Huber Florence, Vandentorren Stephanie, Merceron Alice, Chaponnay Amandine, Gadio Gueda, About Vincent, Pastre Agathe, Nacher Mathieu
1 COREVIH Guyane, Centre Hospitalier André Rosemon, Cayenne, France.
2 Reseau Kikiwi, Cayenne, France.
Int J STD AIDS. 2019 Apr;30(5):460-466. doi: 10.1177/0956462418816452. Epub 2019 Jan 10.
In French Guiana, 4.5-5.0% of HIV-infected persons experienced an incarceration between 2007 and 2013. A cross-sectional survey was performed to describe the epidemiology and treatment outcomes of a population of HIV-infected inmates in French Guiana. The study population was patients released between 1/2007 and 12/2013, after >30 days of incarceration (n = 147). A secondary objective aimed to identify its main specificities, relative to both the general inmate population and the nonincarcerated HIV population. The socioeconomic situation of HIV-infected inmates was particularly precarious, relative to other detainees: 58.1% had never attended school (versus 5.5%, p < 0.01), 31.0% were homeless (versus 8.5%, p < 0.01), 63.9% were repeat offenders (versus 46.6%, p < 0.01), 33.3% were crack cocaine users (versus 9.8-12%, p < 0.01). The frequency of hypertension and chronic B hepatitis was also higher. Only 50.3% of inmates were on antiretroviral therapy (ART) versus 92.6% in the hospital HIV population (p < 0.001). Among untreated patients, 15.1% refused ART. Among those treated, 81.3% were virologically suppressed. Although comparisons were biased, HIV-positive inmates had more psychosocial vulnerabilities than the general inmate population. Despite ART availability and excellent treatment outcomes, undertreatment was a fact not completely explained by patient refusal. HIV-infected inmates should benefit from increased attention by health care and social workers.
在法属圭亚那，2007年至2013年期间，4.5%至5.0%的艾滋病毒感染者曾被监禁。开展了一项横断面调查，以描述法属圭亚那艾滋病毒感染囚犯群体的流行病学情况和治疗结果。研究人群为2007年1月至2013年12月期间在监禁30天以上后获释的患者（n = 147）。次要目标是确定其相对于一般囚犯群体和未被监禁的艾滋病毒感染者群体的主要特点。相对于其他被拘留者，艾滋病毒感染囚犯的社会经济状况尤其不稳定：58.1%从未上学（相比之下为5.5%，p < 0.01），31.0%无家可归（相比之下为8.5%，p < 0.01），63.9%是惯犯（相比之下为46.6%，p < 0.01），33.3%是快克可卡因使用者（相比之下为9.8%至12%，p < 0.01）。高血压和慢性乙型肝炎的发生率也更高。只有50.3%的囚犯接受抗逆转录病毒治疗（ART），而医院艾滋病毒感染者群体中的这一比例为92.6%（p < 0.001）。在未接受治疗的患者中，15.1%拒绝接受ART。在接受治疗的患者中，81.3%病毒学得到抑制。尽管比较存在偏差，但艾滋病毒阳性囚犯比一般囚犯群体有更多的心理社会脆弱性。尽管有ART可用且治疗效果良好，但治疗不足是一个未完全由患者拒绝所解释的事实。艾滋病毒感染囚犯应受益于医疗保健和社会工作者更多的关注。
