@article {3958, title = {Post-release substance abuse outcomes among HIV-infected jail detainees: results from a multisite study.}, journal = {AIDS and behavior}, volume = {17 Suppl 2}, year = {2013}, month = {2013 Oct}, pages = {S171-80}, abstract = {HIV-infected individuals with substance use disorders have a high prevalence of medical and psychiatric morbidities that complicate treatment. Incarceration further disrupts healthcare access and utilization. Without appropriate diagnosis and treatment, drug relapse upon release exceeds 85 \%, which contributes to poor health outcomes. A prospective cohort of 1,032 HIV-infected jail detainees were surveyed in a ten-site demonstration project during incarceration and six-months post-release, in order to examine the effect of predisposing factors, enabling resources and need factors on their subsequent drug use. Homelessness, pre-incarceration cocaine and opioid use, and high drug and alcohol severity were significantly associated with cocaine and opioid relapse. Substance abuse treatment, though poorly defined, did not influence post-release cocaine and opioid use. An approach that integrates multiple services, simultaneously using evidence-based substance abuse, psychiatric care, and social services is needed to improve healthcare outcomes for HIV-infected persons transitioning from jails to the community.}, keywords = {Adult, Behavior, Addictive, Female, Health Services Accessibility, Health Services Needs and Demand, HIV Infections, Homeless Persons, Humans, Insurance, Health, Male, Middle Aged, Multivariate Analysis, Patient Discharge, Prevalence, Prisons, Prospective Studies, Severity of Illness Index, Social Work, Socioeconomic Factors, Substance-Related Disorders, Treatment Outcome, Young Adult}, issn = {1573-3254}, doi = {10.1007/s10461-012-0362-3}, author = {Krishnan, Archana and Wickersham, Jeffrey A and Chitsaz, Ehsan and Springer, Sandra A and Jordan, Alison O and Zaller, Nick and Altice, Frederick L} }