Background: We examined the preliminary effectiveness of a computerized counseling session plus post-incarceration text messaging intervention (CARE+ Corrections) to support ART adherence and linkage/engagement in community care among recently incarcerated HIV-infected persons in Washington, DC. Methods:Recently incarcerated HIV-infected persons ≥18 years old were recruited from the DC jail or community outreach and randomized to CARE+ Corrections or control arm. Participants completed assessments at baseline, three-months and six-months. Multivariable random effects modeling identified predictors of suppressed viral load (≤200 copies/mL) and engagement in HIV care at six months.Results: Participants (N=110) were aged 42 (IQR: 30-49); 58% male, 24% female, 18% transgender, 85% Black, and incarcerated for a median of 7 years (IQR: 2-15). More controls had

Knowledge Brief  Faced with a large and increasing obesity epidemic, in 2013 Mexico enacted taxes on sugarsweetened beverages (SSBs) and calorie-dense foods of low nutritional value.  The decision to implement this fiscal policy was the result of a long advocacy process in which civil society organizations and government agencies participated.  The taxes were designed to avoid, as much as possible, the substitution of consumption of the taxed goods for other unhealthy foods and beverages not subject to taxation.  The taxes have been successful in increasing both the fiscal revenues and the price of the products taxed. There is evidence that they have reduced consumption, particularly of SSBs.  A debate remains on the size of the impact of the taxes, particularly on health outcomes. Thus it is important to continue monitoring the impact of the taxes through the development of price and volume indicators, based on publicly available data, as well as health outcomes indicators.

BackgroundHIV-infected individuals recently released from incarceration have suboptimal linkage and engagement in community HIV care. We conducted a study to evaluate an information and communication technology intervention to increase linkage to community care among HIV-infected persons recently involved in the criminal justice (CJ) system. Baseline characteristics including risk behaviors and HIV care indicators are reported and stratified by gender.MethodsWe recruited HIV-infected individuals in the District of Columbia jail and persons with a recent history of incarceration through community and street outreach. Participants completed a baseline computer-assisted personal interview regarding HIV care and antiretroviral treatment (ART) adherence, substance use, and sexual behaviors. CD4 and HIV plasma viral load testing were performed at baseline or obtained through medical records. Data were analyzed for the sample overall and stratified by gender.ResultsOf 110 individuals, 70% were community-enrolled, mean age was 40 (SD = 10.5), 85% were Black, and 58% were male, 24% female, and 18% transgender women. Nearly half (47%) had condomless sex in the three months prior to incarceration. Although drug dependence and hazardous alcohol use were highly prevalent overall, transgender women were more likely to have participated in drug treatment than men and women (90%, 61%, and 50% respectively; p = 0.01). Prior to their most recent incarceration, 80% had an HIV provider and 91% had ever taken ART. Among those, only 51% reported ≥90% ART adherence. Fewer women (67%) had received HIV medications during their last incarceration compared to men (96%) and transgender women (95%; p = 0.001). Although neither was statistically significant, transgender women and men had higher proportions of baseline HIV viral suppression compared to women (80%, 69%, and 48.0% respectively, p>0.05); a higher proportion of women had a CD4 count ≤200 compared to men and transgender women (17%, 8% and 5% respectively; p>0.05).ConclusionsIn this study, HIV-infected persons with recent incarceration in Washington, DC reported important risk factors and co-morbidities, yet the majority had access to HIV care and ART prior to, during, and after incarceration. Self-reported ART adherence was sub-optimal, and while there were not statistically significant differences, CJ-involved women appeared to be at greatest risk of poor HIV outcomes.Trial registrationRegistered on ClinicalTrials.gov on 10/16/2012. Reference number: NCT01721226.