Improving medical care for patients with HIV in New York City jails.

Correctional institutions play an important role in identifying HIV-positive patients and initiating and continuing their care. However, the actual medical care provided to patients with HIV in jail is poorly characterized. The New York City jail system cares for approximately 7,500 HIV-positive persons each year, including approximately 125 who are newly identified during testing in jail. Analysis of patient data reveals that only 17% of newly identified HIV-positive patients were started on therapy, with the most common reasons for not initiating being not meeting clinical guidelines or short stay. Among known HIV-positive patients, rates of medication continuation were high. Keys to success in maintaining a high level of care for HIV-positive patients include real-time evaluation of the population, routine feedback to providers, and case conferencing.