Retention in HIV Care Drops Steadily After Prison Release
Retention in care three years after release linked to older age, having health insurance
WEDNESDAY, Oct. 10, 2018 (HealthDay News) -- For criminal justice-involved persons living with HIV (PLWH), sustained retention in care decreases over time post-release, according to a study published online Oct. 9 in PLOS Medicine.
Kelsey B. Loeliger, from the Yale School of Medicine in New Haven, Conn., and colleagues conducted a retrospective study of 1,094 PLWH incarcerated during Jan. 1, 2007, to Dec. 31, 2011, with follow-up through Dec. 31, 2014. The authors sought to examine predictors of retention in HIV care (RIC) and viral suppression.
The researchers found that during three years of follow-up, there was a steady decline in post-release RIC (67.2 percent retained for year one, 51.3 percent for years one to two, and 42.5 percent for years one to three). Individuals who were re-incarcerated were more likely to meet RIC criteria (48 versus 34 percent) but were less likely to have viral suppression (72 versus 81 percent). Both sustained RIC and viral suppression three years after release were independently associated with older age (adjusted odds ratios, 1.61 and 1.37, respectively), having health insurance (adjusted odds ratios, 2.15 and 2.01), and receiving an increased number of transitional case management visits. Receipt of antiviral therapy during incarceration (adjusted odds ratios, 1.33 and 1.91, respectively) and early linkage to post-release care (adjusted odds ratios, 2.64 and 1.79, respectively) were associated with improved treatment outcomes.
"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," the authors write.
Two authors disclosed financial ties to the pharmaceutical industry.