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Contribution of Substance Use Disorders on HIV Treatment Outcomes and Antiretroviral Medication Adherence Among HIV-Infected Persons Entering Jail

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Abstract

HIV and substance use are inextricably intertwined. One-sixth of people living with HIV/AIDS (PLWHA) transition through the correctional system annually. There is paucity of evidence on the impact of substance use disorders on HIV treatment engagement among jail detainees. We examined correlates of HIV treatment in the largest sample of PLWHA transitioning through jail in 10 US sites from 2007 to 2011. Cocaine, alcohol, cannabis, and heroin were the most commonly used substances. Drug use severity was negatively and independently correlated with three outcomes just before incarceration: (1) having an HIV care provider (AOR = 0.28; 95 % CI 0.09–0.89); (2) being prescribed antiretroviral therapy (AOR = 0.12; 95 % CI 0.04–0.35) and (3) high levels (>95 %) of antiretroviral medication adherence (AOR = 0.18; 95 % CI 0.05–0.62). Demographic, medical and psychiatric comorbidity, and social factors also contributed to poor outcomes. Evidence-based drug treatments that include multi-faceted interventions, including medication-assisted therapies, are urgently needed to effectively engage this vulnerable population.

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Acknowledgments

Funding from this Grant was provided by the Health Resources and Services Agency for the 10-site demonstration and by the National Institutes on Drug Abuse for career development (K24 DA017072) for Frederick L. Altice.

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Authors and Affiliations

  1. Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, 135 College Street, Suite 323, New Haven, CT, 06510-2283, USA

    Ehsan Chitsaz, Jaimie P. Meyer, Archana Krishnan, Sandra A. Springer, Ruthanne Marcus & Frederick L. Altice

  2. Brown University School of Medicine, Providence, RI, USA

    Nick Zaller & Timothy P. Flanigan

  3. New York City Department of Health and Mental Hygiene, Correctional Health Services, New York, NY, USA

    Alison O. Jordan

  4. Baystate Medical Center, Springfield, MA, USA

    Thomas Lincoln

  5. AID Atlanta, Atlanta, GA, USA

    Jeff Porterfield

  6. Division of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT, USA

    Frederick L. Altice

Authors
  1. Ehsan Chitsaz
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  2. Jaimie P. Meyer
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  3. Archana Krishnan
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  4. Sandra A. Springer
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  5. Ruthanne Marcus
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  6. Nick Zaller
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  7. Alison O. Jordan
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  8. Thomas Lincoln
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  9. Timothy P. Flanigan
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  10. Jeff Porterfield
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  11. Frederick L. Altice
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Correspondence to Frederick L. Altice.

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Chitsaz, E., Meyer, J.P., Krishnan, A. et al. Contribution of Substance Use Disorders on HIV Treatment Outcomes and Antiretroviral Medication Adherence Among HIV-Infected Persons Entering Jail. AIDS Behav 17 (Suppl 2), 118–127 (2013). https://doi.org/10.1007/s10461-013-0506-0

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  • DOI: https://doi.org/10.1007/s10461-013-0506-0

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