Criminal justice involvement history is associated with better HIV care continuum metrics among a population-based sample of young black MSM

Abstract

Objective To examine how history of criminal justice involvement (CJI) is related to HIV care continuum metrics among young Black men who have sex with men (YBMSM) 16–29 years of age. Design Population-based survey Methods From 2013–2014 a representative sample of YBMSM was generated using Respondent Driven Sampling (RDS) in Chicago (n=618). HIV antibody/Ag and RNA testing were performed using dry blood spots. Factors assessed in the care continuum included HIV testing, HIV diagnosis, linkage-to-care within 6 months, retention-in-care, adherence to antiretrovirals, and viral suppression. RDS-weighted regression models examined the associations between history of CJI, including frequency of CJI and durations of stay and each of the continuum metrics. Results A final analytic sample of 618 participants was generated through RDS chains of up to 13 waves in length and with a mean of 2.1 recruits per participant. At enrollment, 40.8% had prior history of CJI and 34.6% were HIV seropositive. Of persons reporting HIV seropositive status, 58.4% were linked to care, 40.2% retained in care, 32.2% adherent to antiretrovirals and 24.3% virally suppressed. Any CJI history was associated with the overall care continuum (aOR, 2.35; 95% CI 1.13–4.88) and was most associated with increased retention-in-care (aOR 3.72 (1.77–7.84)). Having one CJI experience and detention for only one day was associated with better retention-in-care compared to no or more frequent CJI. Conclusions Those with a previous history of CJI were more successful in achieving most HIV care continuum metrics. Frequent and cycling CJI, however, was detrimental to HIV care.

Correlates of Durable Viral Suppression (DVS) Among Criminal Justice-involved (CJI) Black Men Living with HIV in Louisiana

“…The majority of enrolled CJI Black male participants were BMSM with limited education, income, and health insurance which is consistent with the literature on the impact of incarceration among BMSM and low socio-economic and health insurance status among CJI populations in the United States (14,(19)(20)(21). Overall, the current study found that the majority of CJI Black male participants reported low levels of stigma, high levels of social support, and minimal depressive symptoms.…”

“…Participants may be unsure about and/or are still assessing their current HIV care barriers at enrollment. The majority of participants did not report any drug use in the last month which is contrary to previous studies which have shown higher levels of drug use among CJI BMSM populations prior to and post incarceration (14,20,44). This is a high priority sample for HIV care and treatment interventions as most participants were not virally suppressed at baseline (56%) and had not achieved DVS (80%) over a 12-month period.…”

“…Post-release HIV care visits and medication adherence become challenging due to a variety of co-occurring factors including limited income, high levels of unemployment, HIV stigma, mental health issues, and relapse to drug and alcohol use (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). Such barriers have also been noted among CJI Black men who have sex with men (BMSM) living with HIV infection (13,14).…”

HIV treatment cascade in MSM, people who inject drugs, and sex workers

“…Care cascade reports were available from the United States[49,50*,53,54,76,77]; Canada[51*]; the United Kingdom[55]; Nigeria[58]; Burkina Faso and Togo[56]; Russia[57]; and India[52]. MSM living with HIV in Burkina Faso and Togo, Russia, and India had alarmingly low levels of status awareness (18, 20 and 44%, respectively).…”

Implementation of a Socio-structural Demonstration Project to Improve HIV Outcomes Among Young Black Men in the Deep South

“…CBOs = community-based organizations High incarceration rates have also been documented among BMSM and persons living with HIV (PLWH) in the US [29][30][31][32][33][34][35]. For example, a six-city study of BMSM in the US found that 60% of participating BMSM reported a prior history of incarceration [30].…”