Correlates of Retention in HIV Care After Release from Jail: Results from a Multi-site Study

Althoff, Amy; Zelenev, Alexei; Meyer, Jaimie P.; Fu, Jiaju; Brown, Shan Estelle; Vagenas, Panagiotis; Avery, Ann; Cruzado-Quiñones, Jacqueline; Spaulding, Anne C.; Altice, Frederick L.

doi:10.1007/s10461-012-0372-1

Cited by 116 publications

(127 citation statements)

References 44 publications

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“…Based on baseline characteristic comparisons of factors associated with not following up for research visits (e.g., substance use, homelessness, psychiatric conditions), we were able to assume that the data was missing at random (MAR), meaning the probability a variable is missing depends only on available information. 55 Although there are no definitive measures proving data were truly MAR, 14,56 we used all available variables in the imputation dataset rather than just those ultimately used in the model. 57 We imputed five times as recommended 57 for each missing cell, and we used the average for regression analysis.…”

Section: Discussionmentioning

confidence: 99%

“…This cohort has been described across many domains, including HIV treatment outcomes, 39 new HIV infections, 3 longitudinal retention in care, 14 gender differences in service needs 40 and HIV treatment outcomes, 41 pre-and post-release homelessness, 20,35 recidivism, 22 and SUDs. 17,36 Health care utilization among this cohort has not previously been described.…”

Section: Setting and Selection Of Participantsmentioning

confidence: 99%

“…The definitions for retention in HIV care were defined based on previously described methods from an EnhanceLink study. 14 Specifically, an HIV-related visited was one made to an HIV provider and linked to HIV-1 RNA testing. Retention in HIV care over the 6 months post-release was coded as a categorical, single explanatory variable, consisting of the following: (1) no retention; (2) early retention, a visit only within the first 90 days of release; (3) late retention, a visit only after 90 days but before 180 days post-release; and (4) sustained retention, defined as having made visits both within the first 90 days postrelease and during days 90-180.…”

Section: Enabling Resources Included the Following Variablesmentioning

confidence: 99%

“…Retention in HIV care over the 6 months post-release was coded as a categorical, single explanatory variable, consisting of the following: (1) no retention; (2) early retention, a visit only within the first 90 days of release; (3) late retention, a visit only after 90 days but before 180 days post-release; and (4) sustained retention, defined as having made visits both within the first 90 days postrelease and during days 90-180. 14 Treatment for Substance Use Disorders. Utilization of buprenorphine was defined by dates of buprenorphine prescription and follow-up voucher provision as previously described.…”

Section: Enabling Resources Included the Following Variablesmentioning

confidence: 99%

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Emergency Department Use among HIV-Infected Released Jail Detainees

Boyd

Song²,

Meyer

et al. 2014

J Urban Health

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Release from short-term jail detention is highly destabilizing, associated with relapse to substance use, recidivism, and disrupted health care continuity. Little is known about emergency department (ED) use, potentially a surrogate for medical, psychiatric, or social instability, by people living with HIV/AIDS (PLWHA) leaving jails. All ED visits were reviewed from medical records for a cohort of 109 PLHWA in the year following release from county jail in Connecticut, between January 1, 2008 and December 31, 2010. Primary outcomes were frequency and timing of ED visits, modeled using multivariate negative binomial regression and Cox proportional hazards regression, respectively. Demographic, substance use, and psychiatric disorder severity factors were evaluated as potential covariates. . Those in late or sustained HIV care used the ED sooner than those not retained in HIV primary care (median for late retention 16.3 days, median for sustained retention 24.9 days, median for no retention not reached at 12 months, p value 0.004). Using multivariate modeling, those who used the ED earliest upon release were more likely to be homeless ]), to be retained in HIV care ), and to have recently used drugs ), yet had a low lifetime drug severity (HR 0.01 [0.00-0.14]). Among PLWHA released from jail, frequency of ED use is high, often soon after release, and is associated with social and drug-related destabilizing factors. Future interventions for this specific population should focus on addressing these resource gaps, ensuring housing, and establishing immediate linkage to HIV primary care after release from jail.

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Section: Discussionmentioning

confidence: 99%

Section: Setting and Selection Of Participantsmentioning

confidence: 99%

Section: Enabling Resources Included the Following Variablesmentioning

confidence: 99%

Section: Enabling Resources Included the Following Variablesmentioning

confidence: 99%

See 2 more Smart Citations

Emergency Department Use among HIV-Infected Released Jail Detainees

Boyd

Song²,

Meyer

et al. 2014

J Urban Health

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“…Inter-agency coordination and constrained service funding also pose problems. 2,[5][6][7] A recent survey of US correctional systems revealed notable weaknesses in discharge planning and transitional linkage services for inmates with HIV. 8 Springer 5 identified five essential components of transitional care for prison releasees with HIV: case management, continuity of antiretroviral therapy (ART), substance use treatment, mental health treatment, and HIV prevention services.…”

Section: Introductionmentioning

confidence: 99%

Transitions to Care in the Community for Prison Releasees with HIV: a Qualitative Study of Facilitators and Challenges in Two States

et al. 2015

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One in seven people living with HIV in the USA passes through a prison or jail each year, and almost all will return to the community. Discharge planning and transitional programs are critical but challenging elements in ensuring continuity of care, maintaining treatment outcomes achieved in prison, and preventing further viral transmission. This paper describes facilitators and challenges of in-prison care, transitional interventions, and access to and continuity of care in the community in Rhode Island and North Carolina based on qualitative data gathered as part of the mixed-methods Link Into Care Study of prisoners and releasees with HIV. We conducted 65 interviews with correctional and communitybased providers and administrators and analyzed the transcripts using NVivo 10 to identify major themes. Facilitators of effective transitional systems in both states included the following: health providers affiliated with academic institutions or other entities independent of the corrections department; organizational philosophy emphasizing a patient-centered, personal, and holistic approach; strong leadership with effective Bchampions^; a team approach with coordination, collaboration and integration throughout the system, mutual respect and learning between corrections and health providers, staff dedicated to transitional services, and effective communication and information sharing among providers; comprehensive transitional activities and services including HIV, mental health and substance use services in prisons, timely and comprehensive discharge planning with specific linkages/appointments, supplies of medications on release, access to benefits and entitlements, case management and proactive follow-up on missed appointments; and releasees' commitment to transitional plans. These elements were generally present in both study states but their absence, which also sometimes occurred, represent ongoing challenges to success. The qualitative findings on the facilitators and challenges of the transitional systems were similar in the two states despite differences in context, demographics of target population, and system organization. Recommendations for improved transitional systems follow from the analysis of the facilitators and challenges.

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