期刊
AIDS AND BEHAVIOR
卷 17, 期 -, 页码 118-127出版社
SPRINGER/PLENUM PUBLISHERS
DOI: 10.1007/s10461-013-0506-0
关键词
Substance abuse; Jail; Prisoners; Engagement in HIV care; Antiretroviral therapy; Adherence; Criminal justice
资金
- NIDA NIH HHS [K24 DA017072, K23 DA033858, K02 DA032322] Funding Source: Medline
- NIMH NIH HHS [T32 MH020031, P30 MH062294] Funding Source: Medline
HIV and substance use are inextricably intertwined. One-sixth of people living with HIV/AIDS (PLWHA) transition through the correctional system annually. There is paucity of evidence on the impact of substance use disorders on HIV treatment engagement among jail detainees. We examined correlates of HIV treatment in the largest sample of PLWHA transitioning through jail in 10 US sites from 2007 to 2011. Cocaine, alcohol, cannabis, and heroin were the most commonly used substances. Drug use severity was negatively and independently correlated with three outcomes just before incarceration: (1) having an HIV care provider (AOR = 0.28; 95 % CI 0.09-0.89); (2) being prescribed antiretroviral therapy (AOR = 0.12; 95 % CI 0.04-0.35) and (3) high levels (>95 %) of antiretroviral medication adherence (AOR = 0.18; 95 % CI 0.05-0.62). Demographic, medical and psychiatric comorbidity, and social factors also contributed to poor outcomes. Evidence-based drug treatments that include multi-faceted interventions, including medication-assisted therapies, are urgently needed to effectively engage this vulnerable population.
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