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Effect of Release from Prison and Re-Incarceration on the Viral Loads of HIV-Infected Individuals

2005; SAGE Publishing; Volume: 120; Issue: 1 Linguagem: Inglês

10.1177/003335490512000114

1468-2877

Becky Stephenson, David A. Wohl, Carol E. Golin, Hsiao‐Chuan Tien, Paul W. Stewart, Andrew H. Kaplan,

HIV, Drug Use, Sexual Risk

Objectives. The purpose of this study was to determine the effect of release from prison and subsequent re-incarceration on the viral loads of HIV-infected individuals receiving highly active antiretroviral therapy (HAART). Methods. Fifteen re-incarcerated HIV-infected prisoners on HAART were identified from a retrospective cohort of HIV-infected prison inmates released from January 1, 1997, to August 31, 1999. The re-incarcerated prisoners were matched (1:2) to 30 HIV-infected incarcerated prisoners on HAART who remained incarcerated during the re-incarcerated participants' release time period. The outcomes measured were plasma HIV RNA levels, CD4 + lymphocyte counts, percentage of re-incarcerated and incarcerated participants with plasma HIV RNA levels <400 copies/mL, and the median change in plasma HIV RNA levels of the re-incarcerated and incarcerated participants at the end of the study. Results. At the beginning of the study, 8/15 re-incarcerated participants had plasma HIV RNA levels <400 copies/mL, compared with 15/30 incarcerated participants. At the end of the study, only three of those eight re-incarcerated participants had plasma HIV RNA levels <400 copies/mL, compared with 14/15 incarcerated participants ( p=0.0086). The median change in plasma HIV RNA levels of the re-incarcerated participants was 1.29 log 10 copies/mL (interquartile range 0.04 to 1.70), compared with −0.03 log 10 copies/mL (interquartile range −0.65 to 0.09) in the incarcerated participants ( p=0.0183). Conclusions. Release from prison was associated with a deleterious effect on virological and immunological outcomes. These data suggest that comprehensive discharge planning efforts are required to make certain that HIV-infected inmates receive access to quality care following incarceration.