All-cause mortality among people with HIV released from an integrated system of jails and prisons in Connecticut, USA, 2007–14: a retrospective observational cohort study

Loeliger, Kelsey; Altice, Frederick L.; Ciarleglio, Maria; Rich, Katherine M.; Chandra, Divya K; Gallagher, Colleen; Desai, Mayur M.; Meyer, Jaimie P.

doi:10.1016/s2352-3018(18)30175-9

Cited by 24 publications

(15 citation statements)

References 23 publications

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“…Unlike previous studies [ 20 , 56 ], IDU transmission risk and high psychiatric need correlated with VS over time. While IDU and psychiatric need were not associated with frequency of transitional case management utilization, such individuals may have received additional psychiatric case management to link and retain them in treatment for psychiatric or substance use disorders, which could have improved VS. Also, some PLWH with an IDU history died early during follow-up, including from drug overdose [ 66 ], which limited our ability to clearly assess the role of current or past IDU on longitudinal HIV treatment outcomes.…”

Section: Discussionmentioning

confidence: 99%

Retention in HIV care during the 3 years following release from incarceration: A cohort study

et al. 2018

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BackgroundSustained retention in HIV care (RIC) and viral suppression (VS) are central to US national HIV prevention strategies, but have not been comprehensively assessed in criminal justice (CJ) populations with known health disparities. The purpose of this study is to identify predictors of RIC and VS following release from prison or jail.Methods and findingsThis is a retrospective cohort study of all adult people living with HIV (PLWH) incarcerated in Connecticut, US, during the period January 1, 2007, to December 31, 2011, and observed through December 31, 2014 (n = 1,094). Most cohort participants were unmarried (83.7%) men (77.0%) who were black or Hispanic (78.1%) and acquired HIV from injection drug use (72.6%). Prison-based pharmacy and custody databases were linked with community HIV surveillance monitoring and case management databases. Post-release RIC declined steadily over 3 years of follow-up (67.2% retained for year 1, 51.3% retained for years 1–2, and 42.5% retained for years 1–3). Compared with individuals who were not re-incarcerated, individuals who were re-incarcerated were more likely to meet RIC criteria (48% versus 34%; p < 0.001) but less likely to have VS (72% versus 81%; p = 0.048). Using multivariable logistic regression models (individual-level analysis for 1,001 individuals after excluding 93 deaths), both sustained RIC and VS at 3 years post-release were independently associated with older age (RIC: adjusted odds ratio [AOR] = 1.61, 95% CI = 1.22–2.12; VS: AOR = 1.37, 95% CI = 1.06–1.78), having health insurance (RIC: AOR = 2.15, 95% CI = 1.60–2.89; VS: AOR = 2.01, 95% CI = 1.53–2.64), and receiving an increased number of transitional case management visits. The same factors were significant when we assessed RIC and VS outcomes in each 6-month period using generalized estimating equations (for 1,094 individuals contributing 6,227 6-month periods prior to death or censoring). Additionally, receipt of antiretroviral therapy during incarceration (RIC: AOR = 1.33, 95% CI 1.07–1.65; VS: AOR = 1.91, 95% CI = 1.56–2.34), early linkage to care post-release (RIC: AOR = 2.64, 95% CI = 2.03–3.43; VS: AOR = 1.79; 95% CI = 1.45–2.21), and absolute time and proportion of follow-up time spent re-incarcerated were highly correlated with better treatment outcomes. Limited data were available on changes over time in injection drug use or other substance use disorders, psychiatric disorders, or housing status.ConclusionsIn a large cohort of CJ-involved PLWH with a 3-year post-release evaluation, RIC diminished significantly over time, but was associated with HIV care during incarceration, health insurance, case management services, and early linkage to care post-release. While re-incarceration and conditional release provide opportunities to engage in care, reducing recidivism and supporting community-based RIC efforts are key to improving longitudinal treatment outcomes among CJ-involved PLWH.

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Section: Discussionmentioning

confidence: 99%

Retention in HIV care during the 3 years following release from incarceration: A cohort study

et al. 2018

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“…For those treated in correctional facilities, viral suppression on ART is generally observed, sometimes surpassing those in the non-incarcerated population. Nevertheless, virological suppression is often not sustained after release [3,7,18,19,21], mortality is high [6,22] and retention in care is poor [17,[23][24][25].…”

Section: Poor Retention In Care and Lost Benefits After Release An Omentioning

confidence: 99%

“…It has been shown that poor retention in HIV care predicts poor survival [30,31], thus, it is unsurprising to find a poor retention, and a high rate of mortality among former HIV-infected [6,22].…”

Section: Factors Associated With Return To Hiv Carementioning

confidence: 99%

Returning to care after incarceration with HIV: the French Guianese experience

Huber

Vandentorren

Merceron³

et al. 2020

BMC Public Health

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Background: HIV prevalence in correctional facilities may be 2 to 10 times higher than in the general adult population. Antiretroviral therapy (ART) interruption is frequent after an incarceration. This, in combination with post-release high-risk behaviors, may have detrimental consequences on the epidemic. Although return to care after release from correctional facilities has been described in many North American settings, data from South America seemed scarce. French Guiana is the only French territory located in South America. In 2014, HIV prevalence was estimated at 1.2% among pregnant women and oscillated around 4% in the only correctional facility. Method: HIV-infected adults released from the French Guiana correctional facility between 2007 and 2013 were included in a retrospective cohort survey. The first objective was to describe the cascade of care in the 4 years following release. The secondary objectives were to describe contacts with care and to identify factors associated with return to HIV care, 1 year after release. Results: We included 147 people, mostly males (81.6%). The median time before the first ambulatory consultation was 1.8 months. Within 1 year after release, 27.9% came for unscheduled emergency consultations, 22.4% were hospitalized. Within 4 years after release, 40.0-46.5% were in care, 22.4% archieved virological success. Being on ART when incarcerated was associated with HIV care (aIRR: 2.0, CI: 1.2-3.0), whereas being HIV-diagnosed during the last incarceration was associated with poor follow-up (aIRR: 0.3, CI: 0.1-0.9). Conclusion: The risk of HIV-follow-up interruption is high, after an incarceration with HIV. ART supply should be sufficient to cover the timespan following release, several months if possible. Those not on ART at the time of incarceration may require special attention, especially those newly HIV-diagnosed while in custody. Comprehensive programs are necessary to support ex-offenders to stay on ART after incarceration.

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“…Release from prison carries a very high risk of death due to overdose [ 15 , 16 ], particularly among people living with HIV [ 12 , 15 , 17 ]. Given the generally low levels of methadone uptake in Kyrgyz prisons as well as the increased risks surrounding release, we deployed a screening, brief intervention, and referral to treatment (SBIRT) strategy to increase methadone program participation among incarcerated people with OUD who were scheduled to be released from prison within six months.…”

Section: Introductionmentioning

confidence: 99%

Interest without uptake: A mixed-methods analysis of methadone utilization in Kyrgyz prisons

Liberman

Bromberg²,

Litz³

et al. 2022

PLoS ONE

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HIV incidence continues to increase in Eastern Europe and Central Asia (EECA), in large part due to non-sterile injection drug use, especially within prisons. Therefore, medication-assisted therapy with opioid agonists is an evidence-based HIV-prevention strategy. The Kyrgyz Republic offers methadone within its prison system, but uptake remains low. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a framework for identifying people who would potentially benefit from methadone, intervening to identify OUD as a problem and methadone as a potential solution, and providing referral to methadone treatment. Using an SBIRT framework, we screened for OUD in Kyrgyz prisons among people who were within six months of returning to the community (n = 1118). We enrolled 125 people with OUD in this study, 102 of whom were not already engaged in methadone treatment. We conducted a pre-release survey followed by a brief intervention (BI) to address barriers to methadone engagement. Follow-up surveys immediately after the intervention and at 1 month, 3 months, and 6 months after prison release assessed methadone attitudes and uptake. In-depth qualitative interviews with 12 participants explored factors influencing methadone utilization during and after incarceration. Nearly all participants indicated favorable attitudes toward methadone both before and after intervention in surveys; however, interest in initiating methadone treatment remained very low both before and after the BI. Qualitative findings identified five factors that negatively influence methadone uptake, despite expressed positive attitudes toward methadone: (1) interpersonal relationships, (2) interactions with the criminal justice system, (3) logistical concerns, (4) criminal subculture, and (5) health-related concerns.

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All-cause mortality among people with HIV released from an integrated system of jails and prisons in Connecticut, USA, 2007–14: a retrospective observational cohort study

Abstract: US National Institutes of Health.

Cited by 24 publications

References 23 publications

Retention in HIV care during the 3 years following release from incarceration: A cohort study

Retention in HIV care during the 3 years following release from incarceration: A cohort study

Returning to care after incarceration with HIV: the French Guianese experience

Interest without uptake: A mixed-methods analysis of methadone utilization in Kyrgyz prisons

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