Faculty of Health Sciences, Simon Fraser University, Blusson Hall Rm 10522, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
AIDS Behav. 2020 Apr;24(4):1212-1225. doi: 10.1007/s10461-019-02666-7.
Women living with HIV (WLWH) are over-represented in corrections in Canada, yet little is known about women's experiences post-release. We used CHIWOS cross-sectional data from WLWH to estimate associations between social determinants of health and HIV-related care outcomes among WLWH with recent (within past year) or ever (before past year) incarceration experience. Lifetime incarceration prevalence was 36.9% (6.5% recent; 30.4% ever), with significant differences by province of residence (British Columbia: 10% recent; 52% ever; Ontario: 5%; 24%; Quebec: 6%; 22%; p < 0.001). In adjusted multinomial logistic regression analyses, compared with never incarcerated, recent incarceration was associated with Indigenous ancestry, lower annual income (< $20,000 CAD), unstable housing, current sex work, injection drug use (IDU), and sub-optimal antiretroviral therapy (ART) adherence, while ever incarceration was associated with current sex work, IDU, and experiencing adulthood violence. Our findings have implications regarding supports needed by WLWH in the post-release period, including ART adherence and achieving health and social goals.
加拿大的监狱中存在大量 HIV 阳性女性（WLWH），但对于她们出狱后的经历却知之甚少。我们使用 CHIWOS 的横断面数据，调查了社会健康决定因素与近期（过去一年）或以往（过去一年前）监禁经历的 WLWH 的 HIV 相关护理结局之间的关系。终生监禁的患病率为 36.9%（6.5%为近期监禁；30.4%为以往监禁），不同省份的监禁率存在显著差异（不列颠哥伦比亚省：近期监禁率为 10%；以往监禁率为 52%；安大略省：5%；24%；魁北克省：6%；22%；p<0.001）。在调整后的多项逻辑回归分析中，与从未入狱者相比，近期入狱与原住民血统、年收入较低（<20,000 加元）、住房不稳定、当前性工作、注射吸毒（IDU）和抗逆转录病毒治疗（ART）依从性不佳有关，而以往入狱与当前性工作、IDU 和成年期经历暴力有关。我们的研究结果表明，在出狱后阶段，WLWH 需要得到支持，包括 ART 依从性和实现健康和社会目标。
