Table 1.
Summary of studies assessing associations between patient/peer navigation and HIV, OUD, HCV, and other outcomes.
| Study | Study Design | Location | Population | CJ-specific? | Intervention | Outcomes | Peer or Patient Navigation? |
Reported or Perceived Outcomes |
|---|---|---|---|---|---|---|---|---|
| Westergaard et al., 2019 | Retrospective Cohort Study | Wisconsin Department of Corrections | Recently released HIV-positive individuals receiving ART while incarcerated | Yes- State Prison | Effect of patient navigation vs standard release planning | Linkage to care (Obtaining HIV test at any community-based provider within 180 days of release) VS for those linked to care | Patient navigation-No shared experience | Patient navigation increased linkage to care (84% linked with patient navigation, 60% without, p = 0.002). No significant difference in VS among those linked to care. |
| Cunningham et al., 2018 | RCT | Los Angeles County Jails, United States | HIV-positive men and transgender women released from jail | Yes- Jails | Effect of peer navigation vs. traditional case management (assessing needs and referrals to services) | Viral Suppression after release HIV care retention (Number of HIV primary care visits per 12 months, given at least one visit in the previous 12 months (self-report)). | Peer navigators-prior experience with incarceration and HIV | Peer navigation intervention prevented declines in VS (Peer navigation arm: 49% at baseline, 49% at 12 months, Control arm: 52% at baseline, 30% at 12 months, Difference-in-difference 22% (95% CI: 3%–41%, p = 0.02) and improved HIV primary care visit retention after release from incarceration, compared with transitional case management. |
| Myers et al., 2018 | RCT | San Francisco County Jail | People living with HIV in the jail system | Yes- Jails | Effect of patient navigation vs TAU (discharge planning & case management) | Linkage to HIV care HIV care retention HIV sexual risk behaviors VS | Called patient navigation, but peers had prior experience with HIV, incarceration, and substance use disorders | Patient navigation resulted in greater linkage to care within 30 days of release (AOR=2.15 (95% CI: 1.23–3.75) and consistent retention over 12 months (AOR=1.95 (95% CI: 1.11–3.46). No significant difference in HIV sexual risk behaviors or VS |
| Wohl et al., 2016 | One group-baseline and follow-up assessments | Los Angeles, California | Hard to reach HIV-positive persons recently released from jail, prison, or other institutions | Yes- Jails, Prisons, | Effect of patient navigation | Linkage to HIV care VS | Patient navigation-experience with HIV case management | Patient navigation increased% of patients linked to care (68% at 3 month, 85% at 6 months, 94% at 12 months (no statistical test)) and% of patients with VS (51% at pre-enrollment vs. 63% at time of retention X2=11.8, p<0.01) |
| Teixeria et al., 2015 | One group-baseline and follow-up assessments | New York City Jails | HIV-positive individuals released from jails | Yes- Jails | Effect of care coordinator | ART uptake ART adherence (self-report) VL | Care coordinator-background unclear | Care coordinator increased% of patients taking ART (55.6% at baseline 92.6% at 6 months p<0.05),% of patients taking ART as directed (80.7% at baseline 93.2% at 6 months p<0.05), and decreased VLs (54,031 at baseline 13,738 at 6 months p<0.05). |
| Jordan et al., 2013 | Program Outcome Evaluation | New York City Jail System | HIV-positive persons released from jails | Yes- Jails | Effect of patient navigation | Linkage to primary care | Patient Care Coordinator | Patient navigation increased% linked to primary care among those released to the community (70% (941/1345) in 2009; 75% (1259/1676) in 2010; and 73% (1336/1824) in 2011 (no statistical test)). |
| Samuels et al., 2018 | Observational Retrospective Cohort | Rhode Island Emergency Departments (ED) | ED patients discharged after a non-fatal opioid overdose | No | Effect of usual care, receiving take-home naloxone, or take-home naloxone and a peer recovery coach | Time to medication for opioid use disorder (MOUD) initiation | Not stated | Peer recovery coaches decreased time to MOUD initiation (81.5 days vs 139 days usual care). |
| Corrigan et al., 2017 | RCT | Metropolitan Chicago, Illinois | Homeless African Americans with mental illness | No | Effect of peer navigations vs. TAU | Physical and mental health Recovery from mental illness Quality of life | Peer navigators-African American who were homeless during their adult life and in recovery from serious mental illness | Peer navigation intervention improved mental & physical health and quality of life more than TAU. |
| Ford et al., 2016 | Program Outcome Evaluation | New York City Health Centers providing clinical care, harm reduction, and social services | Hepatitis C patients | No | Effect of patient navigation | HCV treatment initiation SVR | No shared experience | Peer navigation participants were twice as likely to initiate HCV treatment (46% vs 25% for off-site participants). Peer navigation improved SVR rates 94% (74) versus 86% (43) receiving off-site care. |
| Metsch et al., 2016 | RCT | Hospitals across the United States | Hospitalized patients with HIV and substance use | No | Effect of patient navigation with or without financial incentive | VS | No shared experience | Patient navigation with or without financial incentives did not improve VS at 12 months relative to TAU |
| Giordano et al., 2016 | RCT | Houston Harris Health System, Texas | Hospitalized adults either newly diagnosed with HIV or out of care | No | Effect of peer mentors | Retention in HIV care VL | No shared experience | Peer mentoring did not increase reengagement in outpatient HIV care among hospitalized, out-of-care persons. |
| Trooskin et al., 2015 | Program Outcome Evaluation | Philadelphia | Door-to-door and street outreach participants with reactive HCV tests | No | Effect of patient navigation | HCV diagnosis Linkage to HCV care | Not stated | Patient navigation increased HCV diagnosis; anti-HCV seroprevalence was 3.9% (n = 52), higher than community rates. Patient navigation improved linkage to HCV care; 87% (n = 42) had successful confirmatory tests performed. |
Antiretroviral Treatment/Therapy (ART), Emergency Department (ED), Hepatitis C Virus (HCV), Human Immunodeficiency Virus (HIV), Medication for Opioid Use Disorder (MOUD), Randomized Control Trial (RCT), Street-connected youth (SCY), Sustained Virologic Response (SVR), Treatment as usual (TAU), Viral Load (VL), Viral Suppression (VS).