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1310. The Impact of Recent Incarceration on Post-Release HIV Linkage to Care and Risk-Taking Behaviors in the Setting of Enhanced Linkage to Care Policies in Florida

BACKGROUND: The United States has the largest incarcerated population in the world with 6.61 million adults in 2016.(1) While incarceration is a known risk factor for difficulties in linkage to care(2–3) and adverse health outcomes(4–6), little is published on post-release incarcerated persons livin...

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Detalles Bibliográficos
Autores principales: Teo, Greg Matthew E, Nagaraj, Suraj, Sunku, Nisha, Aslam, Sadaf, Mhaskar, Rahul, Chen, Liwei, Zhou, Zhi, Cook, Robert L, Morano, Jamie P, Somboonwit, Charurut
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6808731/
http://dx.doi.org/10.1093/ofid/ofz360.1173
Descripción
Sumario:BACKGROUND: The United States has the largest incarcerated population in the world with 6.61 million adults in 2016.(1) While incarceration is a known risk factor for difficulties in linkage to care(2–3) and adverse health outcomes(4–6), little is published on post-release incarcerated persons living with HIV (PLWH) in Florida. METHODS: Data were acquired from the Florida Cohort, an ongoing, longitudinal, cross-sectional study of PLWH recruited across HIV clinics in the state of Florida, from 2014 to 2018. Chi-square and multiple regression analyses correlated recent incarceration (within last 12 months) with demographics, HIV care adherence, perceived barriers to care, and self-reported high-risk behaviors. RESULTS: Of 936 participants, 6.4% (n = 60) reported recent incarceration within the last 12 months. Those recently incarcerated were more likely to report missing at least one appointment in the last 6 months (46.7% vs. 22.2%; P < 0.0001), to have an excessively long travel time ( >60 minutes) to a HIV provider (34.5% vs. 16.6%, P = 0.002; OR 2.66 [95% CI: 1.20–5.92]), and to lack reliable transportation (70% vs. 47.5%, P = 0.0007; OR 1.70 [95% CI: 0.82–3.52]) Those not recently incarcerated reported having completed a high school education (OR: 0.69 [95% CI: 0.5–0.97]) and stated they “never missed an appointment” (OR: 0.42 [95% CI: 0.22–0.81]). Recently incarcerated PLWH also had higher occurrence of high-risk behaviors such as receiving (40.4% vs. 8.7%; P = 0.001) or providing (30.4% vs. 10.4%; P = 0.000) money or drugs for sex, having used IV drugs (15% vs. 4%; P = 0.001), and not using condoms during exchange of drugs for sex (OR: 9.43 [95% CI: 3.78–23.52]). CONCLUSION: Recently incarcerated PLWH continue to have significant geographical and logistical barriers to care and self-report more high-risk behaviors than nonincarcerated peers. Enhanced case management and telehealth services may be useful in linkage to care when PLWH transition from correctional to community healthcare systems in the Florida setting. [Image: see text] [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.