Directly Observed Therapy for Community-Released HIV+ Prisoners

The aim of this study is to develop effective interventions for HIV-infected prisoners who are released to the community. The intervention that we will study will be directly observed therapy (DAART/DOT) and we will compare this to the current standard of care that involves self-administered therapy (SAT). All subjects will get transitional case management and all subjects with a prior history of opiate dependence will be offered opiate substitution therapy (buprenorphine or methadone). Hypotheses: * At the end of six months those receiving DAART will have a higher level of adherence to HAART as compared to the SAT group. * The DAART Intervention will result in subjects having lower viral loads and higher CD4 counts as compared to the SAT group. * At the end of six months, the DAART group will have a lower rate of recidivism to jail/prison as compared to the SAT group. * Over the year, the DAART group will be more likely to make repeated primary HIV care visits than the SAT group.