AIDS Program, Yale University School of Medicine, 135 College Street, Suite 323, New Haven, CT, 06510, USA,
AIDS Behav. 2013 Oct;17 Suppl 2(0 2):S156-70. doi: 10.1007/s10461-012-0372-1.
Retention in care is key to effective HIV treatment, but half of PLWHA in the US 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.
患者坚持治疗是艾滋病治疗取得成效的关键,但美国仍有一半的艾滋病病毒感染者不能持续参与治疗。在押人员是一个难以留住的特殊群体,而且缺乏针对被监禁者的经验数据。我们前瞻性地评估了在参与 10 个地点示范项目的 867 名感染艾滋病毒的被监禁者中坚持治疗的相关因素。在出狱后的 6 个月内,每季度都到诊所就诊被定义为持续坚持治疗。以下因素与坚持治疗独立相关:男性(AOR=2.10,p≤0.01)、海洛因使用(AOR=1.49,p=0.04)、有艾滋病病毒提供者(AOR=1.67,p=0.02),以及在监禁期间获得服务:出院计划(AOR=1.50,p=0.02)和疾病管理课程(AOR=2.25,p≤0.01);在出狱后获得需求评估(AOR=1.59,p=0.02)、艾滋病教育(AOR=2.03,p≤0.01)和交通援助(AOR=1.54,p=0.02)。在出狱后提供教育和病例管理服务可以提高艾滋病病毒感染者坚持治疗的比例。