Human Immunodeficiency Virus in Correctional Facilities: A Review

Abstract

It is estimated that up to one-fourth of the people living with human immunodeficiency virus (HIV) infection in the United States pass through a correctional facility each year. The majority of persons who enter a correctional facility today will return home in the near future. Most inmates with HIV infection acquire it in the outside community; prison does not seem to be an amplifying reservoir. How correctional health services deal with the HIV-infected person has important implications to the overall care of HIV-infected people in the community. Routine HIV testing is well accepted. Combination antiretroviral therapy has been associated with a reduction in mortality in prisons. A link between area HIV specialists and correctional health care providers is an important partnership for ensuring that HIV-infected patients have optimal care both inside prison and after release.

Effect of Release from Prison and Re-Incarceration on the Viral Loads of HIV-Infected Individuals

“…7 In resource-poor settings in a time of declining state budgets, these programs may be in danger of elimination. These findings also have important implications for the communities to which HIV-infected inmates return.…”

“…Although significant reductions in criminal recidivism in HIV-infected cohorts have been demonstrated at correctional institutions in Rhode Island and Massachusetts with these collaborations, 7 the effect on health outcomes to our knowledge is unknown.…”

Alcohol Use and Incarceration Adversely Affect HIV-1 RNA Suppression Among Injection Drug Users Starting Antiretroviral Therapy

“…A number of studies have highlighted the importance of the link between HIV specialists and correctional health care providers for ensuring that HIV-infected patients have optimal care both inside prison and after release. 18,19 In terms of the prescription of antiretroviral therapies in prisons, one study found that 72% of those eligible for treatment (N = 77) in the San Francisco jail were on antiretroviral therapy and that 71% followed medical advice and picked up medication at release. 20 Programs that ensure continuity of care for HIV-infected patients after release clearly need to be established and further evaluated.…”

Directly Observed versus Self-administered Antiretroviral Therapies: Preference of HIV-Positive Jailed Inmates in San Francisco

“…[1][2][3][4][5][6] In jails, HIV-infected individuals pose a significant dilemma to the health care system and are often persons from the local community whose access to medical care has been inconsistent or absent. They may be incarcerated for weeks to months and have high rates of illicit substance or alcohol addiction.…”