AIDS and Behavior

, Volume 17, Issue 8, pp 2654–2666

Adherence to HIV Treatment and Care Among Previously Homeless Jail Detainees

  • Nadine E. Chen
  • Jaimie P. Meyer
  • Ann K. Avery
  • Jeffrey Draine
  • Timothy P. Flanigan
  • Thomas Lincoln
  • Anne C. Spaulding
  • Sandra A. Springer
  • Frederick L. Altice
Original Paper

DOI: 10.1007/s10461-011-0080-2

Cite this article as:
Chen, N.E., Meyer, J.P., Avery, A.K. et al. AIDS Behav (2013) 17: 2654. doi:10.1007/s10461-011-0080-2

Abstract

HIV-infected persons entering the criminal justice system (CJS) often experience suboptimal healthcare system engagement and social instability, including homelessness. We evaluated surveys from a multisite study of 743 HIV-infected jail detainees prescribed or eligible for antiretroviral therapy (ART) to understand correlates of healthcare engagement prior to incarceration, focusing on differences by housing status. Dependent variables of healthcare engagement were: (1) having an HIV provider, (2) taking ART, and (3) being adherent (≥95% of prescribed doses) to ART during the week before incarceration. Homeless subjects, compared to their housed counterparts, were significantly less likely to be engaged in healthcare using any measure. Despite Ryan White funding availability, insurance coverage remains insufficient among those entering jails, and having health insurance was the most significant factor correlated with having an HIV provider and taking ART. Individuals interfacing with the CJS, especially those unstably housed, need innovative interventions to facilitate healthcare access and retention.

Keywords

HIV AIDS Homelessness Jail Incarceration Substance abuse Alcohol Insurance Adherence Healthcare access 

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Nadine E. Chen
    • 1
  • Jaimie P. Meyer
    • 2
  • Ann K. Avery
    • 3
  • Jeffrey Draine
    • 4
  • Timothy P. Flanigan
    • 5
  • Thomas Lincoln
    • 6
  • Anne C. Spaulding
    • 7
  • Sandra A. Springer
    • 2
  • Frederick L. Altice
    • 2
  1. 1.Internal Medicine, Division of Global Public HealthUniversity of California San DiegoSan DiegoUSA
  2. 2.Internal Medicine, Section of Infectious Diseases, Yale AIDS ProgramYale UniversityNew HavenUSA
  3. 3.Infectious DiseasesCase Western Reserve UniversityClevelandUSA
  4. 4.Center for Mental Health Policy and Services ResearchUniversity of PennsylvaniaPhiladelphiaUSA
  5. 5.Infectious DiseasesMiriam Hospital and Brown UniversityProvidenceUSA
  6. 6.Internal MedicineBaystate Medical Center and Tufts UniversitySpringfieldUSA
  7. 7.Epidemiology, Infectious DiseaseEmory UniversityAtlantaUSA