Title | Contribution of substance use disorders on HIV treatment outcomes and antiretroviral medication adherence among HIV-infected persons entering jail. |
Publication Type | Journal Article |
Year of Publication | 2013 |
Authors | Chitsaz, Ehsan, Jaimie P. Meyer, Archana Krishnan, Sandra A. Springer, Ruthanne Marcus, Nick Zaller, Alison O. Jordan, Thomas Lincoln, Timothy P. Flanigan, Jeff Porterfield, and Frederick L. Altice |
Journal | AIDS and behavior |
Volume | 17 Suppl 2 |
Pagination | S118-27 |
Date Published | 2013 Oct |
ISSN | 1573-3254 |
Keywords | Adolescent, Adult, Alcohol Drinking, Anti-Retroviral Agents, Comorbidity, Cross-Sectional Studies, Female, HIV Infections, Humans, Logistic Models, Male, Medication Adherence, Middle Aged, Prisoners, Prisons, Socioeconomic Factors, Substance Abuse, Intravenous, Substance-Related Disorders, Treatment Outcome, United States, Young Adult |
Abstract | HIV and substance use are inextricably intertwined. One-sixth of people living with HIV/AIDS (PLWHA) transition through the correctional system annually. There is paucity of evidence on the impact of substance use disorders on HIV treatment engagement among jail detainees. We examined correlates of HIV treatment in the largest sample of PLWHA transitioning through jail in 10 US sites from 2007 to 2011. Cocaine, alcohol, cannabis, and heroin were the most commonly used substances. Drug use severity was negatively and independently correlated with three outcomes just before incarceration: (1) having an HIV care provider (AOR = 0.28; 95 % CI 0.09-0.89); (2) being prescribed antiretroviral therapy (AOR = 0.12; 95 % CI 0.04-0.35) and (3) high levels (>95 %) of antiretroviral medication adherence (AOR = 0.18; 95 % CI 0.05-0.62). Demographic, medical and psychiatric comorbidity, and social factors also contributed to poor outcomes. Evidence-based drug treatments that include multi-faceted interventions, including medication-assisted therapies, are urgently needed to effectively engage this vulnerable population. |
DOI | 10.1007/s10461-013-0506-0 |
Alternate Journal | AIDS Behav |