinical trial [published online March 12, 2018].  JAMA Intern Med. doi:10.1001/jamainternmed.2018.0150