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AIDS and Behavior

, Volume 17, Supplement 2, pp 118–127 | Cite as

Contribution of Substance Use Disorders on HIV Treatment Outcomes and Antiretroviral Medication Adherence Among HIV-Infected Persons Entering Jail

  • Ehsan Chitsaz
  • Jaimie P. Meyer
  • Archana Krishnan
  • Sandra A. Springer
  • Ruthanne Marcus
  • Nick Zaller
  • Alison O. Jordan
  • Thomas Lincoln
  • Timothy P. Flanigan
  • Jeff Porterfield
  • Frederick L. AlticeEmail author
Original Paper

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.

Keywords

Substance abuse Jail Prisoners Engagement in HIV care Antiretroviral therapy Adherence Criminal justice 

Notes

Acknowledgments

Funding from this Grant was provided by the Health Resources and Services Agency for the 10-site demonstration and by the National Institutes on Drug Abuse for career development (K24 DA017072) for Frederick L. Altice.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Ehsan Chitsaz
    • 1
  • Jaimie P. Meyer
    • 1
  • Archana Krishnan
    • 1
  • Sandra A. Springer
    • 1
  • Ruthanne Marcus
    • 1
  • Nick Zaller
    • 2
  • Alison O. Jordan
    • 3
  • Thomas Lincoln
    • 4
  • Timothy P. Flanigan
    • 2
  • Jeff Porterfield
    • 5
  • Frederick L. Altice
    • 1
    • 6
    Email author
  1. 1.Section of Infectious Diseases, AIDS ProgramYale University School of MedicineNew HavenUSA
  2. 2.Brown University School of MedicineProvidenceUSA
  3. 3.New York City Department of Health and Mental HygieneCorrectional Health ServicesNew YorkUSA
  4. 4.Baystate Medical CenterSpringfieldUSA
  5. 5.AID AtlantaAtlantaUSA
  6. 6.Division of Epidemiology of Microbial DiseasesYale University School of Public HealthNew HavenUSA

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