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Hoff E, Hansen L, Pulitzer Z, Campalans N, Salyards M, Muquith M, Shavit S, Nguyen H, Crain C, Walker R, Nijhawan AE. A randomized control trial of a combined community health worker and re-entry intervention for people with HIV recently released from jail who use substances. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 152:209118. [PMID: 37454733 DOI: 10.1016/j.josat.2023.209118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/21/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION People with human immunodeficiency virus (HIV; PWH) who use substances are disproportionately involved in the criminal justice system. While HIV viral suppression typically improves during incarceration, these gains are frequently lost after release. We evaluated the impact of a combined intervention (formerly incarcerated community health workers [CHW] plus a re-entry organization; CHW+) on postrelease HIV- and substance use-related outcomes. METHODS We conducted a pilot randomized controlled trial of a CHW+ for PWH who use substances, within 30 days of release from a large southern, urban jail. Between February 2019 and August 2021, participants were recruited, enrolled, and randomized to treatment as usual (TAU; passive referral to care) or CHW+. Follow up study visits occurred at 3, 6, and 12 months. The primary outcome was HIV VL at 6 months; secondary outcomes included 6-month urinary toxicology and high-risk substance use at 12 months. RESULTS A total of 31 participants were enrolled who were primarily male (n = 24; 77 %), Black (n = 22; 71 %), unemployed (n = 23; 74.2 %), had unstable housing (n = 18; 58 %), had food insecurity (n = 14; 45 %), and reported their drug of choice was stimulants (n = 24; 77 %). The study identified no significant difference in HIV VL suppression at 6 months (20 % v. 37 %; [CHW+ v. TAU], p = 0.61). We observed improved substance use outcomes in CHW+ v. TAU, including fewer positive urinary toxicology screens for stimulants (40 % v. 100 %; p = 0.01) and a trend toward less high-risk substance use (30 % v. 43 %). The CHW+ group met more basic needs, such as food security [+32 % v. +11 %], housing security [+52 % v. -7 %] and full-time employment [+20 % v. +5 %] compared to TAU. CONCLUSIONS PWH who use substances assigned to a combined intervention of CHW+ after jail release did not achieve higher rates of HIV VL suppression than TAU; however, they had improved substance use outcomes and met more basic subsistence needs. Results highlight the potential of culturally informed interventions to address the competing needs of PWH who use substances after release from jail and call for further development of innovative solutions to successfully bridge to HIV care in the community.
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Affiliation(s)
- Emily Hoff
- Department of Internal Medicine, University of Texas-Southwestern, Dallas, TX, United States
| | - Laura Hansen
- Division of Infectious Diseases and Geographic Medicine, University of Texas-Southwestern, Dallas, TX, United States
| | - Zoe Pulitzer
- Division of Infectious Diseases and Geographic Medicine, University of Texas-Southwestern, Dallas, TX, United States
| | - Nicholas Campalans
- Department of Internal Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Maverick Salyards
- Division of Infectious Diseases and Geographic Medicine, University of Texas-Southwestern, Dallas, TX, United States; Department of Public Health, Texas Christian University, United States
| | - Maishara Muquith
- Department of Internal Medicine, University of Texas-Southwestern, Dallas, TX, United States
| | - Shira Shavit
- Department of Family and Community Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Hue Nguyen
- Unlocking DOORS®, Dallas, TX, United States
| | | | - Robrina Walker
- Division of Infectious Diseases and Geographic Medicine, University of Texas-Southwestern, Dallas, TX, United States; The Emmes Company, Rockville, MD, United States
| | - Ank E Nijhawan
- Department of Internal Medicine, University of Texas-Southwestern, Dallas, TX, United States; Division of Infectious Diseases and Geographic Medicine, University of Texas-Southwestern, Dallas, TX, United States.
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Reyes JV, Myles RL, Luo Q, Beer L, Burton DC. Sociodemographic and Clinical Characteristics Associated With Recent Incarceration Among People With HIV, United States, 2015-2017. Public Health Rep 2023; 138:610-618. [PMID: 35848105 PMCID: PMC10291169 DOI: 10.1177/00333549221106646] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
OBJECTIVES We examined sociodemographic, clinical, and behavioral factors associated with previous incarceration among people with diagnosed HIV to inform HIV care efforts for this population. METHODS We used 2015-2017 data from a cross-sectional, nationally representative sample of US adults with diagnosed HIV (N = 11 739). We computed weighted percentages and 95% CIs to compare the characteristics of people with HIV incarcerated in the past 12 months (ie, recently) with people with HIV not recently incarcerated. We used adjusted prevalence ratios (aPRs) with predicted marginal means to examine associations between selected factors and incarceration status. RESULTS Adults with HIV who were recently incarcerated, when compared with those who were not, were more likely to be aged 18-29 years (prevalence ratio [PR] = 2.51), non-Hispanic Black (PR = 1.39), less educated ( CONCLUSIONS Among people with HIV, recent incarceration was associated with increased health risks and worse health outcomes. Pre- and postrelease linkage-to-care interventions and reentry services might improve the health of recently incarcerated people with HIV.
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Affiliation(s)
- Jovanni V. Reyes
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ranell L. Myles
- Office of the Director, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Qingwei Luo
- Strategic Innovative Solutions, LLC, Clearwater, FL, USA
| | - Linda Beer
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Deron C. Burton
- Office of the Director, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Dauria EF, Kulkarni P, Clemenzi-Allen A, Brinkley-Rubinstein L, Beckwith CG. Interventions Designed to Improve HIV Continuum of Care Outcomes for Persons with HIV in Contact with the Carceral System in the USA. Curr HIV/AIDS Rep 2022; 19:281-291. [PMID: 35674879 PMCID: PMC9175158 DOI: 10.1007/s11904-022-00609-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW To describe existing evidence and identify future directions for intervention research related to improving HIV care outcomes for persons with HIV involved in the carceral system in the USA, a population with high unmet HIV care needs. RECENT FINDINGS Few recent intervention studies focus on improving HIV care outcomes for this population. Successful strategies to improve care outcomes include patient navigation, substance use treatment, and incentivizing HIV care outcomes. Technology-supported interventions are underutilized in this population. Notable gaps in the existing literature include intervention research addressing HIV care needs for cisgender and transgender women and those under carceral supervision in the community. Future research should address existing gaps in the literature and respond to emergent needs including understanding how the changing HIV care delivery environment resulting from the COVID-19 pandemic and the approval of new injectable ART formulation shape HIV care outcomes in this population.
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Affiliation(s)
- Emily F Dauria
- Graduate School of Public Health, Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Priyanka Kulkarni
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Angelo Clemenzi-Allen
- Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - Lauren Brinkley-Rubinstein
- Department of Social Medicine and Center for Health Equity Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Curt G Beckwith
- Alpert Medical School, Division of Infectious Diseases/Department of Medicine, Brown University, Providence, RI, USA
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Toegel F, Rodewald AM, Novak MD, Pollock S, Arellano M, Leoutsakos JM, Holtyn AF, Silverman K. Psychosocial Interventions to Promote Undetectable HIV Viral Loads: A Systematic Review of Randomized Clinical Trials. AIDS Behav 2022; 26:1853-1862. [PMID: 34783938 PMCID: PMC9050821 DOI: 10.1007/s10461-021-03534-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2021] [Indexed: 10/19/2022]
Abstract
Suppressing HIV viral loads to undetectable levels is essential for ending the HIV/AIDS epidemic. We evaluated randomized controlled trials aimed to increase antiretroviral medication adherence and promote undetectable viral loads among people living with HIV through November 22, 2019. We extracted data from 51 eligible interventions and analyzed the results using random effects models to compare intervention effects between groups within each intervention and across interventions. We also evaluated the relation between publication date and treatment effects. Only five interventions increased undetectable viral loads significantly. As a whole, the analyzed interventions were superior to Standard of Care in promoting undetectable viral loads. Interventions published more recently were not more effective in promoting undetectable viral loads. No treatment category consistently produced significant increases in undetectable viral loads. To end the HIV/AIDS epidemic, we should use interventions that can suppress HIV viral loads to undetectable levels.
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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
- Department of Psychological Science, Northern Michigan University, Marquette, MI, USA
| | - Andrew M Rodewald
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Matthew D Novak
- 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
| | - Meghan Arellano
- 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
| | - August F Holtyn
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, 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.
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Suite 350 East, Baltimore, MD, 21224, USA.
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Improving Post-Release Care Engagement for People Living with HIV Involved in the Criminal Justice System: A Systematic Review. AIDS Behav 2022; 26:1607-1617. [PMID: 34705154 DOI: 10.1007/s10461-021-03513-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2021] [Indexed: 10/20/2022]
Abstract
Given sub-optimal HIV care outcomes for people living with HIV (PLWH) post-release from incarceration, we systematically searched peer-reviewed literature (2010-2021) describing controlled trial interventions aimed at improving Antiretroviral Therapy (ART) adherence and care linkage following release from correctional facilities for PLWH. Of 392 studies, 16 (4%) met the inclusion criteria. All studies were conducted in the United States and involved some form of intensive case management. Trials that scored highest in terms of study quality provided cell phones for engagement, reported sustained viral load suppression as a measurable outcome to infer ART adherence, and measured longitudinal data collected for at least 3-to-6 months following release. The two trials that demonstrated improved HIV viral load suppression involved Peer Navigators, and incentivized undetectable viral load, respectively. Facilitating support for addictions and addressing other social and structural barriers to achieving optimal health is also of vital importance in bridging care gaps for PLWH.
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Fernando NB, Woznica DM, Mabuto T, Hoffmann CJ. In-facility HIV peer-based rehabilitation programs' role in linkage to care among persons transitioning from correctional to community-based HIV care in South Africa. Int J Prison Health 2022; 18:473-482. [PMID: 35076191 DOI: 10.1108/ijph-05-2021-0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This analysis aims to examine the role of pre-release, HIV-related, peer-based rehabilitation program attendance on post-release linkage to community-based HIV care in South Africa. DESIGN/METHODOLOGY/APPROACH During a post-release linkage-to-care prospective study, participants from six correctional facilities who had an HIV-positive diagnosis and were taking anti-retroviral medications at release (N = 351) self-reported rehabilitation program participation. Linkage-to-care status 90 days post-release was verified by medical chart review. FINDINGS In a binomial regression model, HIV-related, peer-based rehabilitation program attendance was insignificant (relative risk [RR] 1.1, 95% confidence interval [CI] [0.8, 1.4], p-value = 0.7), but short-/long-term incarceration site (RR 1.5, 95% CI [1.0, 2.1], p-value = 0.04) and relationship status pre-incarceration (RR 1.9, 95% CI [1.0, 3.6], p-value = 0.05) were significantly associated with linkage to HIV care post-release. ORIGINALITY/VALUE Rehabilitation and peer-based HIV programs have had demonstrated benefit in other settings. Assessment of current programs may identify opportunities for improvement.
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Affiliation(s)
- Nimasha B Fernando
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Daniel M Woznica
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Christopher J Hoffmann
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA, and Aurum Institute, Johannesburg, South Africa
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7
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Dong KR, Daudelin DH, Koutoujian PJ, Cabrera A, Pezzullo O, Grossman A, Siddiqi K, Khorasani S, Wurcel AG. Lessons Learned from the Pathways to Community Health Study to Evaluate the Transition of Care from Jail to Community for Men with HIV. AIDS Patient Care STDS 2021; 35:360-369. [PMID: 34463134 PMCID: PMC8563456 DOI: 10.1089/apc.2021.0060] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Time spent in jail can provide opportunities to deliver comprehensive medical care, including screening and treatment for HIV; however, engagement in HIV care postrelease is often fragmented. Identifying ways to improve the transition of care from jail to community for people with HIV (PWH) may help with engagement in HIV care postrelease. We evaluated the current HIV care transition processes of one jail in Massachusetts and identified change ideas to facilitate improving the transition of care from the jail to the community for PWH. We conducted qualitative interviews in 2018–2019 with incarcerated men with HIV (n = 17), jail staff (n = 7), and community providers (n = 6) to understand the processes of HIV care prerelease from the jail and engagement in care on release. Data from these interviews and quality improvement tools were used to identify ways to improve the release process for PWH, such as using a release planning checklist, to help ensure that a 30-day supply of HIV medication and an appointment with a community provider within 30 days of release were provided. We identified communication process inefficiencies related to knowing release dates between the HIV care team and case managers that prevented providing HIV medications on release. We worked with jail administrators to find ways to improve the prerelease planning process, which is vital to the continuity of successful HIV care. The use of quality improvement methods generated a list of testable change ideas to improve the release planning process to better align with the Centers for Disease Control and Prevention guidelines, which has implications for PWH and public health.
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Affiliation(s)
- Kimberly R. Dong
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Denise H. Daudelin
- Tufts Clinical and Translational Science Institute, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Tufts University, Boston, Massachusetts, USA
| | | | - Alyssa Cabrera
- Tufts Clinical and Translational Science Institute, Tufts Medical Center, Tufts University, Boston, Massachusetts, USA
| | - Olivia Pezzullo
- Tufts Clinical and Translational Science Institute, Tufts Medical Center, Tufts University, Boston, Massachusetts, USA
| | - Anna Grossman
- Tufts University Friedman School of Nutrition Science and Policy, Boston, Massachusetts, USA
| | | | - Sarah Khorasani
- Tufts University School of Medicine, Boston, Massachusetts, USA
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8
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Does Anything Work? Improving HIV Care Engagement for Individuals Transitioning out of Correctional Settings. J Acquir Immune Defic Syndr 2021; 86:286-287. [PMID: 33560746 DOI: 10.1097/qai.0000000000002599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 11/12/2020] [Indexed: 11/25/2022]
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Threats M, Brawner BM, Montgomery TM, Abrams J, Jemmott LS, Crouch PC, Freeborn K, Kamitani E, Enah C. A Review of Recent HIV Prevention Interventions and Future Considerations for Nursing Science. J Assoc Nurses AIDS Care 2021; 32:373-391. [PMID: 33929980 PMCID: PMC8715511 DOI: 10.1097/jnc.0000000000000246] [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] [Indexed: 11/26/2022]
Abstract
ABSTRACT As our knowledge of HIV evolved over the decades, so have the approaches taken to prevent its transmission. Public health scholars and practitioners have engaged in four key strategies for HIV prevention: behavioral-, technological-, biomedical-, and structural/community-level interventions. We reviewed recent literature in these areas to provide an overview of current advances in HIV prevention science in the United States. Building on classical approaches, current HIV prevention models leverage intimate partners, families, social media, emerging technologies, medication therapy, and policy modifications to effect change. Although much progress has been made, additional work is needed to achieve the national goal of ending the HIV epidemic by 2030. Nurses are in a prime position to advance HIV prevention science in partnership with transdisciplinary experts from other fields (e.g., psychology, informatics, and social work). Future considerations for nursing science include leveraging transdisciplinary collaborations and consider social and structural challenges for individual-level interventions.
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Affiliation(s)
- Megan Threats
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Bridgette M. Brawner
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Tiffany M. Montgomery
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Jasmine Abrams
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Loretta Sweet Jemmott
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Pierre-Cedric Crouch
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Kellie Freeborn
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Emiko Kamitani
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Comfort Enah
- Megan Threats, PhD, MSLIS, is an Assistant Professor, School of Communication and Information, Rutgers University, New Brunswick, New Jersey, USA. Bridgette M. Brawner, PhD, MDiv, APRN, is an Associate Professor, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA. Tiffany M. Montgomery, PhD, MSHP, RNC-OB, is a Postdoctoral Research Fellow, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Jasmine Abrams, PhD, is an Assistant Professor, Boston University School of Public Health, Boston, Massachusetts, USA. Loretta Sweet Jemmott, PhD, RN, FAAN, is a Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Pierre-Cedric Crouch, PhD, ANP-BC, ACRN, is Director, Community Health Solutions, San Francisco, California, USA. Kellie Freeborn, PhD, RN, ANP-BC, FNP-BC, is a Postdoctoral Fellow, Division of Global Women’s Health, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA. Emiko Kamitani, PhD, MPH, MS, RN, is a Professor by Special Appointment, Advanced Graduate Program for Future Medicine and Health Care, Tohoku University, Sendai, Japan. Comfort Enah, PhD, RN, FAAN, is an Associate Professor, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
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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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11
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Improving Care Outcomes for PLWH Experiencing Homelessness and Unstable Housing: a Synthetic Review of Clinic-Based Strategies. Curr HIV/AIDS Rep 2020; 17:259-267. [PMID: 32382919 DOI: 10.1007/s11904-020-00488-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW Singular interventions targeting vulnerable populations of people living with HIV (PLWH) are necessary for reducing new infections and optimizing individual-level outcomes, but extant literature for PLWH who experience homelessness and unstable housing (HUH) has not been compiled. To inform implementation of clinic-based programs that improve care outcomes in this population, we present a synthetic review of key studies examining clinic-based interventions, specifically case management, patient navigation, financial incentives, and the use of mobile technology. RECENT FINDINGS Results from unimodal interventions are mixed or descriptive, are limited by inability to address related multi-modal barriers to care, and do not address major challenges to implementation. Multi-component interventions are needed, but gaps in our knowledge base may limit widespread uptake of such interventions before further data are compiled. Future research evaluating interventions for PLWH experiencing HUH should include implementation outcomes in order to facilitate adaptation across diverse clinical settings.
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12
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Wali N, Renzaho A, Wang X, Atkins B, Bhattacharya D. Do interventions to improve adherence to antiretroviral therapy recognise diversity? A systematic review. AIDS Care 2020; 33:1379-1393. [PMID: 32847386 DOI: 10.1080/09540121.2020.1811198] [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: 10/23/2022]
Abstract
People living with HIV (PLWH) are often culturally and linguistically diverse populations; these differences are associated with differing barriers to antiretroviral therapy (ART) adherence. Cultural competence measures the extent to which trial design recognises this diversity. This systematic review aimed to determine whether adherence trial participants represent the diversity of PLWH. Randomised Controlled Trials in Organisation for Economic Co-operation and Development countries to improve ART adherence were eligible. We searched MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews. For all included trials, we searched for their development, testing and evaluation studies. We compared trial participant characteristics with nationally reported PLWH data. We appraised trial cultural competence against ten criteria; scoring each criterion as 0, 1 or 2 indicating cultural blindness, pre-competence or competence respectively. For 80 included trials, a further 13 studies presenting development/testing/evaluation data for the included trials were identified. Only one of the 80 included studies reported trial participants representative of the country's population of PLWH. The median (IQ) cultural competence score was 2.5 (1.0, 4.0) out of 20. HIV adherence trial participants are not reflective of the population with HIV, which may be due to limited adoption of culturally competent research methods.
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Affiliation(s)
- Nidhi Wali
- School of Social Sciences and Psychology, Western Sydney University, Sydney, Australia
| | - Andre Renzaho
- School of Social Sciences and Psychology, Western Sydney University, Sydney, Australia
| | - Xia Wang
- School of Pharmacy, University of East Anglia, Norwich, UK
| | - Bethany Atkins
- School of Pharmacy, University of East Anglia, Norwich, UK
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13
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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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14
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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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15
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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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16
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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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17
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Christopoulos KA, Riley ED, Carrico AW, Tulsky J, Moskowitz JT, Dilworth S, Coffin LS, Wilson L, Peretz JJ, Hilton JF. A Randomized Controlled Trial of a Text Messaging Intervention to Promote Virologic Suppression and Retention in Care in an Urban Safety-Net Human Immunodeficiency Virus Clinic: The Connect4Care Trial. Clin Infect Dis 2019; 67:751-759. [PMID: 29474546 DOI: 10.1093/cid/ciy156] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 02/20/2018] [Indexed: 01/29/2023] Open
Abstract
Background Text messaging is a promising strategy to support human immunodeficiency virus (HIV) care engagement, but little is known about its efficacy in urban safety-net HIV clinics. Methods We conducted a randomized controlled trial of a supportive and motivational text messaging intervention, Connect4Care (C4C), among viremic patients who had a history of poor retention or were new to the clinic. Participants were randomized (stratified by new or established HIV diagnosis status) to receive either of the following for 12 months: (1) thrice-weekly intervention messages, plus texted primary care appointment reminders and a monthly text message requesting confirmation of study participation or (2) texted reminders and monthly messages alone. Viral load was assessed at 6 and 12 months. The primary outcome was virologic suppression (<200 copies/mL) at 12 months, estimated via repeated-measures log-binomial regression, adjusted for new-diagnosis status. The secondary outcome was retention in clinic care. Results Between August 2013 and November 2015, a total of 230 participants were randomized. Virologic suppression at 12 months was similar in intervention and control participants (48.8% vs 45.8%, respectively), yielding a rate ratio of 1.07 (95% confidence interval, .82-1.39). Suppression was higher in those with newly diagnosed infection (78.3% vs 45.3%). There were no intervention effects on the secondary outcome. Exploratory analyses suggested that patients with more responses to study text messages had better outcomes, regardless of arm. Conclusions The C4C text messaging intervention did not significantly increase virologic suppression or retention in care. Response to text messages may be a useful way for providers to gauge risk for poor HIV outcomes. Clinical Trials Registration NCT01917994.
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Affiliation(s)
| | - Elise D Riley
- Division of HIV, ID and Global Medicine, University of California San Francisco
| | - Adam W Carrico
- Department of Public Health Sciences, University of Miami, Florida
| | - Jacqueline Tulsky
- Division of HIV, ID and Global Medicine, University of California San Francisco
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
| | - Samantha Dilworth
- Division of HIV, ID and Global Medicine, University of California San Francisco
| | - Lara S Coffin
- Division of Prevention Science, University of California San Francisco
| | - Leslie Wilson
- Departments of Medicine and Clinical Pharmacy, University of California San Francisco
| | | | - Joan F Hilton
- Department of Epidemiology and Biostatistics, University of California San Francisco
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Abstract
PURPOSE OF REVIEW People with HIV and HCV are concentrated within criminal justice settings globally, primarily related to criminalization of drug use. This review examines updated prevention and treatment strategies for HIV and HCV within prison with a focus on people who inject drugs and the challenges associated with the provision of these services within prisons and other closed settings and transition to the community. RECENT FINDINGS The prevalence of HIV and HCV are several-fold higher in the criminal justice system than within the broader community particularly in regions with high prevalence of injecting drug use, such as Asia, Eastern Europe and North America and where drug use is criminalized. Strategies to optimize management for these infections include routine screening linked to treatment within these settings and medication-assisted treatments for opioid dependence and access to syringe services programs. We build upon the 2016 WHO Consolidated Guidelines through the lens of the key populations of prisoners. Linkage to treatment postrelease, has been universally dismal, but is improved when linked to medication-assisted therapies like methadone, buprenorphine and overdose management. In many prisons, particularly in low-income and middle-income settings, provision of even basic healthcare including mental healthcare and basic HIV prevention tools remain suboptimal. SUMMARY In order to address HIV and HCV prevention and treatment within criminal justice settings, substantial improvement in the delivery of basic healthcare is needed in many prisons worldwide together with effective screening, treatment and linkage of treatment and prevention services to medication-assisted therapies within prison and linkage to care after release.
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Affiliation(s)
- Adeeba Kamarulzaman
- Centre of Excellence on Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
- Section of Infectious Diseases, Yale University School of Medicine and School of Public Health, New Haven, Connecticut, USA
| | | | - Frederick L. Altice
- Centre of Excellence on Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
- Section of Infectious Diseases, Yale University School of Medicine and School of Public Health, New Haven, Connecticut, USA
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19
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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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20
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Hill LM, Golin CE, Gottfredson NC, Pence BW, DiPrete B, Carda-Auten J, Groves JS, Napravnik S, Wohl D, Knight K, Flynn PM. Drug Use Mediates the Relationship Between Depressive Symptoms and Adherence to ART Among Recently Incarcerated People Living with HIV. AIDS Behav 2019; 23:2037-2047. [PMID: 30535731 DOI: 10.1007/s10461-018-2355-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Depression is a known risk factor for antiretroviral therapy (ART) non-adherence, but little is known about the mechanisms explaining this relationship. Identifying these mechanisms among people living with HIV (PLHIV) after release from prison is particularly important, as individuals during this critical period are at high risk for both depression and poor ART adherence. 347 PLHIV recently released from prison in North Carolina and Texas were included in analyses to assess mediation of the relationship between depressive symptoms at 2 weeks post-release and ART adherence (assessed by unannounced telephone pill counts) at weeks 9-21 post-release by the hypothesized explanatory mechanisms of alcohol use, drug use, adherence self-efficacy, and adherence motivation (measured at weeks 6 and 14 post-release). Indirect effects were estimated using structural equation models with maximum likelihood estimation and bootstrapped confidence intervals. On average, participants achieved 79% ART adherence. The indirect effect of depression on adherence through drug use was statistically significant; greater symptoms of depression were associated with greater drug use, which was in turn associated with lower adherence. Lower adherence self-efficacy was associated with depressive symptoms, but not with adherence. Depression screening and targeted mental health and substance use services for depressed individuals at risk of substance use constitute important steps to promote adherence to ART after prison release.
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Affiliation(s)
- Lauren M Hill
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Carol E Golin
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nisha C Gottfredson
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brian W Pence
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Bethany DiPrete
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jessica Carda-Auten
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer S Groves
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sonia Napravnik
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - David Wohl
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kevin Knight
- Department of Psychology, Texas Christian University, Fort Worth, TX, USA
| | - Patrick M Flynn
- Department of Psychology, Texas Christian University, Fort Worth, TX, USA
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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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Wang EA, Lin HJ, Aminawung JA, Busch SH, Gallagher C, Maurer K, Puglisi L, Shavit S, Frisman L. Propensity-matched study of enhanced primary care on contact with the criminal justice system among individuals recently released from prison to New Haven. BMJ Open 2019; 9:e028097. [PMID: 31048315 PMCID: PMC6502013 DOI: 10.1136/bmjopen-2018-028097] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Health systems can be integral to addressing population health, including persons with incarceration exposure. Few studies have comprehensively integrated state-wide data to assess how the primary care system can impact criminal justice outcomes. We examined whether enhanced primary care can decrease future contact with the criminal justice system among individuals just released from prison. METHODS We linked administrative data (2013-2016) of Connecticut Department of Correction, Department of Mental Health and Addiction Services, Department of Social Service, Court Support Services Division, and Department of Public Health to conduct a quasi-experimental study using propensity score matching of 94 participants who received enhanced primary care in Transitions Clinic to 94 controls not exposed to the programme. The propensity score included 23 variables, which encompassed participants' medical and incarceration history and service utilisation. The main outcomes were reincarceration rates and days incarcerated in the first year from the index date, which was either enrolment in the Transitions Clinic programme or release from prison in the control group. RESULTS The odds of reincarceration, including arrests and new convictions, were similar for the two groups, but Transitions Clinic participants had lower odds of returning to prison for a parole or probation technical violation (adjusted OR: 0.38; 95% CI 0.16 to 0.93) compared with the control group. Further, Transitions Clinic participants had fewer incarceration days (incidence rate ratio: 0.55; 95% CI 0.35 to 0.84) compared with the control group. CONCLUSIONS Enhanced primary care for individuals just released from prison can reduce reincarceration for technical violations and shorten time spent within correctional facilities. This study shows how community health systems may play a role in current strategies to reduce prison populations.
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Affiliation(s)
- Emily A Wang
- Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Hsiu-Ju Lin
- School of Social Work, University of Connecticut System, Storrs, Connecticut, USA
- Research Division, Connecticut Department of Mental Health and Addiction Services, Hartford, Connecticut, USA
| | - Jenerius A Aminawung
- Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Susan H Busch
- Yale University School of Public Health, New Haven, Connecticut, USA
| | - Colleen Gallagher
- Connecticut Department of Correction, Wethersfield, Connecticut, USA
| | - Kathleen Maurer
- Connecticut Department of Correction, Wethersfield, Connecticut, USA
| | - Lisa Puglisi
- Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Shira Shavit
- Family and Community Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Linda Frisman
- School of Social Work, University of Connecticut System, Storrs, Connecticut, USA
- Research Division, Connecticut Department of Mental Health and Addiction Services, Hartford, Connecticut, USA
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23
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Kuo I, Liu T, Patrick R, Trezza C, Bazerman L, Uhrig Castonguay BJ, Peterson J, Kurth A, Beckwith CG. Use of an mHealth Intervention to Improve Engagement in HIV Community-Based Care Among Persons Recently Released from a Correctional Facility in Washington, DC: A Pilot Study. AIDS Behav 2019; 23:1016-1031. [PMID: 30627850 DOI: 10.1007/s10461-018-02389-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We examined the preliminary effectiveness of a computerized counseling session plus post-incarceration text messaging intervention (CARE + Corrections) to support ART adherence and linkage/engagement in community care among recently incarcerated persons with HIV in Washington, D.C. Recently incarcerated persons with HIV ≥ 18 years old were recruited from the D.C. jail or community outreach and randomized to CARE + Corrections or control arm. Participants completed assessments at baseline, 3-months and 6-months. Multivariable random effects modeling identified predictors of suppressed viral load (≤ 200 copies/mL) and engagement in HIV care at 6 months. Participants (N = 110) were aged 42 (IQR 30-49); 58% male, 24% female, 18% transgender, 85% Black, and lifetime incarceration was a median of 7 years (IQR 2-15). More controls had a regular healthcare provider at baseline. Although not statistically significant, intervention participants had increased odds of viral suppression versus controls at 6 months (AOR 2.04; 95% CI 0.62, 6.70). Those reporting high ART adherence at baseline had higher odds of viral suppression at follow-up (AOR 10.77; 95% CI 1.83, 63.31). HIV care engagement was similar between the two groups, although both groups reported increased engagement at 6 months versus baseline. We observed a positive but non-significant association of viral suppression in the CARE + Corrections group, and care engagement increased in both groups after 6 months. Further attention to increasing viral suppression among CJ-involved persons with HIV upon community reentry is warranted.
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Affiliation(s)
- Irene Kuo
- Department of Epidemiology and Biostatistics, George Washington University Milken Institute School of Public Health, 950 New Hampshire Avenue NW, Suite 500, Washington, DC, 20052, USA.
| | - Tao Liu
- Brown University School of Public Health, Providence, RI, USA
| | - Rudy Patrick
- Department of Epidemiology and Biostatistics, George Washington University Milken Institute School of Public Health, 950 New Hampshire Avenue NW, Suite 500, Washington, DC, 20052, USA
- University of California San Diego, San Diego, CA, USA
| | - Claudia Trezza
- Department of Epidemiology and Biostatistics, George Washington University Milken Institute School of Public Health, 950 New Hampshire Avenue NW, Suite 500, Washington, DC, 20052, USA
| | | | | | - James Peterson
- Department of Epidemiology and Biostatistics, George Washington University Milken Institute School of Public Health, 950 New Hampshire Avenue NW, Suite 500, Washington, DC, 20052, USA
| | - Ann Kurth
- Yale University School of Nursing, New Haven, CT, USA
| | - Curt G Beckwith
- The Miriam Hospital, Providence, RI, USA
- Alpert Medical School of Brown University, Providence, RI, USA
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24
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Murphree J, Batey DS, Kay ES, Westfall AO, Mugavero MJ. Suboptimal Retention in Care Among Recently Released Prisoners: Implications for Social Workers in HIV Primary Care. AIDS Behav 2019; 23:427-432. [PMID: 30117078 DOI: 10.1007/s10461-018-2254-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Certain populations of people living with HIV (PLWH) are at greater risk for falling out of care, including PLWH with a history of incarceration. This is associated with increased risk of morbidity and mortality. In the current retrospective cohort study, we examined patient-level information for 340 PLWH who had transferred HIV care services from prison or from other community-based or private HIV primary care providers to a large urban HIV clinic in the southeastern United States. Results indicated that, compared to those transferring care from another community-based or private medical provider, PLWH transferring care from prison were significantly less likely to be retained in care than PLWH transferring care from other providers, even after controlling for other factors. HIV primary care social workers, who are trained to provide case management services, can help provide PLWH with a coordinated continuum of care that addresses the complex issues faced post-release.
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Affiliation(s)
| | - D Scott Batey
- Department of Social Work, University of Alabama at Birmingham, Birmingham, USA
| | - Emma Sophia Kay
- School of Social Work, University of Michigan, 1080 S. University Ave, Ann Arbor, MI, 48104, USA.
| | - Andrew O Westfall
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, USA
| | - Michael J Mugavero
- Department of Medicine, University of Alabama at Birmingham, Birmingham, USA
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Chandra D, Bazazi AR, Nahaboo Solim MA, Kamarulzaman A, Altice FL, Culbert GJ. Retention in clinical trials after prison release: results from a clinical trial with incarcerated men with HIV and opioid dependence in Malaysia. HIV Res Clin Pract 2019; 20:12-23. [PMID: 31303149 PMCID: PMC6698147 DOI: 10.1080/15284336.2019.1603433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 03/22/2019] [Accepted: 04/01/2019] [Indexed: 01/09/2023]
Abstract
Background: Study retention is a major challenge in HIV clinical trials conducted with persons recruited from correctional facilities. Objective: To examine study retention in a trial of within-prison methadone initiation and a behavioral intervention among incarcerated men with HIV and opioid dependence in Malaysia. Methods: In this 2x2 factorial trial, 296 incarcerated men with HIV and opioid dependence were allocated to (1) an HIV risk reduction intervention, the Holistic Health Recovery Program for Malaysia (HHRP-M), (2) pre-release methadone initiation, (3) both interventions, or (4) standard care (NCT02396979). Here we estimate effects of these interventions on linkage to the study after prison release and completion of post-release study visits. Results: Most participants (68.9%) completed at least one post-release study visit but few (18.6%) completed all 12. HHRP-M was associated with a 13.5% (95% confidence interval (CI): 3.8%, 23.2%) increased probability of completing at least one post-release study visit. Although not associated with initial linkage, methadone treatment was associated with an 11% (95% CI: 2.0%, 20.6%) increased probability of completing all twelve post-release study visits. Being subject to forced relocation outside Kuala Lumpur after prison release decreased retention by 43.3% (95% CI: -51.9%, -34.8%). Conclusion: Retaining study participants in HIV clinical trials following prison release is challenging and potentially related to the broader challenges that participants experience during community reentry. Researchers conducting clinical trials with this population may want to consider methadone and HHRP as means to improve post-release retention, even in clinical trials where these interventions are not being directly evaluated.
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Affiliation(s)
- Divya Chandra
- Yale School of Medicine, Department of Medicine, Section of Infectious Diseases, AIDS Program, 135 College Street, New Haven, CT 06510, USA
| | - Alexander R. Bazazi
- Department of Psychiatry, University of California, San Francisco School of Medicine, San Francisco, CA, USA
| | | | - Adeeba Kamarulzaman
- Yale School of Medicine, Department of Medicine, Section of Infectious Diseases, AIDS Program, 135 College Street, New Haven, CT 06510, USA
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
| | - Frederick L. Altice
- Yale School of Medicine, Department of Medicine, Section of Infectious Diseases, AIDS Program, 135 College Street, New Haven, CT 06510, USA
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
- Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT, USA
| | - Gabriel J. Culbert
- Health Systems Science, University of Illinois at Chicago College of Nursing, Chicago, IL, USA
- Center for HIV/AIDS Nursing Research, Universitas Indonesia, Faculty of Nursing, Depok, Indonesia
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Herce ME, Muyoyeta M, Topp SM, Henostroza G, Reid SE. Coordinating the prevention, treatment, and care continuum for HIV-associated tuberculosis in prisons: a health systems strengthening approach. Curr Opin HIV AIDS 2018; 13:492-500. [PMID: 30222608 PMCID: PMC7705648 DOI: 10.1097/coh.0000000000000505] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE OF REVIEW To advance a re-conceptualized prevention, treatment, and care continuum (PTCC) for HIV-associated tuberculosis (TB) in prisons, and to make recommendations for strengthening prison health systems and reducing HIV-associated TB morbidity and mortality throughout the cycle of pretrial detention, incarceration, and release. RECENT FINDINGS Despite evidence of increased HIV-associated TB burden in prisons compared to the general population, prisoners face entrenched barriers to accessing anti-TB therapy, antiretroviral therapy, and evidence-based HIV and TB prevention. New approaches, suitable for the complexities of healthcare delivery in prisons, have emerged that may address these barriers, and include: novel TB diagnostics, universal test and treat for HIV, medication-assisted treatment for opioid dependence, comprehensive transitional case management, and peer navigation, among others. SUMMARY Realizing ambitious international HIV and TB targets in prisons will only be possible by first addressing the root causes of the TB/HIV syndemic, which are deeply intertwined with human rights violations and weaknesses in prison health systems, and, second, fundamentally re-organizing HIV and TB services around a coordinated PTCC. Taking these steps can help ensure universal access to comprehensive, good-quality, free and voluntary TB/HIV prevention, treatment, and care, and advance efforts to strengthen health resourcing, staffing, information management, and primary care access within prisons.
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Affiliation(s)
- Michael E Herce
- Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia
- Division of Infectious Diseases, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Monde Muyoyeta
- Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia
| | - Stephanie M Topp
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland, Australia
| | - German Henostroza
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama, USA
| | - Stewart E Reid
- Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama, USA
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27
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Masyukova MI, Hanna DB, Fox AD. HIV treatment outcomes among formerly incarcerated transitions clinic patients in a high prevalence setting. HEALTH & JUSTICE 2018; 6:16. [PMID: 30225817 PMCID: PMC6755570 DOI: 10.1186/s40352-018-0074-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 08/31/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Incarceration disproportionately affects people living with HIV/AIDS. When people are released from jail or prison, they face multiple barriers to HIV care, and those who do engage in care may have suboptimal HIV treatment outcomes. A limited number of studies have investigated HIV treatment outcomes among people who have been released from incarceration. METHODS We conducted a retrospective cohort study comparing HIV viral load (VL) suppression and retention in care 12 months after entry into care among patients of a post-incarceration Transitions Clinic (TC) and a comparison group who received HIV care in the same community. Of 138 participants, 38 TC patients were matched to 100 non-TC controls based on age, race/ethnicity, gender, and date of HIV care entry. RESULTS There was no significant difference in clinical study outcomes between TC and non-TC patients: 63% vs. 67% (p = 0.67) were retained in care and 54% vs. 63% (p = 0.33) had suppressed VL at 12 months. After adjusting for substance use disorder and viral load suppression at the start of treatment, the odds ratio of TC patients' 12-month retention was 0.60 (95% CI 0.25-1.49) and VL suppression was 0.44 (95% CI 0.16-1.23) compared with non-TC patients. CONCLUSIONS Our findings show HIV care outcomes for patients at a post-incarceration Transitions Clinic that are similar to those of community-based comparison patients. The transitions clinic model, which provides medical, behavioral health, and supportive services to formerly incarcerated people, may be an effective model of care for this population; however, more scholarship is needed to quantify the components most effective in supporting retention in care and viral load suppression.
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Affiliation(s)
- Mariya I Masyukova
- Department of Family and Social Medicine, Montefiore Medical Center/ Albert Einstein College of Medicine, Bronx, New York, USA.
| | - David B Hanna
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Aaron D Fox
- Department of Medicine, Division of General Internal Medicine, Montefiore Medical Center/ Albert Einstein College of Medicine, Bronx, New York, USA
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Costa M, Montague BT, Solomon L, Sammartino C, Gutman R, Zibman C, Rosen D, Rich JD. Assessing the Effect of Recent Incarceration in Prison on HIV Care Retention and Viral Suppression in Two States. J Urban Health 2018; 95:499-507. [PMID: 29717402 PMCID: PMC6095755 DOI: 10.1007/s11524-018-0255-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The prevalence of HIV among people in correctional facilities remains much higher than that of the general population. Numerous studies have demonstrated the effectiveness and acceptability of HIV treatment for individuals incarcerated in US prisons and jails. However, the period following incarceration is characterized by significant disruptions in HIV care. These disruptions include failure to link in a timely manner (or at all) to community care post-release, as well as not being retained in care after linking. We used a retrospective, propensity-matched cohort design to compare retention in care between HIV-positive individuals recently released from prison (releasees) who linked to care in Ryan White HIV/AIDS Program (RWHAP) clinics and RWHAP patients without a recent incarceration history (community controls). We also performed analyses comparing viral load suppression of those retained in both groups. This study shows that even for those who do successfully link to care after prison, they are 24 to 29 percentage points less likely to be retained in care than those already in community care. However, we found that for those who did retain in care, there was no disparity in rates of viral suppression. These findings provide valuable insight regarding how best to address challenges associated with ensuring that HIV-positive individuals leaving prison successfully move through the HIV care continuum to become virally suppressed.
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Affiliation(s)
| | - Brian T Montague
- School of Public Health, and Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA
| | | | - Cara Sammartino
- School of Public Health, and Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA
| | - Roee Gutman
- School of Public Health, and Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA
| | | | - David Rosen
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Josiah D Rich
- School of Public Health, and Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA
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29
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Cunningham WE, Weiss RE, Nakazono T, Malek MA, Shoptaw SJ, Ettner SL, Harawa NT. Effectiveness of a Peer Navigation Intervention to Sustain Viral Suppression Among HIV-Positive Men and Transgender Women Released From Jail: The LINK LA Randomized Clinical Trial. JAMA Intern Med 2018; 178. [PMID: 29532059 PMCID: PMC5885257 DOI: 10.1001/jamainternmed.2018.0150] [Citation(s) in RCA: 122] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE Diagnosis of human immunodeficiency virus (HIV) infection, linkage and retention in care, and adherence to antiretroviral therapy are steps in the care continuum enabling consistent viral suppression for people living with HIV, extending longevity and preventing further transmission. While incarcerated, people living with HIV receive antiretroviral therapy and achieve viral suppression more consistently than after they are released. No interventions have shown sustained viral suppression after jail release. OBJECTIVE To test the effect on viral suppression in released inmates of the manualized LINK LA (Linking Inmates to Care in Los Angeles) peer navigation intervention compared with standard transitional case management controls. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial conducted from December 2012 through October 2016 with people living with HIV being released from Los Angeles (LA) County Jail. All participants were (1) 18 years or older; (2) either men or transgender women diagnosed with HIV; (3) English speaking; (4) selected for the transitional case management program prior to enrollment; (5) residing in LA County; and (6) eligible for antiretroviral therapy. MAIN OUTCOMES AND MEASURES Change in HIV viral suppression (<75 copies/mL) over a 12-month period. INTERVENTIONS During the 12-session, 24-week LINK LA Peer Navigation intervention, trained peer navigators counseled participants on goal setting and problem solving around barriers to HIV care and adherence, starting while the participants were still in jail. After their release, they continued counseling while they accompanied participants to 2 HIV care visits, then facilitated communication with clinicians during visits. RESULTS Of 356 participants randomized, 151 (42%) were black; 110 (31%) were Latino; 303 (85%) were men; 53 (15%) were transgender women; and the mean (SD) age was 39.5 (10.4) years. At 12 months, viral suppression was achieved by 62 (49.6%) of 125 participants in the peer navigation (intervention) arm compared with 45 (36.0%) of 125 in the transitional case management (control) arm, for an unadjusted treatment difference of 13.6% (95% CI, 1.34%-25.9%; P = .03). In the repeated measures, random effects, logistic model the adjusted probability of viral suppression declined from 52% at baseline to 30% among controls, while those in the peer navigation arm maintained viral suppression at 49% from baseline to 12 months, for a difference-in-difference of 22% (95% CI, 0.03-0.41; P = .02). CONCLUSIONS AND RELEVANCE The LINK LA peer navigation intervention was successful at preventing declines in viral suppression, typically seen after release from incarceration, compared with standard transitional case management. Future research should examine ways to strengthen the intervention to increase viral suppression above baseline levels. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01406626.
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Affiliation(s)
- William E Cunningham
- Department of Medicine, Division of General Internal Medicine and Health Services Research, Geffen School of Medicine, University of California, Los Angeles.,Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles
| | - Robert E Weiss
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles
| | - Terry Nakazono
- Department of Medicine, Division of General Internal Medicine and Health Services Research, Geffen School of Medicine, University of California, Los Angeles
| | - Mark A Malek
- Los Angeles County Sheriff's, Los Angeles, California.,Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles
| | - Steve J Shoptaw
- Department of Family Medicine, Geffen School of Medicine, University of California, Los Angeles
| | - Susan L Ettner
- Department of Medicine, Division of General Internal Medicine and Health Services Research, Geffen School of Medicine, University of California, Los Angeles.,Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles
| | - Nina T Harawa
- Department of Medicine, Division of General Internal Medicine and Health Services Research, Geffen School of Medicine, University of California, Los Angeles.,Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles.,Charles R. Drew University College of Medicine, Los Angeles, California
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30
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Censoring of HIV Viremia Data of Reincarcerated Individuals: A Response to Wohl et al. J Acquir Immune Defic Syndr 2018; 76:e22-e23. [PMID: 28797025 DOI: 10.1097/qai.0000000000001465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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31
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Wohl DA, Rosen DL. Inadequate HIV care after incarceration: case closed. Lancet HIV 2018; 5:e64-e65. [PMID: 29191441 DOI: 10.1016/s2352-3018(17)30210-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 10/13/2017] [Indexed: 06/07/2023]
Affiliation(s)
- David Alain Wohl
- Institute of Global Health and Infectious Diseases, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA.
| | - David Loren Rosen
- Institute of Global Health and Infectious Diseases, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
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32
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Loeliger KB, Altice FL, Desai MM, Ciarleglio MM, Gallagher C, Meyer JP. Predictors of linkage to HIV care and viral suppression after release from jails and prisons: a retrospective cohort study. Lancet HIV 2017; 5:e96-e106. [PMID: 29191440 DOI: 10.1016/s2352-3018(17)30209-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/15/2017] [Accepted: 09/19/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Incarceration provides an opportunity for engagement in HIV care but is associated with poor HIV treatment outcomes after release. We aimed to assess post-release linkage to HIV care (LTC) and the effect of transitional case management services. METHODS To create a retrospective cohort of all adults with HIV released from jails and prisons in Connecticut, USA (2007-14), we linked administrative custody and pharmacy databases with mandatory HIV/AIDS surveillance monitoring and case management data. We examined time to LTC (defined as first viral load measurement after release) and viral suppression at LTC. We used generalised estimating equations to show predictors of LTC within 14 days and 30 days of release. FINDINGS Among 3302 incarceration periods for 1350 individuals between 2007 and 2014, 672 (21%) of 3181 periods had LTC within 14 days of release, 1042 (34%) of 3064 had LTC within 30 days of release, and 301 (29%) of 1042 had detectable viral loads at LTC. Factors positively associated with LTC within 14 days of release are intermediate (31-364 days) incarceration duration (adjusted odds ratio 1·52; 95% CI 1·19-1·95), and transitional case management (1·65; 1·36-1·99), receipt of antiretroviral therapy during incarceration (1·39; 1·11-1·74), and two or more medical comorbidities (1·86; 1·48-2·36). Reincarceration (0·70; 0·56-0·88) and conditional release (0·62; 0·50-0·78) were negatively associated with LTC within 14 days. Hispanic ethnicity, bonded release, and psychiatric comorbidity were also associated with LTC within 30 days but reincarceration was not. INTERPRETATION LTC after release is suboptimal but improves when inmates' medical, psychiatric, and case management needs are identified and addressed before release. People who are rapidly cycling through jail facilities are particularly vulnerable to missed linkage opportunities. The use of integrated programmes to align justice and health-care goals has great potential to improve long-term HIV treatment outcomes. FUNDING US National Institutes of Health.
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Affiliation(s)
- Kelsey B Loeliger
- Yale AIDS Program, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Frederick L Altice
- Yale AIDS Program, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA; Centre of Excellence in Research in AIDS, University of Malaya, Kuala Lumpur, Malaysia
| | - Mayur M Desai
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Maria M Ciarleglio
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Colleen Gallagher
- Health and Addiction Services Quality Improvement Program, Connecticut Department of Correction, Wethersfield, CT, USA
| | - Jaimie P Meyer
- Yale AIDS Program, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA.
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Christopoulos KA, Cunningham WE, Beckwith CG, Kuo I, Golin CE, Knight K, Flynn PM, Spaulding AC, Coffin LS, Kruszka B, Kurth A, Young JD, Mannheimer S, Crane HM, Kahana SY. Lessons Learned From the Implementation of Seek, Test, Treat, Retain Interventions Using Mobile Phones and Text Messaging to Improve Engagement in HIV Care for Vulnerable Populations in the United States. AIDS Behav 2017; 21:3182-3193. [PMID: 28578543 DOI: 10.1007/s10461-017-1804-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In the United States, little is known about interventions that rely on mobile phones and/or text messaging to improve engagement in HIV care for vulnerable populations. Domestic studies using these technologies as part of the National Institute on Drug Abuse "Seek, Test, Treat, Retain" research initiative were queried regarding intervention components, implementation issues, participant characteristics, and descriptive statistics of mobile phone service delivery. Across five studies with 1,135 predominantly male, minority participants, implementation challenges occurred in three categories: (1) service interruptions; (2) billing/overage issues, and; (3) the participant user experience. Response rules for automated text messages frequently frustrated participants. The inability to reload minutes/texting capacity remotely was a significant barrier to intervention delivery. No study encountered confidentiality breaches. Service interruption was common, even if studies provided mobile phones and plans. Future studies should attend to the type of mobile phone and service, the participant user experience, and human subjects concerns.
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Affiliation(s)
- Katerina A Christopoulos
- Division of HIV, ID and Global Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco, 995 Potrero Avenue, 4th Floor, San Francisco, CA, 94110, USA.
| | - William E Cunningham
- Departments of Medicine and Health Policy and Management, UCLA Schools of Medicine and Public Health, Los Angeles, CA, USA
| | - Curt G Beckwith
- Division of Infectious Diseases, Warren Alpert School of Medicine at Brown University, Providence, RI, USA
| | - Irene Kuo
- Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, D.C., USA
| | - Carol E Golin
- Department of Health Behavior, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Kevin Knight
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX, USA
| | - Patrick M Flynn
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX, USA
| | - Anne C Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lara S Coffin
- Division of HIV, ID and Global Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco, 995 Potrero Avenue, 4th Floor, San Francisco, CA, 94110, USA
| | - Bridget Kruszka
- Collaborative Health Studies Coordinating Center, University of Washington, Seattle, WA, USA
| | - Ann Kurth
- School of Nursing, Yale University, New Haven, CT, USA
| | - Jeremy D Young
- Division of Infectious Disease, University of Illinois at Chicago, Chicago, IL, USA
| | - Sharon Mannheimer
- Departments of Medicine and Epidemiology, Columbia University, New York, NY, USA
| | - Heidi M Crane
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA
| | - Shoshana Y Kahana
- Services Research Branch, National Institute on Drug Abuse, Bethesda, MD, USA
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