Building policy evidence for guaranteed income for people living with HIV leaving carceral settings as part of the HIV care system
Abstract
Although entry to carceral facilities presents opportunities to link PWH to HIV treatment, retention drops dramatically following release; HIV outcomes are generally worse post- release than before incarceration. This project develops new directions in HIV research by building policy evidence regarding the benefits of guaranteed income (GI) on HIV outcomes for People Living with HIV Leaving Carceral Settings (PWH-LCS). Because research on evidence-based interventions is often not translated to policy or practice, simultaneous study of policy evidence at the piloting stage of interventions is needed to facilitate timely expansion and potential scale-up. Specifically, two major barriers to moving policy are harmful narratives about PWH-LCS to receive GI and lack of information about the costs of implementing a GI for PWH-LCS. This research builds on a new parent pilot study that will evaluate HIV outcomes associated with a GI intervention among PWH-LCS exiting the San Francisco Jail system. We aim to 1) qualitatively examine factors that shape the attitudes of key HIV system stakeholders (N=15) (e.g., jail health providers, case managers, behavioral health clinicians, parole officers, etc.) regarding the ‘deservingness’ of PWH-LCS to receive GI; and 2) conduct a real-time, activity-based micro-costing and time-and-motion study of the GI pilot to estimate the explicit costs required to implement a GI intervention among PWH-LCS post-release. This project will provide opportunities for Dr. Michelle Nakphong to receive mentorship from Drs. Sheri Lippman and Starley Shade to develop skills and expertise in Implementation Science and HIV translational research and support an external funding proposal for a larger-scale clinical trial.