AIDS and Behavior

, Volume 17, Supplement 2, pp 171–180

Post-Release Substance Abuse Outcomes Among HIV-Infected Jail Detainees: Results from a Multisite Study

  • Archana Krishnan
  • Jeffrey A. Wickersham
  • Ehsan Chitsaz
  • Sandra A. Springer
  • Alison O. Jordan
  • Nick Zaller
  • Frederick L. Altice
Original Paper


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.


HIV/AIDS Substance use disorders Jail detainees Substance abuse treatment Addiction severity Heroin Cocaine Homelessness 


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Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Archana Krishnan
    • 1
  • Jeffrey A. Wickersham
    • 1
  • Ehsan Chitsaz
    • 1
  • Sandra A. Springer
    • 1
  • Alison O. Jordan
    • 2
  • Nick Zaller
    • 3
  • Frederick L. Altice
    • 1
    • 4
  1. 1.Section of Infectious Diseases, AIDS ProgramYale University School of MedicineNew HavenUSA
  2. 2.New York City Department of Health and Mental HygieneNew YorkUSA
  3. 3.Warren Alpert Medical School of Brown UniversityProvidenceUSA
  4. 4.Division of Epidemiology of Microbial DiseasesYale University School of Public HealthNew HavenUSA

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