Dose-response Effect of Incarceration Events on Nonadherence to HIV Antiretroviral Therapy Among Injection Drug Users

Milloy, M‐J; Kerr, Thomas; Buxton, Jane A.; Rhodes, Tim; Guillemi, Silvia; Hogg, Robert S.; Montaner, Julio S. G.; Wood, Evan

doi:10.1093/infdis/jir032

Cited by 147 publications

(141 citation statements)

References 38 publications

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“…This highlights the critical need to improve adherence in criminal justice settings. 38,39 Thus, our study supports the provision of increased and improved support for ART adherence among these younger drug users, those in the sex trade and the recently incarcerated, to reduce the risk of viral rebound.…”

Section: Discussionsupporting

confidence: 65%

Social and Environmental Predictors of Plasma HIV RNA Rebound Among Injection Drug Users Treated With Antiretroviral Therapy

Milloy

Kerr

Buxton

et al. 2012

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Introduction Evidence is needed to improve HIV treatment outcomes for individuals who use injection drugs (IDU). Although studies have suggested higher rates of plasma viral load (PVL) rebound among IDU on antiretroviral therapy (ART), risk factors for rebound have not been thoroughly investigated. Methods We used data from a long-running community-recruited prospective cohort of IDU in Vancouver, Canada, linked to comprehensive ART and clinical monitoring records. Using proportional hazards methods, we modeled the time to confirmed PVL rebound above 1000 copies/mL among IDU on ART with sustained viral suppression, defined as two consecutive undetectable PVL measures. Results Between 1996 and 2009, 277 individuals had sustained viral suppression. Over a median follow-up of 32 months, 125 participants (45.1%) experienced at least one episode of virologic failure for an incidence of 12.6 (95% Confidence Interval [CI]: 10.5 – 15.0) per 100 person years. In a multivariate model, PVL rebound was independently associated with sex trade involvement (Adjusted Hazard Ratio [AHR] = 1.40, 95% CI: 1.08 – 1.82) and recent incarceration (AHR = 1.83, 95% CI: 1.33 – 2.52). Methadone maintenance therapy (AHR = 0.79, 95% CI: 0.66 – 0.94) was protective. No measure of illicit drug use was predictive. Conclusions In this setting of free ART, several social and environmental factors predicted higher risks of viral rebound among IDU, including sex trade involvement and incarceration. These findings should help inform efforts to identify individuals at risk of viral rebound as well as targeted interventions to treat and retain individuals in effective ART.

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Section: Discussionsupporting

confidence: 65%

Social and Environmental Predictors of Plasma HIV RNA Rebound Among Injection Drug Users Treated With Antiretroviral Therapy

Milloy

Kerr

Buxton

et al. 2012

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…19,20 Adherence and maintenance of routine engagement in medical services is often a struggle for HIV-positive individuals after release from incarceration, due in large part to the fact that a history of incarceration itself can be a barrier to adhering to HIV antiretroviral medications. 21 For instance, among injection drug users, Milloy and colleagues 21 found that HIV-positive individuals with a history of incarceration had nearly double the odds of anti-retroviral adherence lapse.…”

Section: Introductionmentioning

confidence: 99%

Health Impact of Incarceration on HIV-Positive African American Males: A Qualitative Exploration

Brinkley‐Rubinstein

Turner

2013

AIDS Patient Care and STDs

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Previous research suggests that incarceration can have a negative effect on health. These health effects have an especially profound impact on HIV-positive individuals. As such, the current study investigates how incarceration affects the health of 12 African American HIV-positive formerly incarcerated males recruited via an AIDS Service Organization. Individuals were enrolled via purposive sampling and engaged in a series of in-depth interviews over a yearlong period (n=46). Participants ranged in age from 33 to 61 years. Most had finished high school, were not employed at time of first and last interview, and most were primarily residing at a homeless shelter. The time incarcerated ranged among participants from 3 months to 3 years. Findings suggest that health is impacted via limited and delayed access to medication, stigma, and poor quality of medical care while incarcerated. Health continues to worsen after release, largely due to incarceration's impact on individuals' social context. Macro-level policy limits opportunity to fulfill basic needs such as housing and hinders one's ability to be gainfully employed. Moreover, stigma, loss of social support, and a delay in accessing HIV-related services deleteriously impacts individuals' mental and physical health status. Implications for practice, policy and future research are also discussed.

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“…These linkages are critical to maintaining continuance of ART after release given incarceration and subsequent release have been associated with virologic failure. [18][19][20] Social work and case management support is also an important component to successful transitional care. We found that 58% of newly diagnosed persons linked to care at the Miriam Hospital at some point through 2009, but only 12.5% linked within 90 days of the index incarceration in a system that had co-located physicians and dedicated case management services for HIV-infected prisoners being released to the community.…”

Section: Discussionmentioning

confidence: 99%

The Feasibility of Implementing the HIV Seek, Test, and Treat Strategy in Jails

Beckwith

Bazerman

Gillani

et al. 2014

AIDS Patient Care and STDs

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To successfully implement the Seek, Test, and Treat (STT) strategy to curb the HIV epidemic, the criminal justice system must be a key partner. Increasing HIV testing and treatment among incarcerated persons has the potential to decrease HIV transmission in the broader community, but whether it is feasible to consider the implementation of the STT within jail facilities is not known. We conducted a retrospective review of Rhode Island Department of Corrections (RIDOC) medical records to assess whether persons newly diagnosed in the jail were able to start ART and be linked to community HIV care after release. From 2001 to 2007, 64 RIDOC detainees were newly diagnosed with HIV. During their index incarcerations, 64% were informed of positive confirmatory HIV test results, 50% completed baseline evaluations, and 9% began ART. Linkage to community care was confirmed for 58% of subjects. Subjects incarcerated for >14 days were significantly more likely to receive HIV test results and complete baseline evaluation ( p < 0.001). A similar association was not observed for ART initiation until incarceration length reached 60 days ( p < 0.001). There was no association between incarceration length and linkage to care. This comprehensive analysis demonstrates that length of incarceration impacts HIV test result delivery, baseline evaluation, and ART initiation in the RIDOC. Jails are an important venue to ''Seek'' and ''Test''; however, completing the ''Treat'' part of the STT strategy is hindered by the transient nature of this criminal justice population and may require new strategies to improve linkage to care.

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Dose-response Effect of Incarceration Events on Nonadherence to HIV Antiretroviral Therapy Among Injection Drug Users

Abstract: Among HIV-seropositive IDUs receiving ART, an increasing burden of incarceration was associated with poorer adherence in a dose-dependent fashion. Our findings support improved adherence support for HIV-seropositive IDUs experiencing incarceration.

Cited by 147 publications

References 38 publications

Social and Environmental Predictors of Plasma HIV RNA Rebound Among Injection Drug Users Treated With Antiretroviral Therapy

Social and Environmental Predictors of Plasma HIV RNA Rebound Among Injection Drug Users Treated With Antiretroviral Therapy

Health Impact of Incarceration on HIV-Positive African American Males: A Qualitative Exploration

The Feasibility of Implementing the HIV Seek, Test, and Treat Strategy in Jails

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