Original Paper

AIDS and Behavior

, Volume 17, Issue 2, pp 203-211

Planning for Success Predicts Virus Suppressed: Results of a Non-Controlled, Observational Study of Factors Associated with Viral Suppression Among HIV-Positive Persons Following Jail Release

  • Anne C. SpauldingAffiliated withDivision of Infectious Diseases, Emory University School of MedicineDepartment of Epidemiology, Rollins School of Public Health, Emory University School of Medicine Email author 
  • , Lauren C. MessinaAffiliated withDepartment of Epidemiology, Rollins School of Public Health, Emory University School of Medicine
  • , Bryan I. KimAffiliated withDepartment of Epidemiology, Rollins School of Public Health, Emory University School of Medicine
  • , Koo-Whang ChungAffiliated withDepartment of Epidemiology, Rollins School of Public Health, Emory University School of Medicine
  • , Thomas LincolnAffiliated withInternal Medicine, Baystate Medical Center and Tufts University
  • , Paul TeixeiraAffiliated withNew York City Department of Health and Mental Hygiene, Transitional Health Care Coordination
  • , Ann K. AveryAffiliated withInfectious Diseases, MetroHealth Medical Center and Case Western Reserve University
  • , Marc CunninghamAffiliated withDepartment of Epidemiology, Rollins School of Public Health, Emory University School of Medicine
  • , Matthew S. SteinAffiliated withDepartment of Epidemiology, Rollins School of Public Health, Emory University School of Medicine
    • , Divya AhujaAffiliated withUniversity of South Carolina Research Foundation
    • , Timothy P. FlaniganAffiliated withInfectious Diseases, Miriam Hospital and Brown University

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Abstract

In the United States, jail frequently disrupts access to HIV care. EnhanceLink, a 10-site demonstration project promoting linkage to HIV primary care upon jail discharge, offered an opportunity to gauge how many releasees had favorable clinical outcomes. Individual level data were available on 1270 participants. Persons never discharged from the correctional environment were excluded. Multivariate logistic regression identified factors associated with viral suppression 6 months post discharge (6M-VL < 400). Among 1082 individuals eligible for follow-up evaluation, 25.7 % had 6M-VL < 400. 6M-VL < 400 was associated with case managers assessing whether help was needed for linkage to HIV-related medical services and clients keeping an appointment with a case manager. The adjusted odds ratio (aOR) of 6M-VL < 400 associated with attending a meeting with an HIV care provider within 30 days of release was 1.85. The results of this non-controlled, observational study support further development and rigorous evaluation of transitional care programs for HIV-positive jailed persons across the country.

Keywords

HIV Linkage to care Retention in care Inmate Jail