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HIV Care After Jail: Low Rates of Engagement in a Vulnerable Population

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Abstract

The criminal justice system is a critical area of focus to improve HIV outcomes and reduce health disparities. We analyzed demographic, incarceration, socioeconomic, and clinical data for HIV-positive persons released to the community from the Dallas County Jail (1450 incarcerations, 1111 unique individuals) between January 2011 and November 2013. The study population was 68% black and 14% Hispanic; overall linkage to care within 90 days of release was 34%. In adjusted analyses, Hispanics were more likely to link than whites (aOR 2.33 [95% CI: 1.55–3.50]), and blacks were as likely to link as whites (aOR 1.14 [95% CI: 0.84–1.56]). The majority of HIV-positive jail releases did not re-engage in HIV care after release, though Hispanics were twice as likely as other groups to link to care. Further efforts are needed to improve the transition from jail to community HIV care with particular attention to issues of housing, mental illness, and substance use.

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Acknowledgements

The investigators were supported by the following grants from the National Institutes of Health: R01 DA030778 (J.R.), K24 DA022122 (J.R.), T32 DA013911 (Y.T.), K23 AI112477 (A.N.), P30 AI042583, CTSA UL1-RR024982.

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Authors and Affiliations

  1. Department of Internal Medicine, Boston Medical Center, Boston, MA, USA

    Benjamin Ammon

  2. Department of Internal Medicine, Division of Infectious Diseases, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9169, USA

    Princess Iroh & Ank E. Nijhawan

  3. Tyler School of Public Health, University of Texas, UT Health Northeast, Tyler, TX, USA

    Yordanos Tiruneh

  4. Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Xilong Li

  5. Department of Internal Medicine, Division of Infectious Diseases, University of Colorado School of Medicine, Aurora, CO, USA

    Brian T. Montague

  6. Department of Medicine and Epidemiology, Brown University, Providence, RI, USA

    Josiah D. Rich

  7. Center for Prisoner Health and Human Rights, The Miriam Hospital, Providence, RI, USA

    Josiah D. Rich

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  1. Benjamin Ammon
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  2. Princess Iroh
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  7. Ank E. Nijhawan
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Corresponding author

Correspondence to Ank E. Nijhawan.

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Ammon, B., Iroh, P., Tiruneh, Y. et al. HIV Care After Jail: Low Rates of Engagement in a Vulnerable Population. J Urban Health 95, 488–498 (2018). https://doi.org/10.1007/s11524-018-0231-0

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  • DOI: https://doi.org/10.1007/s11524-018-0231-0

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