Antiretroviral Treatment Regimen Outcomes Among HIV-Infected Prisoners

Springer, Sandra A.; Friedland, Gerald; Doros, Gheorghe; Pesanti, Edward L.; Altice, Frederick L.

doi:10.1310/hct0804-205

Cited by 46 publications

(40 citation statements)

References 25 publications

(4 reference statements)

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“…Among potentially modifiable predictors, by contrast with an earlier study where ART regimen type did not influence viral suppression, 31 we noted that individuals prescribed a pre-release NNRTI-based regimen were twice as likely to maintain viral suppression on reincarceration than those receiving other categories of pre-release regimens. Most NNRTI-based regimens were single-tablet regimens.…”

Section: Discussioncontrasting

confidence: 99%

HIV in people reincarcerated in Connecticut prisons and jails: an observational cohort study

et al. 2014

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Summary Background Reincarceration in prison or jail correlates with non-sustained HIV viral suppression, but HIV treatment outcomes in released prisoners who are reincarcerated have not recently been systematically assessed despite advances in antiretroviral treatment (ART) potency, simplicity, and tolerability. Methods In a retrospective cohort of reincarcerated inmates with HIV in Connecticut (2005–12), we used longitudinally linked demographic, pharmacy, and laboratory databases to examine correlates of viral suppression. The primary outcome was viral suppression on reincarceration, defined as viral load lower than 400 RNA copies per mL. Findings Of 497 prisoners and jail detainees with HIV, with 934 reincarcerations, individuals were mostly unmarried, uninsured, and black men prescribed a protease-inhibitor-based ART regimen. During the median 329 days (IQR 179–621) between prison release and reincarceration, the proportion of incarceration periods with viral suppression decreased significantly from 52% to 31% (mean HIV-RNA increased by 0·4 log10; p<0·0001), lower than Connecticut’s HIV-infected prison population and those prescribed ART nationally. 158 (51%) of 307 individuals with viral suppression on release had viral suppression on reincarceration. Viral suppression on reincarceration was associated with increasing age (adjusted odds ratio [aOR] 1·04, 95% CI 1·01–1·07), being prescribed non-nucleoside reverse transcriptase inhibitor-based regimens (1·63, 1·14–2·34), and having higher levels of medical or psychiatric comorbidity (1·16, 1·03–1·30). Interpretation Identification of individuals most at risk for recidivism and loss of viral suppression might mitigate the risk that repeated reincarceration poses to systems of public health and safety. Funding Bristol-Myers Squibb Virology, Patterson Trust, and National Institute on Drug Abuse.

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Section: Discussioncontrasting

confidence: 99%

HIV in people reincarcerated in Connecticut prisons and jails: an observational cohort study

et al. 2014

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“…In other studies, only 20% to 54% of inmates enrolled in an HIV clinic within 1 month of release (Baillargeon et al, 2010; Wohl et al, 2011). Disruptions in care and poor adherence lead to higher HIV-related mortality, poorer HIV-related outcomes, and resistance to HIV medications in recently released individuals (Rosen, Schoenbach, & Wohl, 2008; Springer, Friedland, Doros, Pesanti, & Altice, 2007). Release from prison has been associated with an increase in viral load (Stephenson et al, 2005), which can result in ongoing HIV transmission if individuals engage in HIV-related risk behaviors (Rosen et al, 2008; Springer et al, 2007).…”

mentioning

confidence: 99%

“…Disruptions in care and poor adherence lead to higher HIV-related mortality, poorer HIV-related outcomes, and resistance to HIV medications in recently released individuals (Rosen, Schoenbach, & Wohl, 2008; Springer, Friedland, Doros, Pesanti, & Altice, 2007). Release from prison has been associated with an increase in viral load (Stephenson et al, 2005), which can result in ongoing HIV transmission if individuals engage in HIV-related risk behaviors (Rosen et al, 2008; Springer et al, 2007). Understanding facilitators and barriers to linkage to HIV care and adherence to treatment post-release is critical for reducing HIV-related morbidity and mortality and preventing transmission within the communities to which these individuals return (Spaulding et al, 2009; Stephenson et al, 2005).…”

mentioning

confidence: 99%

“You're in a World of Chaos”: Experiences Accessing HIV Care and Adhering to Medications After Incarceration

Dennis¹,

Barrington²,

Hino³

et al. 2015

Journal of the Association of Nurses in AIDS Care

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Most HIV-infected inmates leave prison with a suppressed viral load; many, however, become disconnected from care and non-adherent to medications during reentry to community life. In this secondary data analysis of focus groups (N = 6) and in-depth interviews (N = 9) with 46 formerly incarcerated HIV-infected people during reentry, we used an inductive analytic approach to explore the interplay between individual, interpersonal, community, and structural factors and HIV management. Participants described barriers and facilitators to care engagement and adherence at each of these 4 levels, as well as a milieu of HIV and incarceration-related stigma and discrimination. The constellation of barriers and facilitators created competing demands and a sense of chaos in participants’ lives, which led them to address reentry-related basic needs (e.g., housing, food) before health care needs. Interventions that simultaneously address multiple levels, including augmenting employment and housing opportunities, enhancing social support, and reducing stigma, are needed.

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“…HIV testing on entry results in diagnosing persons with HIV who were not diagnosed by community HIV testing services [10][11][12][13][14][15], and at year-end 2010, 1.5 % of males and 1.9 % of females entering state and federal prisons were reported to be infected with HIV [16]. Medical services in correctional facilities can improve the health status of incarcerated people with HIV by providing treatment for HIV infection [17][18][19], thereby contributing to the prevention of new HIV infections from incarcerated and released persons with HIV.…”

Section: Introductionmentioning

confidence: 99%

Positive Transitions (POST): Evaluation of an HIV Prevention Intervention for HIV-Positive Persons Releasing from Correctional Facilities

et al. 2014

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People with HIV who are released from custody frequently do not maintain the viral suppression and other health benefits achieved while incarcerated. This study was conducted to provide preliminary evidence of efficacy of an intervention to reduce HIV risk behaviors and increase use of HIV medical services following release from custody. People with HIV were recruited from San Francisco County jails, San Quentin State Prison and the California Medical Facility (Vacaville, CA), and randomly assigned to the "standard of care" or POST intervention. POST consisted of 4 sessions pre-release and 2 sessions post-release, focusing on HIV prevention and access to care. Behavioral data were obtained for the 3 months before incarceration and 3 months after release. Although POST participants reported a statistically significant increase in receiving health care at HIV clinics (62.5-84.4 %), there were no significant differences between the POST and control participants with respect to any primary outcomes.

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Antiretroviral Treatment Regimen Outcomes Among HIV-Infected Prisoners

Abstract: Background-Despite the high prevalence of HIV in correctional settings, the duration of therapy and response to various highly active antiretroviral therapy (HAART) regimens in this setting is unknown.

Cited by 46 publications

References 25 publications

HIV in people reincarcerated in Connecticut prisons and jails: an observational cohort study

HIV in people reincarcerated in Connecticut prisons and jails: an observational cohort study

“You're in a World of Chaos”: Experiences Accessing HIV Care and Adhering to Medications After Incarceration

Positive Transitions (POST): Evaluation of an HIV Prevention Intervention for HIV-Positive Persons Releasing from Correctional Facilities

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