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Bauermeister JA, Bonett S, Rosengren AL, Choi SK, Watson D. Approaches to Promoting Linkage to and Retention in HIV Care in the United States: a Scoping Review. Curr HIV/AIDS Rep 2021; 18:339-350. [PMID: 33954910 DOI: 10.1007/s11904-021-00557-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW Linkage to and retention in HIV care, as conceptualized in the HIV care continuum, remain critical steps towards achieving and maintaining viral suppression. We evaluated recently published (Jan 2018-Nov 2020) peer-reviewed clinical trials of linkage to and retention in care outcomes in the United States. RECENT FINDINGS We identified 12 trials evaluating linkage to and retention in care outcomes in the United States. Most trials did not adhere to standardized definitions or metrics for linkage to or retention in HIV care, hindering comparisons between studies. Four interventions indicated improvements on linkage to or retention in HIV care at follow-up, relying on behavioral incentives and/or case management as key intervention strategies. We recommend the adoption standardize metrics across linkage and retention trials, and the future use of implementation science frameworks to identify implementation facilitators and barriers, and evaluate key strategies associated with improvements in linkage to and retention in care.
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Affiliation(s)
- José A Bauermeister
- University of Pennsylvania, 418 Curie Blvd, Room 222L, Philadelphia, PA, 19104, USA.
| | - Stephen Bonett
- University of Pennsylvania, 418 Curie Blvd, Room 235L, Philadelphia, PA, 19104, USA
| | - A Lina Rosengren
- University of North Carolina - Chapel Hill, 130 Mason Farm Rd, CB 7215, Chapel Hill, NC, 27599, USA
| | - Seul Ki Choi
- University of Pennsylvania, 418 Curie Blvd, Room 235L, Philadelphia, PA, 19104, USA
| | - Dovie Watson
- University of Pennsylvania, 418 Curie Blvd, Room 235L, Philadelphia, PA, 19104, USA
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52
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Wiersema JJ, Teixeira PA, Pugh T, Cruzado-Quiñones J, Jordan AO. HIV Care Engagement Among Justice-Involved and Substance Using People of Puerto Rican Origin Who are Living with HIV. J Immigr Minor Health 2021:10.1007/s10903-021-01191-x. [PMID: 33945078 DOI: 10.1007/s10903-021-01191-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
Persons living with diagnosed HIV (PLWDH) are overrepresented in correctional settings, as are Latinx including those of Puerto Rican (PR) origin. Little is known about this population's HIV care engagement after incarceration. Semi-structured interviews were conducted with 23 PLWDH of PR origin incarcerated in NYC jails using the Behavioral Model for Vulnerable Populations as the theoretical basis. Most participants described a fragile connection to HIV care and inconsistent antiretroviral therapy adherence due to issues including substance use, poverty (e.g. homelessness), and other factors. Most were satisfied with their current communitybased providers and reported that their PR ethnicity and transnational ties to PR did not impact their HIV care, although some preferred Spanish-speaking providers. Greater access to stable housing and HIV care that is convenient to substance use treatment and other services appear to be the greatest needs of PLWDH of PR origin leaving jail.
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Affiliation(s)
- Janet J Wiersema
- Correctional Health Services, NYC Health + Hospitals, 55 Water Street, 18th Floor, New York, NY, 10041, USA.
| | - Paul A Teixeira
- Correctional Health Services, NYC Health + Hospitals, 55 Water Street, 18th Floor, New York, NY, 10041, USA
| | - Tracy Pugh
- Mailman School of Public Health, Columbia University, New York, NY, USA
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53
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Winetsky D, Fox A, Nijhawan A, Rich JD. Treating Opioid Use Disorder and Related Infectious Diseases in the Criminal Justice System. Infect Dis Clin North Am 2021; 34:585-603. [PMID: 32782103 DOI: 10.1016/j.idc.2020.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This article provides an overview of the diagnosis and management of opioid use disorder and its infectious complications among populations with criminal justice involvement. Opioid use disorder and chronic infections such as human immunodeficiency virus and hepatitis C virus are highly prevalent among incarcerated individuals and some of the unique features of correctional facilities present challenges for their appropriate medical management. We outline evidence-based strategies for integrated, patient-centered treatment during incarceration and the potentially hazardous transition back to the community upon release.
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Affiliation(s)
- Daniel Winetsky
- Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center, 622 West 168th Street, PH 8 W-876, New York, NY 10032, USA; HIV Center for Clinical and Behavioral Studies at Columbia University and New York State Psychiatric Institute, New York, NY, USA.
| | - Aaron Fox
- Department of Internal Medicine, Montefiore Medical Center, 305 East 161th Street, Room 4, Bronx, NY, USA
| | - Ank Nijhawan
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Josiah D Rich
- Department of Medicine, Brown University, 164 Summit Avenue, Providence, RI 02906, USA; Department of Epidemiology, Brown University, 164 Summit Avenue, Providence, RI 02906, USA
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54
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Crable EL, Blue TR, McKenzie M, Rich JD, Gordon MS. Effect of Case Management on HIV Outcomes for Community Corrections Population: Results of an 18-Month Randomized Controlled Trial. J Acquir Immune Defic Syndr 2021; 87:755-762. [PMID: 33492021 PMCID: PMC8026504 DOI: 10.1097/qai.0000000000002624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/21/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Evidence-based interventions that engage community-dwelling, justice-involved, people living with HIV (PLWH) in care are urgently needed. Project Bridge, an intensive case management intervention, has demonstrated efficacy for linking PLWH to care transitioning from prison to the community. We assessed whether a modified Project Bridge model was effective for increasing rates of HIV treatment engagement, antiretroviral therapy receipt, and adherence for community-dwelling individuals supervised on probation and parole. SETTING Baltimore, Maryland. METHODS In this study, the 18-month outcomes of a randomized controlled trial in which PLWH were also on probation or parole received either Project Bridge (n = 50) or treatment as usual (n = 50) were assessed. HIV treatment engagement (primary outcome), antiretroviral therapy prescription, and adherence (secondary outcomes) are evaluated using the intent-to-treat approach. RESULTS There were no statistically significant differences in rates of HIV treatment engagement, antiretroviral therapy prescription receipt, or adherence between groups over the 18-month study period. Across groups, participants were 5.6 times more likely to receive HIV care, 5.8 times more likely to receive an antiretroviral therapy prescription, and 4 times more likely to report antiretroviral therapy adherence at each follow-up period. CONCLUSIONS Future research is needed to identify potentially less-intensive interventions that target the unique needs of PLWH under community supervision.
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Affiliation(s)
- Erika L. Crable
- Evans Center for Implementation and Improvement Sciences, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
- Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, USA
| | | | - Michelle McKenzie
- The Miriam Hospital, Providence, RI, USA
- Center for Prisoner Health and Human Rights, Brown University, Providence, RI, USA
| | - Josiah D. Rich
- The Miriam Hospital, Providence, RI, USA
- Center for Prisoner Health and Human Rights, Brown University, Providence, RI, USA
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55
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Vincent W, Lin J, Veloso D, Miller D, McFarland W. Homelessness, HIV testing, and the reach of public health efforts for people who inject drugs, San Francisco, California. Drug Alcohol Depend 2021; 221:108560. [PMID: 33607498 PMCID: PMC8494070 DOI: 10.1016/j.drugalcdep.2021.108560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 12/20/2020] [Accepted: 01/02/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND There is a dearth of literature that explicitly examines associations between housing and HIV testing among people who inject drugs (PWID). Thus, the present study investigated the links between housing status and HIV testing for PWID. METHODS Respondent-driven sampling recruited 382 HIV-negative PWID, who completed structured interviews in San Francisco. Logistic regression determined whether housing statuses in the past 12 months ([1] owned/rented, [2] single-room occupancy hotels [SROs], [3] living with friends/family/partners, [4] shelters, [5] outdoors) were associated with getting HIV tested in the past 12 months while adjusting for sociodemographics and receptive sharing of injection paraphernalia in the past 12 months. RESULTS PWID who lived in SROs had greater odds of being tested for HIV than PWID who did not live in SROs (aOR = 1.95, CI.95: 1.06-3.60) while adjusting for covariates. Although bivariable analyses indicated that receptively sharing syringes was more common for PWID who lived with others (χ2[3] = 7.94, p = 0.047) or lived outdoors (χ2[3] = 9.50, p = 0.023) than those who did not, respectively, PWID who lived with others (aOR = 1.72, CI.95 = 0.95-3.14) or lived outdoors (aOR = 1.37, CI.95 = 0.74-2.53) did not show greater odds of HIV testing in multivariable analyses. CONCLUSIONS PWID who lived in SROs had greater odds of HIV testing than PWID who did not live in SROs. Although PWID who lived with others or outdoors showed greater HIV risk, they did not show greater odds of HIV testing. Public health efforts may be reaching PWID in SROs, but more work is needed to reach PWID who live with other people or outdoors.
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Affiliation(s)
- Wilson Vincent
- Department of Psychology, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19122, United States.
| | - Jess Lin
- Department of Psychology, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19122, United States
| | - Danielle Veloso
- Department of Psychology, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19122, United States
| | - Desmond Miller
- Department of Psychology, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19122, United States
| | - Willi McFarland
- Department of Psychology, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19122, United States
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56
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Turpin R, Khan M, Scheidell J, Feelemyer J, Hucks-Ortiz C, Abrams J, Cleland C, Mayer K, Dyer T. Estimating the Roles of Racism and Homophobia in HIV Testing Among Black Sexual Minority Men and Transgender Women With a History of Incarceration in the HPTN 061 Cohort. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2021; 33:143-157. [PMID: 33821677 PMCID: PMC10576191 DOI: 10.1521/aeap.2021.33.2.143] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Black sexual minority men (BSMM) and Black transgender women (BTW) have disproportionately high HIV prevalence, making HIV testing critical for treatment and prevention. Racism and homophobia may be barriers to testing among BSMM/BTW, particularly in the context of previous incarceration. We analyzed a subsample (n = 655) of HIV-negative, previously incarcerated BSMM/BTW in the HIV Prevention Trials Network 061 study, generating prevalence ratios and interaction terms testing associations between experienced racism and homophobia with past-year HIV testing. Both racism (aPR = 0.83, 95% CI [0.70, 0.98]) and homophobia (aPR: 0.68, 95% CI [0.48, 0.98]) were associated with lower testing, although their interaction was associated with unexpectedly higher testing (Interaction aPR = 1.77, 95% CI [1.25, 2.49]). Among BSMM/BTW with a history of incarceration, racism and homophobia are barriers to HIV testing. Positive interactions between racism and homophobia could be explained by numerous factors (e.g., resilience, coping) and warrants further study.
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Affiliation(s)
- Rodman Turpin
- Rodman Turpin and Typhanye Dyer are affiliated with the University of Maryland, College Park, School of Public Health, Department of Epidemiology and Biostatistics, College Park, Maryland
| | - Maria Khan
- Rodman Turpin and Typhanye Dyer are affiliated with the University of Maryland, College Park, School of Public Health, Department of Epidemiology and Biostatistics, College Park, Maryland
| | - Joy Scheidell
- Rodman Turpin and Typhanye Dyer are affiliated with the University of Maryland, College Park, School of Public Health, Department of Epidemiology and Biostatistics, College Park, Maryland
| | - Jonathan Feelemyer
- Rodman Turpin and Typhanye Dyer are affiliated with the University of Maryland, College Park, School of Public Health, Department of Epidemiology and Biostatistics, College Park, Maryland
| | - Christopher Hucks-Ortiz
- Rodman Turpin and Typhanye Dyer are affiliated with the University of Maryland, College Park, School of Public Health, Department of Epidemiology and Biostatistics, College Park, Maryland
| | - Jasmyn Abrams
- Rodman Turpin and Typhanye Dyer are affiliated with the University of Maryland, College Park, School of Public Health, Department of Epidemiology and Biostatistics, College Park, Maryland
| | - Charles Cleland
- Rodman Turpin and Typhanye Dyer are affiliated with the University of Maryland, College Park, School of Public Health, Department of Epidemiology and Biostatistics, College Park, Maryland
| | - Kenneth Mayer
- Rodman Turpin and Typhanye Dyer are affiliated with the University of Maryland, College Park, School of Public Health, Department of Epidemiology and Biostatistics, College Park, Maryland
| | - Typhanye Dyer
- Rodman Turpin and Typhanye Dyer are affiliated with the University of Maryland, College Park, School of Public Health, Department of Epidemiology and Biostatistics, College Park, Maryland
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57
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Biondi BE, Frank CA, Forray A, Springer SA. Gender differences among criminal justice-involved persons living with HIV interested in extended-release naltrexone treatment. Subst Abus 2021; 42:905-911. [PMID: 33750285 DOI: 10.1080/08897077.2021.1900984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Previous research has shown gender differences with respect to entry into medication treatment of substance use disorders (SUDs), yet few have examined gender differences among participants consented to be treated with extended-release naltrexone (XR-NTX). Understanding gender differences is critical to developing interventions to overcome barriers to initiation of and retention on medication treatment for SUDs. Methods: Data from two double-blind placebo-controlled trials of XR-NTX among persons with HIV and alcohol or opioid use disorders leaving the criminal justice system (CJS) were analyzed for gender differences among clinical characteristics, mental health, drug use severity, and other domains. The study that recruited persons with alcohol use disorder (AUD) was conducted from September 2010-February 2016 at two sites in Connecticut (CT), and the opioid use disorder (OUD) study was conducted from September 2010-March 2016 at three sites in CT and one site in Massachusetts. Results: Baseline data were analyzed from 193 participants consented to be randomized to XR-NTX or placebo; 40 women and 153 men. Women were younger, had worse mental health severity, and were more likely to be diagnosed with cocaine use disorder. There were no statistical differences between men and women in the prescription of antiretroviral therapy (ART) or ART adherence. Conclusions: Women had greater mental health severity and a higher prevalence of cocaine use as compared to men, both of which are known to be barriers to engagement and retention on medication treatment for alcohol and opioid use disorders. For women with CJS involvement and living with HIV and SUDs, understanding factors that may affect initiation and retention on medication treatment of SUDs are necessary to improve treatment outcomes in women.
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Affiliation(s)
- Breanne E Biondi
- AIDS Program, Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Cynthia A Frank
- AIDS Program, Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Ariadna Forray
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Sandra A Springer
- AIDS Program, Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.,Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, USA
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58
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Winetsky D, Burack D, Antoniou P, Garcia B, Gordon P, Scherer M. Psychosocial Factors and the Care Cascade for Hepatitis C Treatment Colocated at a Syringe Service Program. J Infect Dis 2021; 222:S392-S400. [PMID: 32877544 DOI: 10.1093/infdis/jiaa142] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) is highly effective. However, people who inject drugs face significant barriers to DAA access. METHODS We describe a program that colocates HCV management within a syringe service program in New York City. We performed a retrospective chart review of all patients with confirmed HCV viremia. RESULTS From 2015 to 2018, 102 patients with viremia completed intake. Fifty-eight patients started DAAs. Nine patients discontinued treatment or were lost to follow-up before completion; 1 is continuing DAA treatment. Of 48 patients who completed therapy, sustained virologic response (SVR) was achieved in 43 (89.6%). Age and established mental health treatment at intake were associated with SVR. Regular cocaine use was negatively associated with SVR in univariate analysis, but this association was not significant after adjustment for age. Of 30 patients completing DAA therapy with active illicit opioid use at intake, 14 (46.4%) engaged in opioid use disorder (OUD) treatment during therapy, and 9 remained in OUD treatment after completion of DAA treatment. CONCLUSIONS Loss to follow-up is a challenge for people who inject drugs, but among those who completed treatment, SVR was achieved at a high rate. Mental health treatment may facilitate HCV cure. Conversely, HCV therapy may facilitate engagement in OUD treatment and other services.
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Affiliation(s)
- Daniel Winetsky
- Comprehensive Health Program, New York Presbyterian Hospital, New York, USA.,Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, USA.,HIV Center for Clinical and Behavioral Studies at Columbia University and New York State Psychiatric Institute, New York, USA
| | - Daniel Burack
- Department of Medicine, Columbia University Irving Medical Center, New York, USA
| | - Pantelis Antoniou
- Comprehensive Health Program, New York Presbyterian Hospital, New York, USA
| | - Bill Garcia
- Washington Heights Corner Project, New York, USA
| | - Peter Gordon
- Comprehensive Health Program, New York Presbyterian Hospital, New York, USA.,Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, USA
| | - Matthew Scherer
- Comprehensive Health Program, New York Presbyterian Hospital, New York, USA.,Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, USA
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59
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Woznica DM, Fernando NB, Bonomo EJ, Owczarzak J, Zack B, Hoffmann CJ. Interventions to Improve HIV Care Continuum Outcomes Among Individuals Released From Prison or Jail: Systematic Literature Review. J Acquir Immune Defic Syndr 2021; 86:271-285. [PMID: 33079904 PMCID: PMC8495492 DOI: 10.1097/qai.0000000000002523] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 09/23/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND HIV care continuum outcomes deteriorate among people returning from incarceration. Interventions to improve care outcomes postincarceration have been characterized by substantial heterogeneity in approach, outcome metrics, and results. A large number of recently published interventions have not been systematically reviewed. METHODS We searched peer reviewed and scholarly databases for published and gray literature describing interventions to improve HIV care continuum outcomes among individuals released from prison or jail. We systematically screened quantitative and qualitative intervention reports published through 2018, then extracted and analyzed study data using a classification scheme that we developed for categorizing intervention levels and strategies. RESULTS We included 23 reports from the peer-reviewed literature, 2 from gray literature, and 2 from conference abstracts (27 total). Seventeen studies were classified as individual level, 3 as biomedical level, 2 as organizational level, and 5 as multilevel. Nine studies were randomized controlled trials, 4 of which reported power calculations. Fifteen studies were quasiexperimental; one was a case study. Eleven studies were conducted in prisons, 7 in jails, and 9 in both prisons and jails. Of 11 studies reporting hypothesis tests, 5 found statistically significant effect sizes on primary outcomes. CONCLUSIONS Interventions that demonstrate postrelease improvements in clinic attendance and viral suppression include patient navigation strategies, especially involving peer support, and substance use treatment strategies.
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Affiliation(s)
- Daniel M Woznica
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | | | - Jill Owczarzak
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | - Christopher J Hoffmann
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of Medicine, Johns Hopkins University, Baltimore, MD; and
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60
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Quinn KG, Spector A, Takahashi L, Voisin DR. Conceptualizing the Effects of Continuous Traumatic Violence on HIV Continuum of Care Outcomes for Young Black Men Who Have Sex with Men in the United States. AIDS Behav 2021; 25:758-772. [PMID: 32944841 PMCID: PMC7886964 DOI: 10.1007/s10461-020-03040-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 01/06/2023]
Abstract
The United States (US) is on track to achieve the 90-90-90 targets set forth by UNAIDS and the National HIV/AIDS strategy, yet significant racial disparities in HIV care outcomes remain, particularly for young Black men who have sex with men (YBMSM). Research has demonstrated that various types of violence are key aspects of syndemics that contribute to disparities in HIV risk. However, little research has looked collectively at cumulative violent experiences and how those might affect HIV treatment and care outcomes. Drawing on extant literature and theoretical underpinnings of syndemics, we provide a conceptual model that highlights how continuous traumatic violence experienced by YBMSM may affect HIV outcomes and contribute to racial disparities in HIV outcomes. The findings of this focused review suggest a need for research on how continuous exposure to various types of violence influence HIV prevention and treatment outcomes for young Black MSM.
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Affiliation(s)
- Katherine G Quinn
- Center for AIDS Intervention Research (CAIR), Medical College of Wisconsin, 2071 N. Summit Ave., Milwaukee, WI, 53202, USA.
| | - Antoinette Spector
- Medical College of Wisconsin, Institute for Health Equity, Milwaukee, USA
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61
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Trajectories of Viral Suppression in People Living With HIV Receiving Coordinated Care: Differences by Comorbidities. J Acquir Immune Defic Syndr 2021; 84:387-395. [PMID: 32598118 DOI: 10.1097/qai.0000000000002351] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND In March of 2013, the Los Angeles County (LAC) Division of HIV and STD Programs implemented a clinic-based Medical Care Coordination (MCC) Program to increase viral suppression (VS) (<200 c/mL) among people living with HIV (PLWH) at high risk for poor health outcomes. OBJECTIVE This study aimed to estimate trajectories of VS and to assess whether these trajectories differed by stimulant use, housing instability, and depressive symptom severity as reported by PLWH participating in MCC. METHODS Data represent 6408 PLWH in LAC receiving services from the MCC Program and were obtained from LAC HIV surveillance data matched to behavioral assessments obtained across 35 Ryan White Program clinics participating in MCC. Piecewise mixed-effects logistic regression with a random intercept estimated probabilities of VS from 12 months before MCC enrollment through 36 months after enrollment, accounting for time by covariate interactions for 3 comorbid conditions: housing instability, stimulant use, and depressive symptoms. RESULTS The overall probability of VS increased from 0.35 to 0.77 within the first 6 months in the MCC Program, and this probability was maintained up to 36 months after enrollment. Those who reported housing instability, stimulant use, or multiple comorbid conditions did not achieve the same probability of VS by 36 months as those with none of those comorbidities. CONCLUSIONS Findings suggest that MCC improved the probability of VS for all patient groups regardless of the presence of comorbidities. However, those with comorbid conditions will still require increased support from patient-centered programs to address disparities in VS.
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62
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Assoumou SA, Tasillo A, Vellozzi C, Eftekhari Yazdi G, Wang J, Nolen S, Hagan L, Thompson W, Randall LM, Strick L, Salomon JA, Linas BP. Cost-effectiveness and Budgetary Impact of Hepatitis C Virus Testing, Treatment, and Linkage to Care in US Prisons. Clin Infect Dis 2021; 70:1388-1396. [PMID: 31095676 DOI: 10.1093/cid/ciz383] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 05/14/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) testing and treatment uptake in prisons remains low. We aimed to estimate clinical outcomes, cost-effectiveness (CE), and budgetary impact (BI) of HCV testing and treatment in United States (US) prisons or linkage to care at release. METHODS We used individual-based simulation modeling with healthcare and Department of Corrections (DOC) perspectives for CE and BI analyses, respectively. We simulated a US prison cohort at entry using published data and Washington State DOC individual-level data. We considered permutations of testing (risk factor based, routine at entry or at release, no testing), treatment (if liver fibrosis stage ≥F3, for all HCV infected or no treatment), and linkage to care (at release or no linkage). Outcomes included quality-adjusted life-years (QALY); cases identified, treated, and cured; cirrhosis cases avoided; incremental cost-effectiveness ratios; DOC costs (2016 US dollars); and BI (healthcare cost/prison entrant) to generalize to other states. RESULTS Compared to "no testing, no treatment, and no linkage to care," the "test all, treat all, and linkage to care at release" model increased the lifetime sustained virologic response by 23%, reduced cirrhosis cases by 54% at a DOC annual additional cost of $1440 per prison entrant, and would be cost-effective. At current drug prices, targeted testing and liver fibrosis-based treatment provided worse outcomes at higher cost or worse outcomes at higher cost per QALY gained. In sensitivity analysis, fibrosis-based treatment restrictions were cost-effective at previous higher drug costs. CONCLUSIONS Although costly, widespread testing and treatment in prisons is considered to be of good value at current drug prices.
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Affiliation(s)
- Sabrina A Assoumou
- Section of Infectious Disease, Department of Medicine, Boston Medical Center, Massachusetts.,Section of Infectious Disease, Department of Medicine, Boston University School of Medicine, Massachusetts
| | - Abriana Tasillo
- Section of Infectious Disease, Department of Medicine, Boston Medical Center, Massachusetts
| | - Claudia Vellozzi
- Grady Health System, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Golnaz Eftekhari Yazdi
- Section of Infectious Disease, Department of Medicine, Boston Medical Center, Massachusetts
| | - Jianing Wang
- Section of Infectious Disease, Department of Medicine, Boston Medical Center, Massachusetts
| | - Shayla Nolen
- Section of Infectious Disease, Department of Medicine, Boston Medical Center, Massachusetts
| | - Liesl Hagan
- Prevention Branch, Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - William Thompson
- Prevention Branch, Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Lara Strick
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle.,Washington State Department of Corrections, Tumwater
| | | | - Benjamin P Linas
- Section of Infectious Disease, Department of Medicine, Boston Medical Center, Massachusetts.,Section of Infectious Disease, Department of Medicine, Boston University School of Medicine, Massachusetts.,Department of Epidemiology, Boston University School of Public Health, Massachusetts
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63
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Lopez KD, Cravero C, Krishnan A, Carvalho de Sousa Freire VE, Culbert GJ. Feasibility of a mHealth survey application for incarcerated and postrelease people living with HIV in a low-resource setting. Res Nurs Health 2020; 44:201-212. [PMID: 33341994 DOI: 10.1002/nur.22098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 11/06/2022]
Abstract
Mobile health (mHealth) holds considerable promise as a way to give people greater control of their health information, privacy, and sharing in the context of HIV research and clinical services. The purpose of this study was to determine the feasibility of an mHealth research application from the perspective of three stakeholder groups involved in an HIV clinical trial in Jakarta, Indonesia: (a) incarcerated people living with HIV (PLWH), (b) research assistants (RAs), and (c) research investigators. Incarcerated PLWH (n = 150) recruited from two large all-male prisons completed questionnaires, including questions about mHealth acceptability, on an mHealth survey application using a proprietary data collection software development platform. RAs who administered questionnaires (n = 8) rated the usability of the software application using the system usability scale (SUS) and open-ended questions. Research investigators (n = 2) completed in-depth interviews, that were coded and analyzed using the technology acceptance model (TAM) as a conceptual framework. Over 90% of incarcerated PLWH felt the mHealth application offered adequate comfort, privacy, and accuracy in recording their responses. RAs' SUS scores ranged from 60% to 90% (M = 76.25) and they found the mHealth survey application challenging to learn, but highly satisfying. Compared with paper-based data collection, researchers felt that electronic data collection led to improved accuracy and efficiency of data collection and the ability to monitor data collection remotely and in real time. The researchers perceived the learnability of the application as acceptable but required self-instruction.
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Affiliation(s)
| | | | - Archana Krishnan
- University at Albany, State University of New York, New York, New York, USA
| | | | - Gabriel J Culbert
- University of Illinois at Chicago, Chicago, Illinois, USA.,University of Indonesia, Depok, Indonesia
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Akiyama MJ, Ross J, Rimawi F, Fox A, Jordan AO, Wiersema J, Litwin AH, Kaba F, MacDonald R. Knowledge, attitudes, and acceptability of direct-acting antiviral hepatitis C treatment among people incarcerated in jail: A qualitative study. PLoS One 2020; 15:e0242623. [PMID: 33264311 PMCID: PMC7710033 DOI: 10.1371/journal.pone.0242623] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 11/03/2020] [Indexed: 01/27/2023] Open
Abstract
Introduction While U.S. jails are critical sites for engagement in HCV care, short lengths-of-stay often do not permit treatment in jail. Therefore, linkage to HCV care after incarceration is crucial. However, little is known about HCV treatment acceptability among justice-involved individuals in U.S. jails. The goal of this study was to understand knowledge, attitudes, and acceptability of HCV treatment among people living with HCV in the New York City (NYC) jail system. Methods We recruited 36 HCV-antibody-positive individuals in the NYC jails using clinical data reports and performed semi-structured interviews to explore participants’ attitudes toward HCV treatment in jail and following return to the community. We continued interviews until reaching thematic saturation and analyzed interviews using an inductive, thematic approach. Results Participants were mostly male, Latina/o, with a mean age of 40 years. Nearly all were aware they were HCV antibody-positive. Two thirds of participants had some awareness of the availability of new HCV therapies. Key themes included: 1) variable knowledge of new HCV therapies affecting attitudes toward HCV treatment, 2) the importance of other incarcerated individuals in communicating HCV-related knowledge, 3) vulnerability during incarceration and fear of treatment interruption, 4) concern for relapse to active drug use and HCV reinfection, 5) competing priorities (such as other medical comorbidities, ongoing substance use, and housing), 6) social support and the importance of family. Conclusions Patient-centered approaches to increase treatment uptake in jail settings should focus on promoting HCV-related knowledge including leveraging peers for knowledge dissemination. In addition, transitional care programs should ensure people living with HCV in jail have tailored discharge plans focused on competing priorities such as housing instability, social support, and treatment of substance use disorders.
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Affiliation(s)
- Matthew J. Akiyama
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, United States of America
- * E-mail:
| | - Jonathan Ross
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Fatimah Rimawi
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Aaron Fox
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Alison O. Jordan
- Correctional Health Services, New York City Health + Hospitals, New York, NY, United States of America
| | - Janet Wiersema
- Correctional Health Services, New York City Health + Hospitals, New York, NY, United States of America
| | - Alain H. Litwin
- Department of Medicine, University of South Carolina School of Medicine–Greenville, Greenville, South Carolina, United States of America
- Department of Medicine, Prisma Health, Greenville, South Carolina, United States of America
- Clemson University School of Health Research, Clemson, South Carolina, United States of America
| | - Fatos Kaba
- Correctional Health Services, New York City Health + Hospitals, New York, NY, United States of America
| | - Ross MacDonald
- Correctional Health Services, New York City Health + Hospitals, New York, NY, United States of America
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Millett GA. New pathogen, same disparities: why COVID-19 and HIV remain prevalent in U.S. communities of colour and implications for ending the HIV epidemic. J Int AIDS Soc 2020; 23:e25639. [PMID: 33222424 PMCID: PMC7645849 DOI: 10.1002/jia2.25639] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION The U.S. Ending the HIV Epidemic (EHE) Initiative was launched nationally in February 2019. With a target of ending the HIV epidemic by 2030, EHE initially scales up effective HIV prevention and care in 57 localities that comprise the greatest proportion of annual HIV diagnoses in the United States (US). However, the EHE effort has been eclipsed by another infectious disease 11 months into the Initiative's implementation. SARS-COV-2, a novel coronavirus, has infected more than eight million Americans and at least 223 000 (as of 23 October 2020) have succumbed to the disease. This commentary explores the social conditions that place communities of colour at greater risk for COVID-19 and HIV, and assesses challenges to EHE in a post-COVID-19 universe. DISCUSSION One of the many common threads between HIV and COVID-19 is the disproportionate impact of each disease among communities of colour. A recent report by the National Academy of Sciences surmised that as much as 70% of health outcomes are due to health access, socio-economic factors and environmental conditions. Social determinants of health associated with greater HIV burden in Black and Brown communities have re-emerged in epidemiological studies of disproportionate COVID-19 cases, hospitalizations and deaths in communities of colour. Using data from the scientific literature, this commentary makes direct comparisons between HIV and COVID-19 racial disparities across the social determinants of health. Furthermore, I examine three sets of challenges facing EHE: (1) Challenges that hamper both the EHE and COVID-19 response (i.e. insufficiently addressing the social determinants of health; amplification of disparities as new health technologies are introduced) (2) Challenges posed by COVID-19 (i.e. diverting HIV resources to address COVID-19 and tapering of EHE funding generally); and (3) Challenges unrelated to COVID-19 (i.e. emergence of new and related health disparities; repeal of the Affordable Care Act and long-term viability of EHE). CONCLUSIONS Racism and discrimination place communities of colour at greater risk for COVID-19 as well as HIV. Achieving and sustaining an end to the U.S. HIV epidemic will require structural change to eliminate conditions that give rise to and maintain disparities.
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Hotton AL, Perloff J, Paul J, Parker C, Ducheny K, Holloway T, Johnson AK, Garofalo R, Swartz J, Kuhns LM. Patterns of Exposure to Socio-structural Stressors and HIV Care Engagement Among Transgender Women of Color. AIDS Behav 2020; 24:3155-3163. [PMID: 32335760 DOI: 10.1007/s10461-020-02874-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Transgender women are disproportionately affected by HIV and experiences of social adversity that may interfere with engagement in care and viral suppression. We used latent class analysis to examine patterns of social adversity and their impact on HIV care continuum outcomes in an urban sample of transgender women of color. Participants (n = 224) were median age 29 and 86% non-Hispanic Black. Lack of resources, unemployment, and housing instability were reported by over 50%, and 41% reported history of incarceration. Latent class analysis identified 2 distinct classes representing higher and lower levels of social adversity. In latent class regression, membership in the higher social adversity class was associated with statistically significantly lower odds of viral suppression and HIV care engagement in univariate analysis; when adjusted for age, race, and recruitment site the association remained statistically significant for viral suppression (aOR 0.38, 95% CI 0.18-0.79; chi-square = 6.681, d.f. = 1, p = 0.010), though not for HIV care engagement. Our findings highlight the impact of socio-structural barriers on engagement in the HIV care continuum among transgender women.
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Affiliation(s)
- Anna L Hotton
- Section of Infectious Diseases and Global Health & The Chicago Center for HIV Elimination, The University of Chicago Medicine, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA.
| | - Judy Perloff
- Chicago House and Social Service Agency, Chicago, IL, USA
| | - Josie Paul
- Chicago House and Social Service Agency, Chicago, IL, USA
| | - Channyn Parker
- Chicago House and Social Service Agency, Chicago, IL, USA
| | | | | | - Amy K Johnson
- The Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital, Chicago, IL, USA
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Robert Garofalo
- The Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital, Chicago, IL, USA
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - James Swartz
- Jane Addams College of Social Work, University of Illinois at Chicago, Chicago, IL, USA
| | - Lisa M Kuhns
- The Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital, Chicago, IL, USA
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Hotton AL, Chen YT, Schumm P, Khanna AS, Brewer R, Skaathun B, Issema RS, Ramani S, Ramachandran A, Ozik J, Fujimoto K, Harawa NT, Schneider JA. Socio-Structural and Neighborhood Predictors of Incident Criminal Justice Involvement in a Population-Based Cohort of Young Black MSM and Transgender Women. J Urban Health 2020; 97:623-634. [PMID: 32180129 PMCID: PMC7560631 DOI: 10.1007/s11524-020-00428-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Black men who have sex with men (MSM) and transgender women are disproportionately affected by criminal justice involvement (CJI) and HIV. This study recruited 618 young Black MSM and transgender women in Chicago, IL, using respondent-driven sampling between 2013 and 2014. Random effects logistic regression evaluated predictors of incident CJI over 18 months of follow-up. Controlling for respondent age, gender and sexual identity, spirituality (aOR 0.56, 95% CI 0.33-0.96), and presence of a mother figure (aOR 0.41, 95% CI 0.19-0.89) were protective against CJI. Economic hardship (financial or residential instability vs. neither aOR 2.23, 95% CI 1.10-4.51), two or more past episodes of CJI vs. none (aOR 2.66, 95% CI 1.40-5.66), and substance use (marijuana use vs. none aOR 2.79, 95% CI 1.23-6.34; other drug use vs. none aOR 4.49, 95% CI 1.66-12.16) were associated with CJI during follow-up. Research to identify and leverage resilience factors that can buffer the effects of socioeconomic marginalization may increase the effectiveness of interventions to address the socio-structural factors that increase the risk for CJI among Black MSM and transgender women. Given the intersection of incarceration, HIV and other STIs, and socio-structural stressors, criminal justice settings are important venues for interventions to reduce health inequities in these populations.
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Affiliation(s)
- Anna L Hotton
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA.
| | - Yen-Tyng Chen
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA
| | - Phil Schumm
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Aditya S Khanna
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA
| | - Russell Brewer
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA
| | - Britt Skaathun
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA
| | - Rodal S Issema
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA
| | - Santhoshini Ramani
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA
| | - Arthi Ramachandran
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, 5837 S. Maryland Ave, L-038, Chicago, IL, 60637, USA
| | - Jonathan Ozik
- Consortium for Advanced Science and Engineering, University of Chicago, Chicago, IL, USA.,Decision and Infrastructure Sciences Division, Argonne National Laboratory, Lemont, IL, USA
| | | | | | - John A Schneider
- Departments of Medicine and Public Health Sciences, Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
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do Nascimento CT, Pena DZ, Giuffrida R, Bandeira Monteiro FN, da Silva FA, Flores EF, Prestes-Carneiro LE. Prevalence and epidemiological characteristics of inmates diagnosed with infectious diseases living in a region with a high number of prisons in São Paulo state, Brazil. BMJ Open 2020; 10:e037045. [PMID: 32895275 PMCID: PMC7476464 DOI: 10.1136/bmjopen-2020-037045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To determine the prevalence and epidemiological characteristics of inmates diagnosed with infectious diseases living in a region with a high number of prisons, São Paulo, Brazil. DESIGN This is a retrospective and descriptive study conducted from November 2017 to October 2018. SETTING Prisons located in the western and northwestern regions of São Paulo, Brazil. METHODS We conducted a retrospective analysis on infectious diseases and coinfections (HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis and tuberculosis (TB)) of inmates from 28 prisons. Inmates were previously diagnosed following the protocol for control and surveillance of infectious diseases, through laboratory or imaging methods. A questionnaire was completed by the healthcare staff. Prevalence was obtained by dividing the number of individuals with positive results by the number of inmates in each prison. Locations of prisons were obtained and maps were constructed using geographic information systems. RESULTS A total of 741 of 37 497 inmates (1.97%) were diagnosed with HIV, HBV, HCV, syphilis or TB. HIV was the most prevalent infectious disease (0.68%), followed by TB (0.66%), syphilis (0.2%), HCV (0.2%) and HBV (0.04%). For all of these diseases, prevalence rates varied from very low to high (3.11% and 2.45%) for TB and HIV, respectively, in the five prisons where they were most prevalent. HIV-syphilis was the most associated coinfection (OR, 63.7; 95% CI 41.4 to 96.7). Three of those diagnosed with the infection were female and the ratio of female to men was 0.004:1. CONCLUSIONS Our findings demonstrate that the number of cases of infectious disease among inmates in the northwestern and western region of São Paulo is probably underestimated, with lower rates of HCV, HBV and syphilis. This represents a challenge to prisoners' health. Improvements in diagnosis, mainly to reduce viral hepatitis, are crucial with benefits for inmates and the general population.
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Affiliation(s)
| | - Danilo Zangirolami Pena
- Postgraduate Department, Master in Health Sciences, Oeste Paulista University, Presidente Prudente, São Paulo, Brazil
| | - Rogério Giuffrida
- Postgraduate Department, Master in Health Sciences, Oeste Paulista University, Presidente Prudente, São Paulo, Brazil
| | | | - Francisco Assis da Silva
- Postgraduate Department, Master in Health Sciences, Oeste Paulista University, Presidente Prudente, São Paulo, Brazil
| | - Edilson Ferreira Flores
- Statistics Department, School of Sciences and Technology, São Paulo State University, Presidente Prudente, São Paulo, Brazil
| | - Luiz Euribel Prestes-Carneiro
- Postgraduate Department, Master in Health Sciences, Oeste Paulista University, Presidente Prudente, São Paulo, Brazil
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McCree DH, Beer L, Fugerson AG, Tie Y, Bradley ELP. Social and Structural Factors Associated with Sustained Viral Suppression Among Heterosexual Black Men with Diagnosed HIV in the United States, 2015-2017. AIDS Behav 2020; 24:2451-2460. [PMID: 32020509 DOI: 10.1007/s10461-020-02805-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This paper describes sociodemographic, sexual risk behavior, and clinical care factors associated with sustained viral suppression (SVS) among heterosexual Black men with diagnosed HIV in the US. Sample was 968 men, 2015-2017 cycles of Medical Monitoring Project. We used prevalence ratios and a multivariable logistic regression model to identify independent predictors of SVS. About 9% of sexually active men had sex that carries a risk of HIV transmission. Nearly 2/3 lived at or below the poverty level, 13% were under or uninsured, 1/4 experienced food insecurity and 15% reported recent homelessness. About 26% were not engaged in HIV care, 8% not currently taking antiretroviral therapy (ART) and 59% had SVS. Among men taking ART, care engagement and adherence were the only significant independent predictors of SVS. Efforts to increase VS should focus on increasing ART use, care engagement, and ART adherence, and include strategies that address the social and structural factors that influence them.
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Affiliation(s)
- Donna Hubbard McCree
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Linda Beer
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Yunfeng Tie
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Erin L P Bradley
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
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Tiruneh YM, Li X, Bovell-Ammon B, Iroh P, Flanigan TP, Montague BT, Rich JD, Nijhawan AE. Falling Through the Cracks: Risk Factors for Becoming Lost to HIV Care After Incarceration in a Southern Jail. AIDS Behav 2020; 24:2430-2441. [PMID: 32006154 PMCID: PMC10411387 DOI: 10.1007/s10461-020-02803-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
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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Affiliation(s)
- Yordanos M Tiruneh
- Department of Community Health, School of Community and Rural Health, The University of Texas Health Science Center at Tyler, 11937 US Hwy 271, Tyler, TX, 75708, USA.
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Xilong Li
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Princess Iroh
- Department of Internal Medicine, Division of Infectious Diseases, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Timothy P Flanigan
- Departments of Medicine and Health Services, Policy, Practice, Brown University, Providence, RI, USA
| | - Brian T Montague
- Department of Internal Medicine, Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO, USA
| | - Josiah D Rich
- Departments of Medicine and Epidemiology, Brown University, Providence, RI, USA
| | - Ank E Nijhawan
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Internal Medicine, Division of Infectious Diseases, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Abstract
PURPOSE OF REVIEW Knowledge of HIV status is the gateway to HIV treatment and prevention, and optimizing this pillar is essential to bend the curve of the HIV epidemic toward zero new infections. This review will discuss the epidemiology of serostatus awareness, including disparities among key populations, and explore interventions and societal barriers. RECENT FINDINGS Rates of serostatus awareness have improved overall; however, progress is lagging in many regions, nations and populations, with substantial disparities seen among key populations. These populations and their partners now contribute the majority of new infections, fueling the epidemic. Data support a variety of interventions that have demonstrated effectiveness in increasing new diagnoses, particularly among underserved populations. Structural and societal barriers such as stigma, discriminatory laws and policies, and social determinants of health disproportionately affect key populations, and these must be addressed to achieve equity and end the epidemic. SUMMARY According to United Nations Programme on HIV/AIDS (UNAIDS), the pace of progress toward epidemic control has slowed. Achieving substantial increases in serostatus awareness to meet 2020 and 2030 UNAIDS goals will require attacking complex societal barriers while bringing evidence-based interventions to scale in each nation and key population. A robust advocacy effort is now needed as political will and funding wane.
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Stevenson KA, Podewils LJ, Zishiri VK, Castro KG, Charalambous S. HIV prevalence and the cascade of care in five South African correctional facilities. PLoS One 2020; 15:e0235178. [PMID: 32614878 PMCID: PMC7332003 DOI: 10.1371/journal.pone.0235178] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 06/09/2020] [Indexed: 01/24/2023] Open
Abstract
Background South Africa is home to the world’s largest HIV epidemic. Throughout the world, incarcerated individuals have a higher prevalence of HIV than the general public, and South Africa has one of the highest rates of incarceration in sub-Saharan Africa. In spite of this, little has been published about the burden of HIV and how care is delivered in South African correctional facilities. Objective To estimate the prevalence of people living with HIV and identify initiation and retention in the HIV cascade of care across five correctional facilities. Methods Cross-sectional retrospective analysis of 30,571 adult inmates who participated in a tuberculosis screening and HIV counseling and testing campaign in South African correctional facilities (January 1, 2014—January 31, 2015). Descriptive statistics were used to estimate the proportion and 95% confidence intervals of HIV. Proportions of persons retained and lost at each step in the HIV cascade of care under this intervention were calculated. Poisson regression with robust variance estimates were used, and clustering by facility was accounted for in all analyses. Results Results of the screening campaign found previously undiagnosed HIV among 13.0% of those consenting to screening, with a total estimated HIV prevalence of 17.7% (n = 3,184, 95% CI: 17.2–18.3%) in the sample. When examining the overall cascade of care, 48.3% of those with HIV initiated care, and overall 45.6% of persons who entered care qualified for ART initiated treatment. A Poisson regression accounting for clustering by facility found HIV high risk groups within the population such as women (aRR = 1.72, 95% CI: 1.57, 1.89), those over 35 years of age (aRR = 2.43, 95% CI: 1.53, 3.85), and people incarcerated less than one year (aRR = 1.41, 95% CI: 1.19, 1.67). Conclusion In this setting, routine screening is recommended, and measures are needed to ensure that persons diagnosed are adequately linked to and retained in care.
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Affiliation(s)
- Kelsey A. Stevenson
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- * E-mail:
| | - Laura J. Podewils
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | | | - Kenneth G. Castro
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Salome Charalambous
- The Aurum Institute, Johannesburg, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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Medford RJ, Saleh SN, Sumarsono A, Perl TM, Lehmann CU. An "Infodemic": Leveraging High-Volume Twitter Data to Understand Early Public Sentiment for the Coronavirus Disease 2019 Outbreak. Open Forum Infect Dis 2020; 7:ofaa258. [PMID: 33117854 DOI: 10.1101/2020.04.03.20052936] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/22/2020] [Indexed: 05/22/2023] Open
Abstract
BACKGROUND Twitter has been used to track trends and disseminate health information during viral epidemics. On January 21, 2020, the Centers for Disease Control and Prevention activated its Emergency Operations Center and the World Health Organization released its first situation report about coronavirus disease 2019 (COVID-19), sparking significant media attention. How Twitter content and sentiment evolved in the early stages of the COVID-19 pandemic has not been described. METHODS We extracted tweets matching hashtags related to COVID-19 from January 14 to 28, 2020 using Twitter's application programming interface. We measured themes and frequency of keywords related to infection prevention practices. We performed a sentiment analysis to identify the sentiment polarity and predominant emotions in tweets and conducted topic modeling to identify and explore discussion topics over time. We compared sentiment, emotion, and topics among the most popular tweets, defined by the number of retweets. RESULTS We evaluated 126 049 tweets from 53 196 unique users. The hourly number of COVID-19-related tweets starkly increased from January 21, 2020 onward. Approximately half (49.5%) of all tweets expressed fear and approximately 30% expressed surprise. In the full cohort, the economic and political impact of COVID-19 was the most commonly discussed topic. When focusing on the most retweeted tweets, the incidence of fear decreased and topics focused on quarantine efforts, the outbreak and its transmission, as well as prevention. CONCLUSIONS Twitter is a rich medium that can be leveraged to understand public sentiment in real-time and potentially target individualized public health messages based on user interest and emotion.
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Affiliation(s)
- Richard J Medford
- University of Texas Southwestern Medical Center, Department of Internal Medicine, Division of Infectious Diseases and Geographic Medicine, Dallas, Texas, USA
- University of Texas Southwestern Medical Center, Clinical Informatics Center, Dallas, Texas, USA
| | - Sameh N Saleh
- University of Texas Southwestern Medical Center, Department of Internal Medicine, Dallas, Texas, USA
- University of Texas Southwestern Medical Center, Clinical Informatics Center, Dallas, Texas, USA
| | - Andrew Sumarsono
- University of Texas Southwestern Medical Center, Department of Internal Medicine, Dallas, Texas, USA
| | - Trish M Perl
- University of Texas Southwestern Medical Center, Department of Internal Medicine, Division of Infectious Diseases and Geographic Medicine, Dallas, Texas, USA
| | - Christoph U Lehmann
- University of Texas Southwestern Medical Center, Clinical Informatics Center, Dallas, Texas, USA
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Puing AG, Li X, Rich J, Nijhawan AE. Emergency department utilization by people living with HIV released from jail in the US South. HEALTH & JUSTICE 2020; 8:16. [PMID: 32594269 PMCID: PMC7321540 DOI: 10.1186/s40352-020-00118-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 06/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Incarceration is disruptive to HIV care, often resulting in poor retention in care for people living with HIV (PLWH) after jail release. This gap in HIV care might result in potentially preventable emergency department (ED) utilization. We analyzed demographic, incarceration, socioeconomic and clinical data for PLWH released from the Dallas County Jail to the community (1450 incarcerations, 1155 unique individuals) between January 2011 and November 2013. RESULTS The study population consisted of predominantly men (77%), with a mean age of 39 years, 67% were black and 14% were Hispanic; half of the releasees visited the ED at least once during the first-year post-jail. In adjusted analyses, female gender, family awareness of HIV status, serious mental illness, and late engagement to HIV care were significantly associated with higher ED utilization. Compared to the general Dallas population, PLWH released from jail had a 5-fold higher proportion of ED visits classified as related to substance use or mental health. CONCLUSIONS Further efforts are needed to improve the transition from incarceration to community-based HIV care, substance use disorder treatment and mental health services, and to directly address re-engagement in HIV care for out-of-care PLWH who visit the ED.
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Affiliation(s)
| | - Xilong Li
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Josiah Rich
- Department of Internal Medicine and Epidemiology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Ank E Nijhawan
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA.
- Department of Internal Medicine, Division of Infectious Diseases, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9169, USA.
- Parkland Health and Hospital Systems, Dallas, TX, USA.
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A Systematic Mixed Studies Review of the Intersections of Social-Ecological Factors and HIV Stigma in People Living With HIV in the U.S. South. J Assoc Nurses AIDS Care 2020; 30:330-343. [PMID: 31021963 DOI: 10.1097/jnc.0000000000000076] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The role of stigma on psychological wellness and treatment outcomes in people living with HIV (PLWH) has been well documented. However, within the context of the southern United States, the intersection between HIV-related stigma and social-ecological factors has been understudied. Thus, a results-based convergent, mixed synthesis design was used to examine the manifestations of HIV-related stigma in PLWH in the U.S. South. A literature search was conducted using PsycINFO, PubMed (includes MEDLINE), and CINAHL. The first level of screening by title and abstract was administered on 1,829 articles. A full-text screening of 169 studies was completed, and a total of 30 relevant articles were extracted. The mixed synthesis highlighted intervention strategies that can reduce HIV-related stigma while promoting positive health-behavior change. The findings of this review underscored the uniqueness of PLWH in the south and demonstrated the crucial role of intersectionality in investigating HIV-related stigma in treating and preventing HIV.
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76
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Wiersema JJ, Cruzado-Quiñones J, Cosme Pitre CG, Jordan AO. Client Outcomes From a Multilevel Intervention to Support Persons Living With HIV and Returning to the Community After Incarceration in Puerto Rico. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2020; 32:181-195. [PMID: 32749876 DOI: 10.1521/aeap.2020.32.3.181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The twin epidemics of HIV and incarceration impact Puerto Rico, which has limited resources to address the social and structural determinants of health in incarcerated populations. A Special Programs of National Significance grant supported a Puerto Rican community-based organization to implement the evidence-informed Transitional Care Coordination intervention among incarcerated persons living with HIV, targeting changes at the individual, organization, and systems levels. After implementation (November 2015-July 2018; n = 69), 93.1% of eligible clients were linked to community-based HIV care, 86.3% remained in care for 6 months, and 78.6% remained for 12 months. A greater proportion reported consistent HIV care, ART adherence, food security, and transportation to access care. Integrating HIV case management with housing and employment services, and developing buy-in and collaboration from partners across systems of care, including after a natural disaster, led to positive client outcomes. This intervention shows promise for adaptation to other HIV care and service delivery systems.
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Affiliation(s)
- Janet J Wiersema
- NYC Health + Hospitals Correctional Health Services, New York, New York
| | | | | | - Alison O Jordan
- NYC Health + Hospitals Correctional Health Services, New York, New York
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77
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Huber F, Vandentorren S, Merceron A, Bonifay T, Pastre A, Lucarelli A, Nacher M. Returning to care after incarceration with HIV: the French Guianese experience. BMC Public Health 2020; 20:754. [PMID: 32448209 PMCID: PMC7245866 DOI: 10.1186/s12889-020-08772-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 04/24/2020] [Indexed: 11/10/2022] Open
Abstract
Background HIV prevalence in correctional facilities may be 2 to 10 times higher than in the general adult population. Antiretroviral therapy (ART) interruption is frequent after an incarceration. This, in combination with post-release high-risk behaviors, may have detrimental consequences on the epidemic. Although return to care after release from correctional facilities has been described in many North American settings, data from South America seemed scarce. French Guiana is the only French territory located in South America. In 2014, HIV prevalence was estimated at 1.2% among pregnant women and oscillated around 4% in the only correctional facility. Method HIV-infected adults released from the French Guiana correctional facility between 2007 and 2013 were included in a retrospective cohort survey. The first objective was to describe the cascade of care in the 4 years following release. The secondary objectives were to describe contacts with care and to identify factors associated with return to HIV care, 1 year after release. Results We included 147 people, mostly males (81.6%). The median time before the first ambulatory consultation was 1.8 months. Within 1 year after release, 27.9% came for unscheduled emergency consultations, 22.4% were hospitalized. Within 4 years after release, 40.0–46.5% were in care, 22.4% archieved virological success. Being on ART when incarcerated was associated with HIV care (aIRR: 2.0, CI: 1.2–3.0), whereas being HIV-diagnosed during the last incarceration was associated with poor follow-up (aIRR: 0.3, CI: 0.1–0.9). Conclusion The risk of HIV-follow-up interruption is high, after an incarceration with HIV. ART supply should be sufficient to cover the timespan following release, several months if possible. Those not on ART at the time of incarceration may require special attention, especially those newly HIV-diagnosed while in custody. Comprehensive programs are necessary to support ex-offenders to stay on ART after incarceration.
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Affiliation(s)
- F Huber
- COREVIH Guyane, Centre Hospitalier Andree Rosemon, Cayenne, Guyane Française, France. .,Réseau Kikiwi, Cayenne, Guyane Française, France.
| | - S Vandentorren
- Département d'épidemiologie sociale, INSERM, Sorbonne université, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
| | - A Merceron
- Université des Antilles et de la Guyane, Faculté de Médecine Hyacinthe Basturaud, Pointe-à-Pitre, France
| | - T Bonifay
- UCSA, Centre Hospitalier Andree Rosemon, Cayenne, Guyane Française, France
| | - A Pastre
- UCSA, Centre Hospitalier Andree Rosemon, Cayenne, Guyane Française, France
| | - A Lucarelli
- Hôpital de Jour Adulte, Centre Hospitalier Andree Rosemon, Cayenne, Guyane Française, France
| | - M Nacher
- Inserm CIC Antilles-Guyane INSERM 1424 (Pole Guyane), Universite de Guyane, Cayenne, France
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78
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Fuge TG, Tsourtos G, Miller ER. A systematic review and meta-analyses on initiation, adherence and outcomes of antiretroviral therapy in incarcerated people. PLoS One 2020; 15:e0233355. [PMID: 32421754 PMCID: PMC7233580 DOI: 10.1371/journal.pone.0233355] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 05/04/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Incarcerated people are at increased risk of human immunodeficiency virus (HIV) infection relative to the general population. Despite a high burden of infection, HIV care use among prison populations is often suboptimal and varies among settings, and little evidence exists explaining the discrepancy. Therefore, this review assessed barriers to optimal use of HIV care cascade in incarcerated people. METHODS Quantitative and qualitative studies investigating factors affecting linkage to care, ART (antiretroviral therapy) initiation, adherence and/or outcomes among inmates were systematically searched across seven databases. Studies published in English language and indexed up to 26 October 2018 were reviewed. We performed a narrative review for both quantitative and qualitative studies, and meta-analyses on selected quantitative studies. All retrieved quantitative studies were assessed for risk of bias. Meta-analyses were conducted using RevMan-5 software and pooled odds ratios were calculated using Mantel-Haenszel statistics with 95% confidence interval at a p<0.05. The review protocol has been published at the International Prospective Register of Systematic Reviews (PROSPERO; Number: CRD42019135502). RESULTS Of forty-two studies included in the narrative review, eight were qualitative studies. Sixteen of the quantitative studies were eligible for meta-analyses. The narrative synthesis revealed structural factors such as: a lack of access to community standard of HIV care, particularly in resource limited countries; loss of privacy; and history of incarceration and re-incarceration as risk factors for poor HIV care use in prison populations. Among social and personal characteristics, lack of social support, stigma, discrimination, substance use, having limited knowledge about, and negative perception towards ART were the main determinants of suboptimal use of care in incarcerated people. In the meta-analyses, lower odds of ART initiation was noticed among inmates with higher baseline CD4 count (CD4 ≥500celss/mm3) (OR = 0.37, 95%CI: 0.14-0.97, I2 = 43%), new HIV diagnosis (OR = 0.07, 95%CI: 0.05-0.10, I2 = 68%), and in those who lacked belief in ART safety (OR = 0.32, 95%CI: 0.18-0.56, I2 = 0%) and efficacy (OR = 0.31, 95%CI: 0.17-0.57, I2 = 0%). Non-adherence was high among inmates who lacked social support (OR = 3.36, 95%CI: 2.03-5.56, I2 = 35%), had low self-efficiency score (OR = 2.50, 95%CI: 1.64,-3.80, I2 = 22%) and those with depressive symptoms (OR = 2.02, 95%CI: 1.34-3.02, I2 = 0%). Lower odds of viral suppression was associated with history of incarceration (OR = 0.40, 95%CI: 0.35-0.46, I2 = 0%), re-incarceration (OR = 0.09, 95%CI: 0.06-0.13, I2 = 64%) and male gender (OR = 0.55, 95%CI: 0.42-0.72, I2 = 0%). Higher odds of CD4 count <200cells/mm3 (OR = 2.01, 95%CI: 1.62, 2.50, I2 = 44%) and lower odds of viral suppression (OR = 0.20, 95%CI: 0.17-0.22, I2 = 0%) were observed during prison entry compared to those noticed during release. CONCLUSION Given the high HIV risk in prison populations and rapid movements of these people between prison and community, correctional facilities have the potential to substantially contribute to the use of HIV treatment as a prevention strategy. Thus, there is an urgent need for reviewing context specific interventions and ensuring standard of HIV care in prisons, particularly in resource limited countries.
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Affiliation(s)
- Terefe G. Fuge
- Medicine and Public Health, Flinders University, Adelaide, Australia
| | - George Tsourtos
- Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Emma R. Miller
- Medicine and Public Health, Flinders University, Adelaide, Australia
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79
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Mabuto T, Woznica DM, Lekubu G, Seatlholo N, Mshweshwe-Pakela N, Charalambous S, Hoffmann CJ. Observational study of continuity of HIV care following release from correctional facilities in South Africa. BMC Public Health 2020; 20:324. [PMID: 32164628 PMCID: PMC7068979 DOI: 10.1186/s12889-020-8417-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 02/26/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND We sought to describe linkage to care, ART continuity, and factors associated with linkage to care among people with HIV following release from incarceration in South Africa. METHODS We conducted a study of South African correctional service community reentrants who were receiving ART at the time of release. The study was implemented in three of 46 correctional service management areas. Participants were enrolled prior to corrections release and followed up to 90 days post-release to obtain self-reported linkage to care status and number of days of ART provided at corrections release. Clinic electronic and paper charts were sought and abstracted to verify self-reported linkage to care. Log-binomial regression, adjusted for facility, was used to identify associations with post-release linkage to care (self-reported and verified). We sought to specifically assess for associations with HIV diagnosis during index incarceration, ART initiation during index incarceration, and duration of incarceration. RESULTS From May 2014 to December 2016, 554 inmates met eligibility and 516 (93%) consented to participate; 391 were released on ART, 40 of whom were excluded from analysis post-release. Of the remaining 351, 301 (86%) were men and the median age was 35 years (interquartile range 30, 40). Linkage to care was self-reported by 227 (64%) and linkage to care could be verified for 121 (34%). At most, 47% of participants had no lapse in ART supply. Initiating ART during the index incarceration showed a trend toward increased self-reported post-release linkage to care. Age > 35 years was associated with increased verified linkage to care while HIV diagnosis outside of a correctional setting and ART initiation during the index incarceration showed trends toward association with increased verified linkage to care. DISCUSSION The results of our study are the first description of retention in care following correctional facility release from an African setting and indicate high levels of attrition during the transition from correctional facility to community care. Initiating ART within a correctional facility did not impair post-release linkage to care.
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Affiliation(s)
- Tonderai Mabuto
- Aurum Institute, Johannesburg, South Africa
- The University of the Witwatersrand School of Public Health, Johannesburg, South Africa
| | - Daniel M Woznica
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
| | - Gloria Lekubu
- Department of Correctional Services, Gauteng Region, South Africa
| | | | | | - Salome Charalambous
- Aurum Institute, Johannesburg, South Africa
- The University of the Witwatersrand School of Public Health, Johannesburg, South Africa
| | - Christopher J Hoffmann
- Aurum Institute, Johannesburg, South Africa.
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA.
- Johns Hopkins University School of Medicine, CRB2 Rm 1M11, 1550 Orleans Rd, Baltimore, MD, 21205, USA.
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80
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Rennie S, Buchbinder M, Juengst E, Brinkley-Rubinstein L, Blue C, Rosen DL. Scraping the Web for Public Health Gains: Ethical Considerations from a 'Big Data' Research Project on HIV and Incarceration. Public Health Ethics 2020; 13:111-121. [PMID: 32765647 DOI: 10.1093/phe/phaa006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Web scraping involves using computer programs for automated extraction and organization of data from the Web for the purpose of further data analysis and use. It is frequently used by commercial companies, but also has become a valuable tool in epidemiological research and public health planning. In this paper, we explore ethical issues in a project that "scrapes" public websites of U.S. county jails as part of an effort to develop a comprehensive database (including individual-level jail incarcerations, court records and confidential HIV records) to enhance HIV surveillance and improve continuity of care for incarcerated populations. We argue that the well-known framework of Emanuel et al. (2000) provides only partial ethical guidance for the activities we describe, which lie at a complex intersection of public health research and public health practice. We suggest some ethical considerations from the ethics of public health practice to help fill gaps in this relatively unexplored area.
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Affiliation(s)
- Stuart Rennie
- UNC Bioethics Center, Department of Social Medicine, University of North Carolina at Chapel Hill
| | - Mara Buchbinder
- UNC Bioethics Center, Department of Social Medicine, University of North Carolina at Chapel Hill
| | - Eric Juengst
- UNC Bioethics Center, Department of Social Medicine, University of North Carolina at Chapel Hill
| | | | - Colleen Blue
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill
| | - David L Rosen
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill
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81
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Uhrig Castonguay BJ, Cressman AE, Kuo I, Patrick R, Trezza C, Cates A, Olsen H, Peterson J, Kurth A, Bazerman LB, Beckwith CG. The Implementation of a Text Messaging Intervention to Improve HIV Continuum of Care Outcomes Among Persons Recently Released From Correctional Facilities: Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e16220. [PMID: 32053119 PMCID: PMC7055782 DOI: 10.2196/16220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/19/2019] [Accepted: 10/20/2019] [Indexed: 01/19/2023] Open
Abstract
Background Previously incarcerated individuals have suboptimal linkage and engagement in community HIV care. Mobile health (mHealth) interventions have been shown to be effective in addressing these gaps. In Washington, District of Columbia (DC), we conducted a randomized trial of an SMS text messaging–based mHealth intervention (CARE+ Corrections) to increase linkage to community HIV care and antiretroviral treatment adherence among HIV-infected persons involved in the criminal justice system. Objective This study aimed to describe the SMS text messaging–based intervention, participant use of the intervention, and barriers and facilitators of implementation. Methods From August 2013 to April 2015, HIV-positive incarcerated individuals were recruited within the DC Department of Corrections, and persons released in the past 6 months were recruited within the community via street-based recruitment, community partnerships, and referrals. Participants were followed for 6 months and received weekly or daily SMS text messages. Formative research resulted in the development of the content of the messages in 4 categories: HIV Appointment Reminders, Medication Adherence, Prevention Reminders, and Barriers to Care following release from jail. Participants could customize the timing, frequency, and message content throughout the study period. Results Of the 112 participants enrolled, 57 (50.9%) were randomized to the intervention group and 55 (49.1%) to the control group; 2 control participants did not complete the baseline visit, and were dropped from the study, leaving a total of 110 participants who contributed to the analyses. Study retention was similar across both study arms. Median age was 42 years (IQR 30-50), 86% (49/57) were black or African American, 58% (33/57) were male, 25% (14/57) were female, and 18% (10/57) were transgender. Median length of last incarceration was 4 months (IQR 1.7-9.0), and median lifetime number of times incarcerated was 6.5 (IQR 3.5-14.0). Most participants (32/54, 59%) had a baseline viral load of <200 copies/mL. Nearly all participants (52/57, 91%) chose to use a cell phone provided by the study. The most preferred Appointment Reminder message was Hey how you feeling? Don’t forget to give a call and make your appointment (19/57, 33%). The most preferred Medication Adherence message was Don’t forget your skittles! (31/57, 54%), and 63% (36/57) of participants chose to receive daily (vs weekly) messages from this category at baseline. The most preferred Prevention Reminder message was Stay strong. Stay clean (18/57, 32%). The most preferred Barriers to Care message was Holla at your case manager, they’re here to help (12/57, 22%). Minor message preference differences were observed among participants enrolled in the jail versus those from the community. Conclusions Participants’ ability to customize their SMS text message plan proved helpful. Further large-scale research on mHealth platforms is needed to assess its efficacy among HIV-infected persons with a history of incarceration. Trial Registration ClinicalTrials.gov NCT01721226; https://clinicaltrials.gov/ct2/show/NCT01721226
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Affiliation(s)
- Breana J Uhrig Castonguay
- University of North Carolina Center for AIDS Research, Lineberger Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Andrew E Cressman
- The Center for Prisoner Health and Human Rights, Providence, RI, United States.,Brown University School of Public Health, Providence, RI, United States
| | - Irene Kuo
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States.,District of Columbia Center for AIDS Research, Washington, DC, United States
| | - Rudy Patrick
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Claudia Trezza
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Alice Cates
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Halli Olsen
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - James Peterson
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States.,District of Columbia Center for AIDS Research, Washington, DC, United States
| | - Ann Kurth
- Yale University School of Nursing, New Haven, CT, United States
| | | | - Curt G Beckwith
- The Miriam Hospital, Providence, RI, United States.,Division of Infectious Diseases, Alpert Medical School of Brown University, Providence, RI, United States
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82
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Mishreki AM, Boardman NJ, Brodine SK, Yang M, Lederman ER. Predictive factors of facilitating linkage to care for HIV-positive detainees in ICE Health Service Corps-staffed facilities. J Public Health (Oxf) 2020; 43:611-617. [PMID: 32052060 DOI: 10.1093/pubmed/fdaa003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/03/2019] [Accepted: 01/10/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Persons in ICE detention represent a population about whom limited health-related data is available in the literature. Since ICE detention is generally brief, facilitating linkage to care (FLC) for detainees with chronic diseases, including HIV-positive detainees, is challenging, yet critical to encourage continued treatment beyond custody. Between 2015 and 2017, IHSC-staffed facilities implemented intensive training related to HIV care and FLC and increased clinical oversight and consultations. This study examined the impact of these changes in relation to FLC. METHODS Demographic and clinical data for detainees with known HIV-positive diagnoses at IHSC-staffed facilities entering custody in 2015 and 2017 were obtained via electronic health record. Univariate analysis and multiple logistic regressions were performed to identify factors that may increase FLC. RESULTS After adjusting for year of entry into custody, detainees who received an infectious disease (ID) consultation had significantly higher odds (2.4, P < 0.001) of receiving FLC resources compared to those who did not receive an ID consultation. Between 2015 and 2017, the proportion of HIV-positive detainees receiving FLC resources increased from 29 to 62%. CONCLUSIONS ID consultations significantly improved FLC for HIV-positive detainees. Continued provider training and education is essential to continue improving the rate of FLC for HIV-positive ICE detainees.
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Affiliation(s)
- Alexandra M Mishreki
- U.S. Immigration and Customs Enforcement (ICE) Health Service Corps (IHSC), 500 12th Street, SW, Washington, DC 20536, USA.,San Diego State University School of Public Health, 5500 Campanile Dr, San Diego, CA 92182, USA
| | - Nicole J Boardman
- U.S. Immigration and Customs Enforcement (ICE) Health Service Corps (IHSC), 500 12th Street, SW, Washington, DC 20536, USA
| | - Stephanie K Brodine
- San Diego State University School of Public Health, 5500 Campanile Dr, San Diego, CA 92182, USA
| | - Mingan Yang
- San Diego State University School of Public Health, 5500 Campanile Dr, San Diego, CA 92182, USA
| | - Edith R Lederman
- U.S. Immigration and Customs Enforcement (ICE) Health Service Corps (IHSC), 500 12th Street, SW, Washington, DC 20536, USA.,San Diego State University School of Public Health, 5500 Campanile Dr, San Diego, CA 92182, USA
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83
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Toegel F, Holtyn AF, Pollock S, Rodewald AM, Leoutsakos JM, Fingerhood M, Silverman K. Effects of incentivizing viral suppression in previously incarcerated adults living with HIV. HIV Res Clin Pract 2020; 21:1-10. [PMID: 32133931 PMCID: PMC7259460 DOI: 10.1080/25787489.2020.1735816] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/12/2020] [Indexed: 12/21/2022]
Abstract
Background: The amount of HIV in a person's blood can be suppressed to an undetectable level through antiretroviral therapy medications (ART). Adhering to an ART regimen can improve a person's health and reduce HIV transmission. Despite these benefits, many people with HIV do not maintain the level of adherence required to achieve an undetectable viral load. This problem is particularly common among people who have been incarcerated.Objective: To determine effects of incentivizing viral suppression in previously incarcerated adults with HIV.Methods: Adults with HIV (N = 102) and detectable viral load (>200 copies/mL) were randomly assigned to a Usual Care or Incentive group. Usual Care participants did not earn incentives for viral suppression. Incentive participants earned incentives ($10/day maximum) for providing blood samples with a reduced or undetectable (<200 copies/mL) viral load. Assessments were conducted every 3 months. Results collected during the first year were aggregated and compared based on group assignment and incarceration history.Results: Previously incarcerated participants in the Incentive group provided more (OR: 2.9; CI: 1.3-6.8; p <.05) blood samples with an undetectable viral load (69%) than those in the Usual Care group (41%). Never-incarcerated participants in the Incentive group provided more (OR: 6.8; CI: 2.2-21.0; p <.01) blood samples with an undetectable viral load (78%) than those in the Usual Care group (36%). Effects of incentives did not differ by incarceration history.Conclusions: Incentivizing viral suppression can increase viral suppression (undetectable viral load) in people who have been incarcerated.
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Affiliation(s)
- Forrest Toegel
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - August F. Holtyn
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sarah Pollock
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrew M. Rodewald
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jeannie-Marie Leoutsakos
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael Fingerhood
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kenneth Silverman
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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84
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Takada S, Ettner SL, Harawa NT, Garland WH, Shoptaw SJ, Cunningham WE. Life Chaos is Associated with Reduced HIV Testing, Engagement in Care, and ART Adherence Among Cisgender Men and Transgender Women upon Entry into Jail. AIDS Behav 2020; 24:491-505. [PMID: 31396766 PMCID: PMC6994355 DOI: 10.1007/s10461-019-02570-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Life chaos, the perceived inability to plan for and anticipate the future, may be a barrier to the HIV care continuum for people living with HIV who experience incarceration. Between December 2012 and June 2015, we interviewed 356 adult cisgender men and transgender women living with HIV in Los Angeles County Jail. We assessed life chaos using the Confusion, Hubbub, and Order Scale (CHAOS) and conducted regression analyses to estimate the association between life chaos and care continuum. Forty-eight percent were diagnosed with HIV while incarcerated, 14% were engaged in care 12 months prior to incarceration, mean antiretroviral adherence was 65%, and 68% were virologically suppressed. Adjusting for sociodemographics, HIV-related stigma, and social support, higher life chaos was associated with greater likelihood of diagnosis while incarcerated, lower likelihood of engagement in care, and lower adherence. There was no statistically significant association between life chaos and virologic suppression. Identifying life chaos in criminal-justice involved populations and intervening on it may improve continuum outcomes.
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Affiliation(s)
- Sae Takada
- Division of General Internal Medicine and Health Services Research, Department of Medicine, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
- Veterans Affairs Health Services Research and Development Service, Center for the Study of Healthcare Innovation, Implementation, and Policy, Los Angeles, CA, USA.
| | - Susan L Ettner
- Division of General Internal Medicine and Health Services Research, Department of Medicine, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Nina T Harawa
- Division of General Internal Medicine and Health Services Research, Department of Medicine, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- College of Medicine, Charles R. Drew University, Los Angeles, CA, USA
| | - Wendy H Garland
- Los Angeles County Department of Public Health, Division of HIV and STD Programs, Los Angeles, CA, USA
| | - Steve J Shoptaw
- Department of Family Medicine, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - William E Cunningham
- Division of General Internal Medicine and Health Services Research, Department of Medicine, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
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85
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Step MM, McMillen Smith J, Kratz J, Briggs J, Avery A. "Positive Peers": Function and Content Development of a Mobile App for Engaging and Retaining Young Adults in HIV Care. JMIR Form Res 2020; 4:e13495. [PMID: 32012035 PMCID: PMC7055772 DOI: 10.2196/13495] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 07/23/2019] [Accepted: 09/26/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Although treatment for HIV infection is widely available and well tolerated, less than 30% of adolescents and young adults living with HIV infection achieve stable viral suppression. Mobile technology affords increased opportunities for young people living with HIV to engage with information, health management tools, and social connections that can support adherence to treatment recommendations and medication. Although mobile apps are increasingly prevalent, few are informed by the target population. OBJECTIVE The objective of this study was to describe the "Positive Peers" app, a mobile app currently being evaluated in a public hospital in the Midwestern United States. Formative development, key development strategies, user recruitment, and lessons learned are discussed in this paper. METHODS "Positive Peers" was developed in collaboration with a community advisory board (CAB) comprising in-care young adults living with HIV and a multidisciplinary project team. Mobile app functions and features were developed over iterative collaborative sessions that were tailored to the CAB members. In turn, the CAB built rapport with the project team and revealed unique information that was used in app development. RESULTS The study was funded on September 1, 2015; approved by the MetroHealth Institutional Review Board on August 31, 2016; and implemented from October 11, 2016, to May 31, 2019. The "Positive Peers" mobile app study has enrolled 128 users who reflect priority disparity population subgroups. The app administrator had frequent contact with users across app administration and study-related activities. Key lessons learned from the study include changing privacy concerns, data tracking reliability, and user barriers. Intermediate and outcome variable evaluation is expected in October 2019. CONCLUSIONS Successful development of the "Positive Peers" mobile app was supported by multidisciplinary expertise, an enthusiastic CAB, and a multifaceted, proactive administrator.
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Affiliation(s)
- Mary M Step
- College of Public Health, Kent State University, Kent, OH, United States
| | | | | | | | - Ann Avery
- Metrohealth Medical Center, Cleveland, OH, United States.,Case Western Reserve University, School of Medicine, Cleveland, OH, United States
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86
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ADAMS JW, MARSHALL BD, MOHD SALLEH NA, BARRIOS R, NOLAN S, MILLOY MJ. Receipt of opioid agonist treatment halves the risk of HIV-1 RNA viral load rebound through improved ART adherence for HIV-infected women who use illicit drugs. Drug Alcohol Depend 2020; 206:107670. [PMID: 31711873 PMCID: PMC7012150 DOI: 10.1016/j.drugalcdep.2019.107670] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 09/23/2019] [Accepted: 09/24/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Women living with HIV who use illicit drugs may be particularly vulnerable to HIV-1 RNA viral load (VL) rebound. METHODS We used longitudinal data from 2006 to 2017 to evaluate the impact of sociodemographic, behavioral, social-structural, and clinical factors on the hazard of viral rebound for women enrolled in the ACCESS study, a prospective cohort with systematic VL monitoring. Women were included if they achieved VL suppression (<50 copies/mL) following antiretroviral therapy (ART) initiation and had more than one study interview. Sociodemographic as well as substance use, social-structural, addiction treatment, and HIV clinical factors were evaluated as predictors of viral rebound (VL > 1000 copies/mL). Cox regressions using a recurrent events framework, time-varying covariates, robust standard errors, and a frailty component were used. RESULTS Of the 185 women included, 62 (34%) experienced at least one viral rebound event over an 11-year period, accumulating a total of 87 viral rebound events. In adjusted analysis, stimulant use more than doubled the hazard of viral rebound (adjusted hazard ratio [AHR]: 2.35, 95% confidence interval [CI]: 1.07-5.14) while the only factor protective against viral rebound was receipt of opioid agonist treatment (OAT) in the past six months (AHR: 0.46, 95% CI: 0.26-0.81). After adjusting for ART adherence in the past six months, the effect of OAT was attenuated (AHR: 0.57, 95% CI: 0.32-1.02). CONCLUSIONS Efforts to improve access to and retention within OAT programs and decrease stimulant use may improve rates of viral suppression for HIV-positive women who use illicit drugs.
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Affiliation(s)
- Joëlla W. ADAMS
- Brown University School of Public Health, Department of Epidemiology, 121 South Main Street, Providence, RI 02903, United States
| | - Brandon D.L. MARSHALL
- Brown University School of Public Health, Department of Epidemiology, 121 South Main Street, Providence, RI 02903, United States
| | - Nur Afiqah MOHD SALLEH
- British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC V6Z 2A9, Canada,Interdisciplinary Studies Graduate Program, University of British Columbia, 170-6371 Crescent Road, Vancouver, BC V6T 1Z2, Canada
| | - Rolando BARRIOS
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrad Street, Vancouver, BC V6Z 1Y6, Canada
| | - Seonaid NOLAN
- British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC V6Z 2A9, Canada
| | - M-J MILLOY
- British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC V6Z 2A9, Canada,Department of Medicine, University of British Columbia, 2775 Laurel Street, 10th Floor, Vancouver, BC V5Z 1M9, Canada,Corresponding author: Address: British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, BC, Canada, Tel: +1(604)806-9142, Fax: +1(604)806-9044,
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87
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Wimberly AS, Gross R, Layde M. Effect of Yoga on Antiretroviral Adherence Postincarceration in HIV+ Individuals. JOURNAL OF CORRECTIONAL HEALTH CARE 2020; 26:83-94. [PMID: 32089078 PMCID: PMC7733694 DOI: 10.1177/1078345819897924] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The negative impacts of stress on antiretroviral therapy (ART) adherence and the many stressors faced by people returning from incarceration support the need for stress reduction interventions for this population. We hypothesized that 37 returning citizens living with HIV and substance use problems randomized to a 12-session weekly yoga intervention would experience improved ART adherence, lower viral loads, and lower heart rate and blood pressure as compared to 36 people randomized to treatment as usual (TAU). We found that ART adherence increased for yoga participants and decreased for TAU participants. There were no significant changes for viral load, heart rate, or blood pressure. The lack of statistically significant effects may be due to a small sample size and enrollment of people largely in HIV treatment. Studies with larger sample sizes and participants exhibiting low ART adherence are warranted to better understand yoga's impact.
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Affiliation(s)
| | - Robert Gross
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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88
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Nom NAM, Kyaw KWY, Kumar AMV, Hone S, Thida T, Nwe TW, Soan P, Htun T, Oo HN. HIV Care Cascade among Prisoners of the Mandalay Central Prison in Myanmar: 2011-2018. Trop Med Infect Dis 2020; 5:tropicalmed5010004. [PMID: 31906265 PMCID: PMC7157648 DOI: 10.3390/tropicalmed5010004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/14/2019] [Accepted: 11/19/2019] [Indexed: 11/16/2022] Open
Abstract
Prisoners have a higher HIV prevalence and higher rates of attrition from care as compared with the general population. There is no published evidence on this issue from Myanmar. We assessed (1) HIV test uptake, HIV positivity, and enrollment in care among newly admitted prisoners between 2017 and 18 (2) Treatment outcomes among HIV-positive prisoners enrolled in care between 2011 and 18. This was a cohort study involving secondary analysis of program data. Among 26,767 prisoners admitted to the Mandalay Central Prison between 2017 and 2018, 10,421 (39%) were HIV-tested, 547 (5%) were HIV-positive, and 376 (69%) were enrolled in care. Among the 1288 HIV-positive prisoners enrolled in care between 2011 and 2018, 1178 (92%) were started on antiretroviral therapy. A total of 883 (69%) were transferred out (post-release) to other health facilities, and among these, only 369 (42%) reached their destination health facilities. The final outcomes (censored on 30 June 2019) included the following: (i) Alive and in care 495 (38%), (ii) death 138 (11%), (iii) loss to follow-up 596 (46%), and (iv) transferred out after reaching the health facilities 59 (5%). We found major gaps at every step of the HIV care cascade among prisoners, both inside and outside the prison. Future research should focus on understanding the reasons for these gaps and designing appropriate interventions to fill these gaps.
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Affiliation(s)
- Nang A Mwe Nom
- National AIDS Programme, Ministry of Health and Sports, Sagaing 02371, Myanmar
- Correspondence: ; Tel.: +95-9-962057357
| | - Khine Wut Yee Kyaw
- International Union against Tuberculosis and Lung Disease, 75006 Paris, France; (K.W.Y.K.); (A.M.V.K.)
- International Union against Tuberculosis and Lung Disease, Mandalay 05021, Myanmar;
| | - Ajay M. V. Kumar
- International Union against Tuberculosis and Lung Disease, 75006 Paris, France; (K.W.Y.K.); (A.M.V.K.)
- International Union against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi 110016, India
- Yenepoya Medical College, Yenepoya University, Mangaluru 575018, India
| | - San Hone
- National AIDS Programme, Ministry of Health and Sports, Nay Pyi Taw 15011, Myanmar; (S.H.); (P.S.); (H.N.O.)
| | - Thida Thida
- Department of Medical Research, Ministry of Health and Sports, Pyin Oo Lwin 05085, Myanmar;
| | - Thet Wai Nwe
- Central Epidemiology Unit, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw 15011, Myanmar;
| | - Pyae Soan
- National AIDS Programme, Ministry of Health and Sports, Nay Pyi Taw 15011, Myanmar; (S.H.); (P.S.); (H.N.O.)
| | - Thurain Htun
- International Union against Tuberculosis and Lung Disease, Mandalay 05021, Myanmar;
| | - Htun Nyunt Oo
- National AIDS Programme, Ministry of Health and Sports, Nay Pyi Taw 15011, Myanmar; (S.H.); (P.S.); (H.N.O.)
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89
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Adams LM, Hunt AD. Complexities in Late-Stage HIV Diagnoses. Am J Public Health 2019; 109:1486-1487. [DOI: 10.2105/ajph.2019.305322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Leah M. Adams
- Leah M. Adams is with the Department of Psychology and the Women & Gender Studies Program, George Mason University, Fairfax, VA. Aaron D. Hunt is a doctoral student in the Department of Psychology, George Mason University
| | - Aaron D. Hunt
- Leah M. Adams is with the Department of Psychology and the Women & Gender Studies Program, George Mason University, Fairfax, VA. Aaron D. Hunt is a doctoral student in the Department of Psychology, George Mason University
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90
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Self-reported antiretroviral therapy adherence and viral load in criminal justice-involved populations. BMC Infect Dis 2019; 19:913. [PMID: 31664910 PMCID: PMC6819597 DOI: 10.1186/s12879-019-4443-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 09/06/2019] [Indexed: 01/08/2023] Open
Abstract
Background Self-reported antiretroviral therapy (ART) adherence measures that are associated with plasma viral load (VL) are valuable to clinicians and researchers, but are rarely examined among groups vulnerable to dropping out of care. One-seventh of all those living with HIV pass through incarceration annually and criminal-justice (CJ) involved people living with HIV (PLH) are vulnerable to falling out of care. We examined the association of self-reported ART adherence with VL in a criminal-justice sample compared to a routine-care sample. Methods Samples: We examined data from a multisite collaboration of studies addressing the continuum of HIV care among CjJ involved persons in the Seek, Test, Treat, and Retain cohort. Data pooled from seven CJ- studies (n = 414) were examined and compared with the routine-care sample from the Centers for AIDS Research Network of Integrated Clinical Systems’ seven sites (n = 11,698). Measures: In both samples, data on self-reported percent ART doses taken were collected via the visual analogue scale adherence measure. Viral load data were obtained by blood-draw. Analysis: We examined the associations of adherence with VL in both cohorts using mixed effects linear regression of log-VL, and mixed effects logistic regression of binary VL (≥ 200 copies/mL) outcomes. Interactions by CD4 count and self-reported health status were also tested. Results Among the CJ sample, the coefficient for log-VL was − 0.31 (95% CI = − 0.43, − 0.18; P < 0.01) and that in the routine-care sample was − 0.42 (95% CI = − 0.45, − 0.38; P < 0.01). For the logistic regression of binary detectable VL on 10% increments of adherence we found the coefficient was − 0.26 (95% CI = − 0.37, − 0.14; P < 0.01) and in the routine-care sample it was − 0.38 (95% CI = − 0.41, − 0.35; P < 0.01). There was no significant interaction by CD4 count level in the CJ sample, but there was in the routine-care sample. Conversely, there was a significant interaction by self-reported health status level in the criminal-justice sample, but not in the routine-care sample. Conclusions The visual analogue scale is valid and useful to measure ART adherence, supporting treatment for CJ- involved PLH vulnerable to falling out of care. Research should examine adherence and VL in additional populations.
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91
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Kouyoumdjian FG, Lamarche L, McCormack D, Rowe J, Kiefer L, Kroch A, Antoniou T. 90-90-90 for everyone?: Access to HIV care and treatment for people with HIV who experience imprisonment in Ontario, Canada. AIDS Care 2019; 32:1168-1176. [PMID: 31615271 DOI: 10.1080/09540121.2019.1679710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We examined HIV care and treatment in prison and after release for people with HIV in Ontario, Canada, and compared HIV care and treatment with the general population. We used administrative data to identify people with HIV released from provincial prison in 2010 and in the general population. We calculated the proportion of people with HIV who accessed HIV care in prison. We compared HIV care use between people with HIV on prison release and in the general population. We estimated the proportion of people with HIV on antiretroviral therapy in prison as the ratio of the average numbers of people prescribed antiretroviral therapy in prison in 2009/2010 and people with HIV in prison in January 2010. We compared the proportion of people with HIV on public drug benefits that filled an antiretroviral therapy prescription within 6 months for people postrelease and in the general population. Of 344 people with HIV on prison admission, 34.0% received HIV care in prison. Over 1 year, 63.6% of 330 people with HIV on prison release and 67.7% of 15,819 people with HIV in the general population accessed HIV care (p = 0.118), and 43.3% of people with HIV on prison release and 55.2% of people with HIV in the general population had 2 or more HIV care visits (p < 0.001). In prison, 52.4% of people with HIV (39.5/75.4) were on antiretroviral therapy. Of those accessing drug benefits, 60.1% of 226 people with HIV on prison release and 79.6% of 7458 people with HIV in the general population claimed an antiretroviral therapy prescription within 6 months (p < 0.001). Access to HIV care and treatment were suboptimal in prison, and sustained HIV care and treatment were worse for people post-release compared to the general population. Interventions are needed to support HIV care for this population.
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Affiliation(s)
- Fiona G Kouyoumdjian
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada.,ICES, Toronto, ON, Canada.,Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | - Larkin Lamarche
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | | | | | - Lori Kiefer
- Ministry of Community Safety and Correctional Services, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Tony Antoniou
- ICES, Toronto, ON, Canada.,Department of Family and Community Medicine, St. Michael's Hospital and University of Toronto, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
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92
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Spaulding AC, Lemon TL, So M. Measuring Correctional Experience to Inform Development of HIV, Sexually Transmitted Infection, and Substance Use Interventions for Incarcerated Black Men Who Have Sex with Men. Am J Public Health 2019; 108:S237-S239. [PMID: 30383418 DOI: 10.2105/ajph.2018.304810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Anne C Spaulding
- Anne C. Spaulding is with the Department of Epidemiology and Medicine, Emory University Rollins School of Public Health and School of Medicine, and Department of Medicine, Morehouse School of Medicine, Atlanta, GA. Tiffany L. Lemon is with the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA. Marvin So is with the Department of Epidemiology, Emory University Rollins School of Public Health
| | - Tiffany L Lemon
- Anne C. Spaulding is with the Department of Epidemiology and Medicine, Emory University Rollins School of Public Health and School of Medicine, and Department of Medicine, Morehouse School of Medicine, Atlanta, GA. Tiffany L. Lemon is with the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA. Marvin So is with the Department of Epidemiology, Emory University Rollins School of Public Health
| | - Marvin So
- Anne C. Spaulding is with the Department of Epidemiology and Medicine, Emory University Rollins School of Public Health and School of Medicine, and Department of Medicine, Morehouse School of Medicine, Atlanta, GA. Tiffany L. Lemon is with the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA. Marvin So is with the Department of Epidemiology, Emory University Rollins School of Public Health
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93
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Westergaard RP, Hochstatter KR, Andrews PN, Kahn D, Schumann CL, Winzenried AE, Sethi AK, Gangnon RE, Sosman JM. Effect of Patient Navigation on Transitions of HIV Care After Release from Prison: A Retrospective Cohort Study. AIDS Behav 2019; 23:2549-2557. [PMID: 30790170 DOI: 10.1007/s10461-019-02437-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Antiretroviral therapy is successfully administered to people living with HIV while they are incarcerated in most US prison systems, but interruptions in treatment are common after people are released. We undertook an observational cohort study designed to examine the clinical and psychosocial factors that influence linkage to HIV care and viral suppression after release from a single state prison system. In this report we describe baseline characteristics and 6-month post-incarceration HIV care outcomes for 170 individuals in Wisconsin. Overall, 114 (67%) individuals were linked to outpatient HIV care within 180 days of release from prison, and of these, 90 (79%) were observed to have HIV viral suppression when evaluated in the community. The strongest predictor of linkage to care in this study was participation in a patient navigation program: Those who received patient navigation were linked to care 84% of the time, compared to 60% of the individuals who received only standard release planning (adjusted OR 3.69, 95% CI 1.24, 10.96; P < 0.01). Findings from this study demonstrate that building and maintaining intensive patient navigation programs that support individuals releasing from prison is beneficial for improving transitions in HIV care.
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94
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Methamphetamine use drives decreases in viral suppression for people living with HIV released from a large municipal jail: Results of the LINK LA clinical trial. Drug Alcohol Depend 2019; 202:178-184. [PMID: 31352308 PMCID: PMC6686887 DOI: 10.1016/j.drugalcdep.2019.05.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 05/08/2019] [Accepted: 05/08/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND People living with HIV (PLWH) often experience decreases in HIV viral suppression (VS) after release from jail. The Linking Inmates to Care in LA (LINK LA) peer navigation intervention helped maintain VS 12 months after release from jail compared to standard of care. In this study, we analyzed correlates of substance use and tested whether substance use was an independent correlate of decreased VS in LINK LA participants. METHODS We analyzed LINK LA data collected at baseline, 3, and 12 months. We defined high-risk drug use as any reported methamphetamine, cocaine, or opioid use in the 30 days prior to a study visit (or jail entry at baseline). We used generalized linear mixed models to test associations of sociodemographic variables with type of substance used, and we tested correlates of VS while controlling for time, the intervention, and their interaction. RESULTS At baseline (n = 356), 71% of participants reported high-risk drug use: 58%, methamphetamine; 17%, cocaine; 7%, heroin; and 4%, prescription opioids. Non-Hispanic Whites and those younger than 35 were most likely to use methamphetamine; Blacks were most likely to use cocaine; people who inject drugs were most likely to use opioids. Participants who used high-risk drugs had 53% lower adjusted odds than non-users of maintaining VS (AOR 0.47, 95% CI 0.31-0.70, p < 0.001). CONCLUSION High-risk drug use, dominated by methamphetamine use, independently correlated with decreased VS among recently incarcerated PLWH. Improving HIV care continuum outcomes among populations leaving jail requires attention to efforts to address high-risk drug use.
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95
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Antiretroviral Adherence Following Prison Release in a Randomized Trial of the imPACT Intervention to Maintain Suppression of HIV Viremia. AIDS Behav 2019; 23:2386-2395. [PMID: 30963321 DOI: 10.1007/s10461-019-02488-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Many people living with HIV (PLWH) pass through correctional facilities each year, a large proportion of whom do not maintain viral suppression following release. We examined the effects of imPACT, an intervention designed to promote post-release viral suppression, on antiretroviral therapy (ART) adherence. PLWH awaiting release from prisons in two southern states were randomized to imPACT (consisting of motivational interviewing, care linkage coordination, and text message medication reminders) versus standard care (SC). ART adherence, measured by unannounced monthly telephone pill counts, was compared between study arms over 6 months post-release. Of 381 participants eligible for post-release follow-up, 302 (79%) completed ≥ 1 of 6 possible pill counts (median: 4; IQR 1-6). Average adherence over follow-up was 80.3% (95% CI 77.5, 83.1) and 81.0% (78.3, 83.6) of expected doses taken in the imPACT and SC arms, respectively. There was no difference between arms when accounting for missing data using multiple imputation (mean difference = - 0.2 percentage points [- 3.7, 3.3]), controlling for study site and week of follow-up. Of the 936 (40.9%) pill counts that were missed, 212 (22.7%) were due to re-incarceration. Those who missed pill counts for any reason were more likely to be unsuppressed, suggesting that they had lower adherence. However, missingness was balanced between arms. Among PLWH released from prison, ART adherence averaged > 80% in both study arms over 6 months-a level higher than seen with most other chronic diseases. However, missing data may have led to an overestimate of adherence. Factors independent of the intervention influence ART adherence in this population and should be identified to inform future targeted interventions.
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96
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Ickowicz S, Salleh NAM, Fairbairn N, Richardson L, Small W, Milloy MJ. Criminal Justice System Involvement as a Risk Factor for Detectable Plasma HIV Viral Load in People Who Use Illicit Drugs: A Longitudinal Cohort Study. AIDS Behav 2019; 23:2634-2639. [PMID: 31236749 PMCID: PMC6773261 DOI: 10.1007/s10461-019-02547-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Among HIV-positive people who use illicit drugs (PWUD) in our setting, repeated periods of incarceration adversely affect ART adherence in a dose-dependent manner. However, the impact of non-custodial criminal justice involvement on HIV-related outcomes has not been previously investigated. Data were obtained from a longitudinal cohort of HIV-positive PWUD in a setting of universal no-cost ART and complete dispensation records. Multivariate generalized estimating equations were used to calculate the longitudinal odds of having a detectable HIV VL (VL) associated with custodial and non-custodial CJS exposure. Between 2005 and 2014, 716 HIV-positive ART-exposed PWUD were recruited. In multivariate analysis, both custodial [Adjusted odds ratio (AOR) 0.61, 95% CI 0.45-0.82] and noncustodial (AOR 0.78, 95% CI 0.62-0.99) involvement in the criminal justice system was associated with detectable HIV VL. Among HIV-positive PWUD, both custodial and non-custodial criminal justice involvement is associated with worse HIV treatment outcomes. Our findings highlight the need for increased ART adherence support across the full spectrum of the criminal justice system.
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Affiliation(s)
- Sarah Ickowicz
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
| | - N A Mohd Salleh
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
- Interdisciplinary Studies Graduate Program, University of British Columbia, Vancouver, BC, Canada
| | - Nadia Fairbairn
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
- Department of Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Lindsey Richardson
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
- Department of Sociology, University of British Columbia, Vancouver, BC, Canada
| | - Will Small
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
| | - M-J Milloy
- British Columbia Centre on Substance Use, Vancouver, BC, Canada.
- Department of Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.
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97
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Akiyama MJ, Columbus D, MacDonald R, Jordan AO, Schwartz J, Litwin AH, Eckhardt B, Carmody E. Linkage to hepatitis C care after incarceration in jail: a prospective, single arm clinical trial. BMC Infect Dis 2019; 19:703. [PMID: 31395019 PMCID: PMC6686449 DOI: 10.1186/s12879-019-4344-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 07/31/2019] [Indexed: 12/13/2022] Open
Abstract
Background Hepatitis C virus (HCV) is a major public health problem in correctional settings. HCV treatment is often not possible in U.S. jails due to short lengths of stay. Linkage to care is crucial in these settings, but competing priorities complicate community healthcare engagement and retention after incarceration. Methods We conducted a single arm clinical trial of a combined transitional care coordination (TCC) and patient navigation intervention and assessed the linkage rate and factors associated with linkage to HCV care after incarceration. Results During the intervention, 84 participants returned to the community after their index incarceration. Most participants were male and Hispanic, with a history of mental illness and a mean age of 45 years. Of those who returned to the community, 26 (31%) linked to HCV care within a median of 20.5 days; 17 (20%) initiated HCV treatment, 15 (18%) completed treatment, 9 (11%) had a follow-up lab drawn to confirm sustained virologic response (SVR), and 7 (8%) had a documented SVR. Among those with follow-up labs the known SVR rate was (7/9) 78%. Expressing a preference to be linked to the participant’s existing health system, being on methadone prior to incarceration, and feeling that family or a loved one were concerned about the participant’s wellbeing were associated with linkage to HCV care. Reporting drinking alcohol to intoxication prior to incarceration was negatively associated with linkage to HCV care. Conclusion We demonstrate that an integrated strategy with combined TCC and patient navigation may be effective in achieving timely linkage to HCV care. Additional multicomponent interventions aimed at treatment of substance use disorders and increasing social support could lead to further improvement. Trial registration Clinicaltrials.gov NCT04036760 July 30th, 2019 (retrospectively registered).
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Affiliation(s)
- Matthew J Akiyama
- Montefiore Medical Center/Albert Einstein College of Medicine, 3300 Kossuth Ave, Bronx, NY, 10467, USA. .,New York University School of Medicine, New York, NY, USA.
| | - Devin Columbus
- New York University School of Medicine, New York, NY, USA
| | - Ross MacDonald
- New York City Health + Hospitals, Correctional Health Services, New York, NY, USA
| | - Alison O Jordan
- New York City Health + Hospitals, Correctional Health Services, New York, NY, USA
| | - Jessie Schwartz
- New York City Department of Health and Mental Hygiene, Queens, NY, USA
| | - Alain H Litwin
- University of South Carolina School of Medicine, Greenville, South Carolina, USA.,Clemson University School of Health Research, Clemson, South Carolina, USA.,Prisma Health - Upstate, Greenville, South Carolina, USA
| | | | - Ellie Carmody
- New York University School of Medicine, New York, NY, USA
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98
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Intensified tuberculosis and HIV surveillance in a prison in Northeast India: Implementation research. PLoS One 2019; 14:e0219988. [PMID: 31356606 PMCID: PMC6662996 DOI: 10.1371/journal.pone.0219988] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 07/04/2019] [Indexed: 02/04/2023] Open
Abstract
Structural and individual level factors in prisons create challenges towards detection and management of HIV/tuberculosis. WHO and India’s HIV/tuberculosis control programs recommend intensified case finding in prisons. Low HIV and tuberculosis detection rates suggest poor implementation of existing surveillance strategies within the prison healthcare system in Mizoram’s capital city of Aizawl. We explored the operational feasibility of implementing the intensified case finding strategy in Aizawl central prison. We implemented the intensified screening through entry screening of new inmates, mass screening of resident inmates and exit screening at release. We set up digital chest radiography, sputum smear microscopy and HIV testing facilities within the prison and referral to external facility for Cartridge Based Nucleic Acid Amplification Test (CBNAAT). We screened 738 inmates (Male: 626; Female: 112). Of 53% inmates having presumptive tuberculosis symptoms, 37% underwent sputum microscopy. We detected 14 new tuberculosis cases; overall tuberculosis positivity 1.9%. We tested 65% of 657 inmates for HIV, of which 41 new cases were detected; overall HIV positivity 16.5%. Three male inmates had HIV-tuberculosis co-infection. It is feasible to implement intensified case detection for tuberculosis/HIV in the prison with inter-departmental coordination, albeit with certain challenges.
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99
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Adams JW, Lurie MN, King MRF, Brady KA, Galea S, Friedman SR, Khan MR, Marshall BDL. Decreasing HIV transmissions to African American women through interventions for men living with HIV post-incarceration: An agent-based modeling study. PLoS One 2019; 14:e0219361. [PMID: 31306464 PMCID: PMC6629075 DOI: 10.1371/journal.pone.0219361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 06/21/2019] [Indexed: 11/18/2022] Open
Abstract
Background Incarceration and HIV disproportionately impact African American communities. The mass incarceration of African American men is hypothesized to increase HIV acquisition risk for African American women. Interventions optimizing HIV care engagement and minimizing sexual risk behaviors for men living with HIV post-incarceration may decrease HIV incidence. Methods Using an agent-based model, we simulated a sexual and injection drug using network representing the African American population of Philadelphia. We compared intervention strategies for men living with HIV post-incarceration by the number of averted HIV transmissions to women within the community. Three interventions were evaluated: a 90-90-90 scenario scaling up HIV testing, ART provision, and ART adherence; a behavioral intervention decreasing sexual risk behaviors; and a combination intervention involving both. Results The status quo scenario projected 2,836 HIV transmissions to women over twenty years. HIV transmissions to women decreased by 29% with the 90-90-90 intervention, 23% with the behavioral intervention, and 37% with both. The number of men living with HIV receiving the intervention needed in order to prevent a single HIV transmission ranged between 6 and 10. Conclusion Interventions to improve care engagement and decrease sexual risk behaviors post-incarceration for men living with HIV have the potential to decrease HIV incidence within African American heterosexual networks.
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Affiliation(s)
- Joëlla W. Adams
- Brown University School of Public Health, Providence, Rhode Island, United States of America
| | - Mark N. Lurie
- Brown University School of Public Health, Providence, Rhode Island, United States of America
| | - Maximilian R. F. King
- Brown University School of Public Health, Providence, Rhode Island, United States of America
| | - Kathleen A. Brady
- AIDS Activities Coordinating Office, Philadelphia Department of Public Health, Philadelphia, Pennsylvania, United States of America
| | - Sandro Galea
- Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Samuel R. Friedman
- National Development and Research Institutes, New York City, New York, United States of America
| | - Maria R. Khan
- Division of Comparative Effectiveness and Decision Science, Department of Population Health, New York University, New York City, New York, United States of America
| | - Brandon D. L. Marshall
- Brown University School of Public Health, Providence, Rhode Island, United States of America
- * E-mail:
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100
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Van Meer R, Antoniou T, McCormack D, Khanna S, Kendall C, Kiefer L, Kouyoumdjian FG. A comparison of the observed and expected prevalence of HIV in persons released from Ontario provincial prisons in 2010. Canadian Journal of Public Health 2019; 110:675-682. [PMID: 31250354 DOI: 10.17269/s41997-019-00233-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 05/23/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To estimate the prevalence of HIV infection in persons released from Ontario prisons in 2010 using administrative health data, and to compare this observed prevalence with the expected prevalence based on the most recently available biological sampling data. METHODS We linked identifying data for all adults released from Ontario provincial prisons in 2010 with administrative health data, and applied a validated algorithm to determine the observed HIV prevalence. We calculated the expected HIV prevalence using 2003-2004 age stratum-specific data from a published study using salivary sampling. We calculated an indirect standardized prevalence ratio of the observed to expected prevalence and 95% confidence intervals. Finally, we conducted sensitivity analyses to adjust for the sensitivity of the algorithm to identify persons with HIV and for undiagnosed HIV infection. RESULTS Of 52,313 persons released from Ontario prisons in 2010, we identified 363 persons with HIV, for an observed prevalence of 0.69%. The expected prevalence was 2.38%. Standardized for age, we found a prevalence ratio of 0.29 (95% CI, 0.17-0.77). Sensitivity analyses adjusting for the algorithm's sensitivity and further adjusting for undiagnosed HIV infection produced standardized prevalence ratios of 0.30 and 0.38, respectively. CONCLUSION Our findings suggest that a high proportion of persons with HIV recently released from provincial prisons either do not know they have HIV infection or do know about their infection but are not engaged in care. Interventions are required to screen people for HIV in prison and to link persons with care following release.
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Affiliation(s)
- Ryan Van Meer
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Tony Antoniou
- ICES, Toronto, Ontario, Canada.,Department of Family and Community Medicine, St. Michael's Hospital and University of Toronto, Toronto, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | | | - Sumeet Khanna
- Department of Family and Community Medicine, St. Michael's Hospital and University of Toronto, Toronto, Canada
| | - Claire Kendall
- ICES, Toronto, Ontario, Canada.,C.T. Lamont Primary Health Care Research Group, Bruyère Research Institute, Ottawa, Canada.,Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | - Lori Kiefer
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Ministry of Community Safety and Correctional Services, Toronto, Ontario, Canada
| | - Fiona G Kouyoumdjian
- ICES, Toronto, Ontario, Canada. .,Department of Family Medicine, McMaster University, 100 Main Street West, Hamilton, Ontario, L8P 1H6, Canada. .,MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada.
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