HIV treatment outcomes among formerly incarcerated transitions clinic patients in a high prevalence setting

Research output: Contribution to journalArticle

Abstract

Background: Incarceration disproportionately affects people living with HIV/AIDS. When people are released from jail or prison, they face multiple barriers to HIV care, and those who do engage in care may have suboptimal HIV treatment outcomes. A limited number of studies have investigated HIV treatment outcomes among people who have been released from incarceration. Methods: We conducted a retrospective cohort study comparing HIV viral load (VL) suppression and retention in care 12 months after entry into care among patients of a post-incarceration Transitions Clinic (TC) and a comparison group who received HIV care in the same community. Of 138 participants, 38 TC patients were matched to 100 non-TC controls based on age, race/ethnicity, gender, and date of HIV care entry. Results: There was no significant difference in clinical study outcomes between TC and non-TC patients: 63% vs. 67% (p = 0.67) were retained in care and 54% vs. 63% (p = 0.33) had suppressed VL at 12 months. After adjusting for substance use disorder and viral load suppression at the start of treatment, the odds ratio of TC patients' 12-month retention was 0.60 (95% CI 0.25-1.49) and VL suppression was 0.44 (95% CI 0.16-1.23) compared with non-TC patients. Conclusions: Our findings show HIV care outcomes for patients at a post-incarceration Transitions Clinic that are similar to those of community-based comparison patients. The transitions clinic model, which provides medical, behavioral health, and supportive services to formerly incarcerated people, may be an effective model of care for this population; however, more scholarship is needed to quantify the components most effective in supporting retention in care and viral load suppression.

Original languageEnglish (US)
Article number16
JournalHealth and Justice
Volume6
Issue number1
DOIs
StatePublished - Sep 17 2018

Fingerprint

Patient Transfer
HIV
Viral Load
suppression
Patient Care
Prisons
Health Services
Substance-Related Disorders
patient care
Acquired Immunodeficiency Syndrome
Cohort Studies
community
correctional institution
Retrospective Studies
Odds Ratio
AIDS
ethnicity

Keywords

  • HIV
  • Incarceration
  • Primary care
  • Re-entry
  • Retention in care
  • Transitions clinic

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Law

Cite this

@article{1bb56f4784994690a8f82665cfbc8605,
title = "HIV treatment outcomes among formerly incarcerated transitions clinic patients in a high prevalence setting",
abstract = "Background: Incarceration disproportionately affects people living with HIV/AIDS. When people are released from jail or prison, they face multiple barriers to HIV care, and those who do engage in care may have suboptimal HIV treatment outcomes. A limited number of studies have investigated HIV treatment outcomes among people who have been released from incarceration. Methods: We conducted a retrospective cohort study comparing HIV viral load (VL) suppression and retention in care 12 months after entry into care among patients of a post-incarceration Transitions Clinic (TC) and a comparison group who received HIV care in the same community. Of 138 participants, 38 TC patients were matched to 100 non-TC controls based on age, race/ethnicity, gender, and date of HIV care entry. Results: There was no significant difference in clinical study outcomes between TC and non-TC patients: 63{\%} vs. 67{\%} (p = 0.67) were retained in care and 54{\%} vs. 63{\%} (p = 0.33) had suppressed VL at 12 months. After adjusting for substance use disorder and viral load suppression at the start of treatment, the odds ratio of TC patients' 12-month retention was 0.60 (95{\%} CI 0.25-1.49) and VL suppression was 0.44 (95{\%} CI 0.16-1.23) compared with non-TC patients. Conclusions: Our findings show HIV care outcomes for patients at a post-incarceration Transitions Clinic that are similar to those of community-based comparison patients. The transitions clinic model, which provides medical, behavioral health, and supportive services to formerly incarcerated people, may be an effective model of care for this population; however, more scholarship is needed to quantify the components most effective in supporting retention in care and viral load suppression.",
keywords = "HIV, Incarceration, Primary care, Re-entry, Retention in care, Transitions clinic",
author = "Masyukova, {Mariya I.} and Hanna, {David B.} and Fox, {Aaron D.}",
year = "2018",
month = "9",
day = "17",
doi = "10.1186/s40352-018-0074-5",
language = "English (US)",
volume = "6",
journal = "Health and Justice",
issn = "2194-7899",
publisher = "Springer Open",
number = "1",

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TY - JOUR

T1 - HIV treatment outcomes among formerly incarcerated transitions clinic patients in a high prevalence setting

AU - Masyukova, Mariya I.

AU - Hanna, David B.

AU - Fox, Aaron D.

PY - 2018/9/17

Y1 - 2018/9/17

N2 - Background: Incarceration disproportionately affects people living with HIV/AIDS. When people are released from jail or prison, they face multiple barriers to HIV care, and those who do engage in care may have suboptimal HIV treatment outcomes. A limited number of studies have investigated HIV treatment outcomes among people who have been released from incarceration. Methods: We conducted a retrospective cohort study comparing HIV viral load (VL) suppression and retention in care 12 months after entry into care among patients of a post-incarceration Transitions Clinic (TC) and a comparison group who received HIV care in the same community. Of 138 participants, 38 TC patients were matched to 100 non-TC controls based on age, race/ethnicity, gender, and date of HIV care entry. Results: There was no significant difference in clinical study outcomes between TC and non-TC patients: 63% vs. 67% (p = 0.67) were retained in care and 54% vs. 63% (p = 0.33) had suppressed VL at 12 months. After adjusting for substance use disorder and viral load suppression at the start of treatment, the odds ratio of TC patients' 12-month retention was 0.60 (95% CI 0.25-1.49) and VL suppression was 0.44 (95% CI 0.16-1.23) compared with non-TC patients. Conclusions: Our findings show HIV care outcomes for patients at a post-incarceration Transitions Clinic that are similar to those of community-based comparison patients. The transitions clinic model, which provides medical, behavioral health, and supportive services to formerly incarcerated people, may be an effective model of care for this population; however, more scholarship is needed to quantify the components most effective in supporting retention in care and viral load suppression.

AB - Background: Incarceration disproportionately affects people living with HIV/AIDS. When people are released from jail or prison, they face multiple barriers to HIV care, and those who do engage in care may have suboptimal HIV treatment outcomes. A limited number of studies have investigated HIV treatment outcomes among people who have been released from incarceration. Methods: We conducted a retrospective cohort study comparing HIV viral load (VL) suppression and retention in care 12 months after entry into care among patients of a post-incarceration Transitions Clinic (TC) and a comparison group who received HIV care in the same community. Of 138 participants, 38 TC patients were matched to 100 non-TC controls based on age, race/ethnicity, gender, and date of HIV care entry. Results: There was no significant difference in clinical study outcomes between TC and non-TC patients: 63% vs. 67% (p = 0.67) were retained in care and 54% vs. 63% (p = 0.33) had suppressed VL at 12 months. After adjusting for substance use disorder and viral load suppression at the start of treatment, the odds ratio of TC patients' 12-month retention was 0.60 (95% CI 0.25-1.49) and VL suppression was 0.44 (95% CI 0.16-1.23) compared with non-TC patients. Conclusions: Our findings show HIV care outcomes for patients at a post-incarceration Transitions Clinic that are similar to those of community-based comparison patients. The transitions clinic model, which provides medical, behavioral health, and supportive services to formerly incarcerated people, may be an effective model of care for this population; however, more scholarship is needed to quantify the components most effective in supporting retention in care and viral load suppression.

KW - HIV

KW - Incarceration

KW - Primary care

KW - Re-entry

KW - Retention in care

KW - Transitions clinic

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U2 - 10.1186/s40352-018-0074-5

DO - 10.1186/s40352-018-0074-5

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AN - SCOPUS:85053413128

VL - 6

JO - Health and Justice

JF - Health and Justice

SN - 2194-7899

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M1 - 16

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