Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Office of the Director, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Public Health Rep. 2023 Jul-Aug;138(4):610-618. doi: 10.1177/00333549221106646. Epub 2022 Jul 16.
We examined sociodemographic, clinical, and behavioral factors associated with previous incarceration among people with diagnosed HIV to inform HIV care efforts for this population.
We used 2015-2017 data from a cross-sectional, nationally representative sample of US adults with diagnosed HIV (N = 11 739). We computed weighted percentages and 95% CIs to compare the characteristics of people with HIV incarcerated in the past 12 months (ie, recently) with people with HIV not recently incarcerated. We used adjusted prevalence ratios (aPRs) with predicted marginal means to examine associations between selected factors and incarceration status.
Adults with HIV who were recently incarcerated, when compared with those who were not, were more likely to be aged 18-29 years (prevalence ratio [PR] = 2.51), non-Hispanic Black (PR = 1.39), less educated (<high school diploma; PR = 1.41), unemployed (PR = 1.32), or living at or below the federal poverty level (PR = 1.64); to have recently experienced homelessness (PR = 4.56); and to have recently used drugs (PR = 1.68). Clinically, they were more likely to have been diagnosed with HIV in the past 5 years (aPR = 1.26), have lower CD4 counts (aPR = 1.45), have recently used the emergency department (aPR = 1.15), and have experienced severe anxiety (aPR = 1.50) and less likely to be retained in care, be recently virally suppressed, or have sustained viral suppression.
Among people with HIV, recent incarceration was associated with increased health risks and worse health outcomes. Pre- and postrelease linkage-to-care interventions and reentry services might improve the health of recently incarcerated people with HIV.
我们研究了与诊断为 HIV 的人群中既往监禁相关的社会人口学、临床和行为因素,以为该人群的 HIV 护理工作提供信息。
我们使用了来自 2015-2017 年美国成年人中诊断为 HIV 的代表性横断面全国性样本的数据(N=11739)。我们计算了加权百分比和 95%置信区间,以比较过去 12 个月(即最近)被监禁的 HIV 感染者和最近未被监禁的 HIV 感染者的特征。我们使用调整后的患病率比(aPR)和预测边际均值来检查选定因素与监禁状况之间的关联。
与未被监禁的 HIV 感染者相比,最近被监禁的 HIV 感染者更可能年龄在 18-29 岁(患病率比 [PR]=2.51),非西班牙裔黑人(PR=1.39),受教育程度较低(<高中文凭;PR=1.41),失业(PR=1.32)或生活在或低于联邦贫困线(PR=1.64);最近经历过无家可归(PR=4.56);最近使用过毒品(PR=1.68)。从临床角度来看,他们更可能在过去 5 年内被诊断出患有 HIV(aPR=1.26),CD4 计数较低(aPR=1.45),最近使用过急诊室(aPR=1.15),并且经历过严重的焦虑(aPR=1.50),不太可能被保留在护理中,最近病毒得到抑制或持续病毒抑制。
在 HIV 感染者中,最近被监禁与健康风险增加和健康结果恶化相关。在释放前和释放后的链接护理干预措施和重新融入服务可能会改善最近被监禁的 HIV 感染者的健康状况。