Retention in care is key to effective HIV treatment, but half of PLWHA in the U.S. are continuously engaged in care. Incarcerated individuals are an especially challenging population to retain, and empiric data specific to jail detainees is lacking. We prospectively evaluated correlates of retention in care for 867 HIV-infected jail detainees enrolled in a 10-site demonstration project. Sustained retention in care was defined as having a clinic visit during each quarter in the 6-month post-release period. The following were independently associated with retention: being male (AOR=2.10, p=<0.01), heroin use (AOR 1.49, p=0.04), having an HIV provider (AOR 1.67, p=0.02), and receipt of services: discharge planning (AOR 1.50, p=0.02) and disease management session (AOR 2.25, p=<0.01) during incarceration; needs assessment (AOR 1.59, p=0.02), HIV education (AOR 2.03, p=<0.01), and transportation assistance (AOR 1.54, p=0.02) after release. Provision of education and case management services improve retention in HIV care after release from jail.

In this phase 2 study, single oral doses of gepotidacin were ≥95% effective for bacterial eradication in culture-proven uncomplicated urogenital gonorrhea. New antibiotics for drug-resistant Neisseria gonorrhoeae are urgently needed. With additional evaluation, gepotidacin may provide an alternative therapeutic option.

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.