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The purpose of this paper is to assess the impact of short-term incarceration on antiretroviral therapy (ART) adherence, virologic suppression, and engagement and retention in community care post-release.

A retrospective chart review of patients who attended the human immunodeficiency virus (HIV) Outreach Clinic at a Canadian remand center between September 2007 and December 2011 was carried out. Data extraction included CD4 lymphocyte count, HIV viral load, ART prescription refills, and community engagement and retention during and one-year pre- and post-incarceration.

Outpatient engagement increased by 23 percent (p=0.01), as did ART adherence (55.2-70.7 percent, p=0.01), following incarceration. Retention into community care did not significantly improve following incarceration (22.4 percent pre-incarceration to 25.9 percent post-release, p=0.8). There was a trend toward improved virologic suppression (less than 40 copies/ml; 50-77.8 percent (p=0.08)) during incarceration and 70. 4 percent sustained this one-year post-incarceration (p=0.70).

The impact of short-term incarceration in a Canadian context of universal health coverage has not been previously reported and could have significant implications in optimizing HIV patient outcomes given the large number of HIV-positive patients cycling through short-term remand centers.

In the context of the risks inherent in global warming, public libraries can partner with each other, community-based environmental groups and/or other institutions to enhance community resilience and sustainability. This chapter presents a case study of an ongoing experiment to address this opportunityand challenge. In April 2021, six Western MA libraries formed a collaborative in conjunction with a local citizens’ group, Voices for Climate [V4C], to expand public education opportunities relating to understanding, mitigating, and adapting to climate change. In its initial year, this effort yielded 13 separate programs serving more than 110 patrons, all within the 7 days of Climate Preparedness Week, a state-wide program held annually. Subsequently, this Pioneer Valley Library Collaborative [PVLC] has grown to 10 library partners and continues its close alliance with V4C. In describing the programs offered in the first year, the challenges met, limitations encountered, and lessons learned, the chapter provides one model for how libraries can jointly choose to become hubs of climate conversation and education as a means to promote their communities’ quality of life, sustainability, and resilience.