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Social Determinants of Health and Retention in HIV Care Among Recently Incarcerated Women Living with HIV in Canada

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Abstract

Women living with HIV (WLWH) are over-represented in corrections in Canada, yet little is known about women’s experiences post-release. We used CHIWOS cross-sectional data from WLWH to estimate associations between social determinants of health and HIV-related care outcomes among WLWH with recent (within past year) or ever (before past year) incarceration experience. Lifetime incarceration prevalence was 36.9% (6.5% recent; 30.4% ever), with significant differences by province of residence (British Columbia: 10% recent; 52% ever; Ontario: 5%; 24%; Quebec: 6%; 22%; p < 0.001). In adjusted multinomial logistic regression analyses, compared with never incarcerated, recent incarceration was associated with Indigenous ancestry, lower annual income (< $20,000 CAD), unstable housing, current sex work, injection drug use (IDU), and sub-optimal antiretroviral therapy (ART) adherence, while ever incarceration was associated with current sex work, IDU, and experiencing adulthood violence. Our findings have implications regarding supports needed by WLWH in the post-release period, including ART adherence and achieving health and social goals.

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Acknowledgements

The CHIWOS Research Team thanks women living with HIV for their contributions to this study, and the national team of co-investigators, collaborators and peer research associates. We acknowledge the national steering committee; our three provincial community advisory boards; the national CHIWOS Aboriginal Board; the national CHIWOS African, Caribbean and Black Advisory Board; the British Columbia Centre for Excellence in HIV/AIDS; and all of our partnering organizations. CHIWOS is funded by the Canadian Institutes of Health Research (CIHR), the CIHR Canadian HIV Trials Network (CTN 262), the Ontario HIV Treatment Network (OHTN), and the Academic Health Science Centres (AHSC) Alternative Funding Plans (AFP) Innovation Fund.

CHIWOS Research Team Rahma Abdul-Noor (Women’s College Research Institute), Aranka Anema (Harvard Medical School), Jonathan Angel (Ottawa Hospital Research Institute), Dada Mamvula Bakombo (McGill University Health Centre), Fatimatou Barry (Women’s College Research Institute), Greta Bauer (University of Western Ontario), Kerrigan Beaver (Women’s College Research Institute), Marc Boucher (CHU Ste-Justine), Isabelle Boucoiran (CHU Ste-Justine), Jason Brophy (Children's Hospital of Eastern Ontario), Lori Brotto (University of British Columbia), Ann Burchell (St, Michael’s Hospital), Claudette Cardinal (Simon Fraser University), Allison Carter (Kirby Institute), Lynne Cioppa (Women’s College Research Institute), Tracey Conway (Women’s College Research Institute), José Côté (Centre Hospitalier de l’Université de Montréal), Jasmine Cotnam (Canadian Aboriginal AIDS Network), Cori d’Ambrumenil (AIDS Vancouver Island), Janice Dayle, (McGill University Health Centre), Erin Ding (British Columbia Centre for Excellence in HIV/AIDS), Danièle Dubuc, (McGill University Health Centre), Janice Duddy (Pacific AIDS Network), Mylène Fernet (Université du Québec à Montréal), Annette Fraleigh (Women’s College Research Institute), Peggy Frank (Simon Fraser University), Brenda Gagnier (Women’s College Research Institute), Marilou Gagnon (University of Victoria), Jacqueline Gahagan (Dalhousie University), Claudine Gasingirwa (Women’s College Research Institute), Nada Gataric (British Columbia Centre for Excellence in HIV/AIDS), Rebecca Gormley (British Columbia Centre for Excellence in HIV/AIDS), Saara Greene (McMaster University), Danielle Groleau (McGill University), Charlotte Guerlotté (COCQ-SIDA), Trevor Hart (Ryerson University), Catherine Hankins (McGill University), Roula Hawa (Women’s College Research Institute), Emily Heer (Alberta Health Services), Robert S. Hogg (British Columbia Centre for Excellence in HIV/AIDS and Simon Fraser University), Terry Howard (Glasshouse Consultants), Shazia Islam (Women’s College Research Institute), Joseph Jean-Gilles (GAP-VIES), Hermione Jefferis (AIDS Vancouver Island), Evin Jones (Pacific AIDS Network), Charu Kaushic (McMaster University), Mina Kazemi (Women’s College Research Institute), Mary Kestler (Oak Tree Clinic, BC Women’s Hospital and Health Centre), Maxime Kiboyogo (McGill University Health Centre), Marina Klein (McGill University Health Centre), Nadine Kronfli (McGill University Health Center), Gladys Kwaramba (Women’s College Research Institute), Gary Lacasse (Canadian AIDS Society), Ashley Lacombe-Duncan (University of Michigan), Melanie Lee (Simon Fraser University), Rebecca Lee (CIHR Canadian HIV Trials Network), Jenny Li (British Columbia Centre for Excellence in HIV/AIDS), Viviane Lima (British Columbia Centre for Excellence in HIV/AIDS), Elisa Lloyd-Smith (Vancouver General Hospital), Carmen Logie (University of Toronto), Evelyn Maan (Oak Tree Clinic), Valérie Martel-Lafrenière (Centre Hospitalier de l’Université de Montréal), Carrie Martin (Canadian Aboriginal AIDS Network), Renee Masching (Canadian Aboriginal AIDS Network), Lyne Massie (Université du Québec à Montréal), Melissa Medjuck (formerly of the Positive Women’s Network), Brigitte Ménard, (McGill University Health Centre), Cari L. Miller (formerly of Simon Fraser University), Judy Mitchell (Positive Living North), Gerardo Mondragon (British Columbia Centre for Excellence), Deborah Money (Women’s Health Research Institute and Faculty of Medicine at UBC), Ken Monteith (COCQ-SIDA), Marvelous Muchenje (Women’s Health in Women’s Hands CHC), Florida Mukandamutsa (CASM), Mary Ndung'u (African Partnership Against AIDS), Valerie Nicholson (Simon Fraser University), Kelly O’Brien (University of Toronto), Nadia O'Brien (McGill University Health Centre and McGill University), Gina Ogilvie (University of British Columbia, Women’s Health Research Institute), Susanna Ogunnaike-Cooke (Public Health Agency of Canada), Joanne Otis (Université du Québec à Montréal), Rebeccah Parry (Simon Fraser University), Sophie Patterson (Simon Fraser University), Angela Paul (Positive Living North), Doris Peltier (Canadian Aboriginal AIDS Network), Neora Pick (Oak Tree Clinic, BC Women’s Hospital and Health Centre), Alie Pierre (McGill University Health Centre), Jeff Powis (Michael Garron Hospital), Karène Proulx-Boucher (McGill University Health Centre), Corinna Quan (Windsor Regional Hospital), Jesleen Rana (Women’s Health in Women’s Hands CHC), Eric Roth (University of Victoria), Danielle Rouleau (Centre Hospitalier de l’Université de Montréal), Geneviève Rouleau (Centre Hospitalier de l’Université de Montréal), Sergio Rueda (Centre for Addiction and Metal Health), Kate Salters (Simon Fraser University, British Columbia Centre for Excellence in HIV/AIDS), Margarite Sanchez (ViVA, Southern Gulf Islands AIDS Society, Simon Fraser University), Roger Sandre (Haven Clinic), Jacquie Sas (CIHR Canadian HIV Trials Network), Édénia Savoie (McGill University Health Centre), Paul Sereda (British Columbia Centre for Excellence in HIV/AIDS), Stephanie Smith (Women’s College Research Institute), Marcie Summers (formerly of the Positive Women’s Network), Wangari Tharao (Women’s Health in Women’s Hands CHC), Christina Tom (Simon Fraser University), Cécile Tremblay (Centre Hospitalier de l’Université de Montréal), Jason Trigg (British Columbia Centre for Excellence in HIV/AIDS), Sylvie Trottier (Centre Hospitalier Universitaire de Québec), Angela Underhill (Women’s College Research Institute), Anne Wagner (Ryerson University), Sharon Walmsley (University Health Network), Clara Wang (British Columbia Centre for Excellence), Kath Webster (Simon Fraser University), Wendy Wobeser (Queen’s University), Denise Wozniak (Positive Living Society of British Columbia), Mark Yudin (St. Michael’s Hospital), Wendy Zhang (British Columbia Centre for Excellence in HIV/AIDS), Julia Zhu (British Columbia Centre for Excellence in HIV/AIDS). All other CHIWOS Research Team Members who wish to remain anonymous.

Author information

Authors and Affiliations

  1. Faculty of Health Sciences, Simon Fraser University, Blusson Hall Rm 10522, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada

    Rebecca Gormley, Allison Carter, Valerie Nicholson, Kath Webster, Angela Kaida, Claudette Cardinal, Peggy Frank, Melanie Lee, Cari L. Miller, Valerie Nicholson, Rebeccah Parry, Sophie Patterson, Kate Salters, Margarite Sanchez, Christina Tom & Kath Webster

  2. Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada

    Rebecca Gormley, Allison Carter, Terry Howard, Lu Wang, Erin Ding, Nada Gataric, Rebecca Gormley, Robert S. Hogg, Jenny Li, Viviane Lima, Kate Salters, Paul Sereda, Jason Trigg, Wendy Zhang & Julia Zhu

  3. University of Victoria, Victoria, BC, Canada

    Sally Y. Lin, Marilou Gagnon & Eric Roth

  4. Collaborating Centre for Prison Health and Education, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada

    Ruth Elwood Martin, Lori Brotto & Gina Ogilvie

  5. Division of AIDS, Department of Medicine, University of British Columbia, Vancouver, BC, Canada

    M-J Milloy & Angela Kaida

  6. British Columbia Centre on Substance Use, Vancouver, BC, Canada

    M-J Milloy

  7. Oak Tree Clinic, BC Women’s Hospital and Health Centre, Vancouver, Canada

    Neora Pick, Mary Kestler, Evelyn Maan & Neora Pick

  8. Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, Canada

    Neora Pick

  9. GlassHouse Consultants, Vancouver, Canada

    Terry Howard & Terry Howard

  10. McGill University Health Centre, Montreal, QC, Canada

    Alexandra de Pokomandy, Dada Mamvula Bakombo, Janice Dayle, Danièle Dubuc, Maxime Kiboyogo, Marina Klein, Nadine Kronfli, Brigitte Ménard, Nadia O’Brien, Alie Pierre, Karène Proulx-Boucher & Édénia Savoie

  11. Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada

    Mona Loutfy, Rahma Abdul-Noor, Fatimatou Barry, Kerrigan Beaver, Lynne Cioppa, Tracey Conway, Annette Fraleigh, Brenda Gagnier, Claudine Gasingirwa, Roula Hawa, Shazia Islam, Mina Kazemi, Gladys Kwaramba, Gina Ogilvie, Stephanie Smith & Angela Underhill

  12. Department of Medicine, University of Toronto, Toronto, ON, Canada

    Mona Loutfy, Carmen Logie & Kelly O’Brien

  13. Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia

    Allison Carter & Allison Carter

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  1. Rebecca Gormley
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  2. Sally Y. Lin
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  3. Allison Carter
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  4. Valerie Nicholson
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  5. Kath Webster
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  6. Ruth Elwood Martin
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  7. M-J Milloy
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  8. Neora Pick
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  9. Terry Howard
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  10. Lu Wang
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  11. Alexandra de Pokomandy
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  13. Angela Kaida
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Consortia

on behalf of the CHIWOS Research Team

  • Rahma Abdul-Noor
  • , Aranka Anema
  • , Jonathan Angel
  • , Dada Mamvula Bakombo
  • , Fatimatou Barry
  • , Greta Bauer
  • , Kerrigan Beaver
  • , Marc Boucher
  • , Isabelle Boucoiran
  • , Jason Brophy
  • , Lori Brotto
  • , Ann Burchell
  • , Claudette Cardinal
  • , Allison Carter
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Correspondence to Angela Kaida.

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Gormley, R., Lin, S.Y., Carter, A. et al. Social Determinants of Health and Retention in HIV Care Among Recently Incarcerated Women Living with HIV in Canada. AIDS Behav 24, 1212–1225 (2020). https://doi.org/10.1007/s10461-019-02666-7

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