Falling Through the Cracks: Risk Factors for Becoming Lost to HIV Care After Incarceration in a Southern Jail

Falling Through the Cracks: Risk Factors for Becoming Lost to HIV Care After Incarceration in a Southern Jail

Using a retrospective cohort analysis of inmates released from Dallas County Jail between January 2011 and November 2013, this study characterizes people living with HIV/AIDS (PLWHA) who are lost to care after release from jail. We used Kaplan-Meier analysis to estimate the risk of becoming lost to...

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Bibliographic Details
Published in:AIDS and behavior Vol. 24; no. 8; pp. 2430 - 2441
Main Authors: Tiruneh, Yordanos M., Li, Xilong, Bovell-Ammon, Benjamin, Iroh, Princess, Flanigan, Timothy P., Montague, Brian.T., Rich, Josiah.D., Nijhawan, Ank E.
Format: Journal Article
Language:English
Published: New York Springer US 01-08-2020
Springer Nature B.V
Subjects:
Acquired immune deficiency syndrome
AIDS
Antiretroviral agents
Antiretroviral drugs
Antiretroviral therapy
Cohort analysis
Cracks
Ex-convicts
Female
Hazard identification
Health Psychology
HIV
HIV Infections - drug therapy
HIV Infections - epidemiology
Human immunodeficiency virus
Humans
Imprisonment
Infectious Diseases
Jails
Male
Medicine
Medicine & Public Health
Mental disorders
Methadone
Original Paper
Prisoners
Prisons
Public Health
Regression analysis
Regression models
Residence
Retrospective Studies
Risk analysis
Risk Factors
Substance abuse
Substance use
Texas
Texas
HIV/AIDS
Lost-to-follow-up
Linkage to care
Texas
South
Jail
Re-entry
Incarceration
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Summary:Using a retrospective cohort analysis of inmates released from Dallas County Jail between January 2011 and November 2013, this study characterizes people living with HIV/AIDS (PLWHA) who are lost to care after release from jail. We used Kaplan-Meier analysis to estimate the risk of becoming lost to post-release HIV care and a Cox proportional hazards regression model to identify associated factors. The majority of individuals (78.2%) were men and 65.5% were black. Of the incarcerations that ended with release to the community, approximately 43% failed to link to community HIV care. Non-Hispanic Whites were more likely than Hispanics or Blacks to drop out of care after release. Individuals with histories of substance use or severe mental illness were more likely to become lost, while those under HIV care prior to incarceration and/or who had adhered to antiretroviral therapy (ART) were more likely to resume care upon release. Targeted efforts such as rapid linkage to care and re-entry residence programs could encourage formerly incarcerated individuals to re-engage in care.
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ISSN:1090-7165
1573-3254
DOI:10.1007/s10461-020-02803-7