Accessing antiretroviral therapy following release from prison

Jacques Baillargeon, Thomas P. Giordano, Josiah D. Rich, Z. Helen Wu, Katherine Wells, Brad H. Pollock, David P. Paar

Research output: Contribution to journalArticle

189 Citations (Scopus)

Abstract

Context: Interruption of antiretroviral therapy (ART) during the first weeks after release from prison may increase risk for adverse clinical outcomes, transmission of human immunodeficiency virus (HIV), and drug-resistant HIV reservoirs in the community. The extent to which HIV-infected inmates experience ART interruption following release from prison is unknown. Objectives: To determine the proportion of inmates who filled an ART prescription within 60 days after release from prison and to examine predictors of this outcome. Design, Setting, and Participants: Retrospective cohort study of all 2115 HIV-infected inmates released from the Texas Department of Criminal Justice prison system between January 2004 and December 2007 and who were receiving ART before release. Main Outcome Measure: Proportion of inmates who filled an ART prescription within 10, 30, and 60 days of release from prison. Results: Among the entire study cohort (N=2115), an initial prescription for ART was filled by 115 (5.4%) inmates within 10 days of release (95% confidence interval [CI], 4.5%-6.5%), by 375 (17.7%) within 30 days (95% CI, 16.2%-19.4%), and by 634 (30.0%) within 60 days (95% CI, 28.1%-32.0%). In a multivariate analysis of predictors (including sex, age, race/ethnicity, viral load, duration of ART, year of discharge, duration of incarceration, parole, and AIDS Drug Assistance Program application assistance), Hispanic and African American inmates were less likely to fill a prescription within 10 days (adjusted estimated risk ratio [RR], 0.4 [95% CI, 0.2-0.8] and 0.4 [95% CI, 0.3-0.7], respectively) and 30 days (adjusted estimated RR, 0.7 [95% CI, 0.5-0.9] and 0.7 [95% CI, 0.5-0.9]). Inmates with an undetectable viral load were more likely to fill a prescription within 10 days (adjusted estimated RR, 1.8 [95% CI, 1.2-2.7]), 30 days (1.5 [95% CI, 1.2-1.8]), and 60 days (1.3 [95% CI, 1.1-1.5]). Inmates released on parole were more likely to fill a prescription within 30 days (adjusted estimated RR, 1.3 [95% CI, 1.1-1.6]) and 60 days (1.5 [95% CI, 1.4-1.7]). Inmates who received assistance completing a Texas AIDS Drug Assistance Program application were more likely to fill a prescription within 10 days (adjusted estimated RR, 3.1 [95% CI, 2.0-4.9]), 30 days (1.8 [95% CI, 1.4-2.2]), and 60 days (1.3 [95% CI, 1.1-1.4]). Conclusion: Only a small percentage of Texas prison inmates receiving ART while incarcerated filled an initial ART prescription within 60 days of their release.

Original languageEnglish (US)
Pages (from-to)848-857
Number of pages10
JournalJAMA - Journal of the American Medical Association
Volume301
Issue number8
DOIs
StatePublished - Feb 25 2009

Fingerprint

Prisons
Confidence Intervals
Prescriptions
Therapeutics
Odds Ratio
HIV
Anti-HIV Agents
Viral Load
Cohort Studies
Criminal Law
Hispanic Americans
African Americans

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Baillargeon, J., Giordano, T. P., Rich, J. D., Wu, Z. H., Wells, K., Pollock, B. H., & Paar, D. P. (2009). Accessing antiretroviral therapy following release from prison. JAMA - Journal of the American Medical Association, 301(8), 848-857. https://doi.org/10.1001/jama.2009.202

Accessing antiretroviral therapy following release from prison. / Baillargeon, Jacques; Giordano, Thomas P.; Rich, Josiah D.; Wu, Z. Helen; Wells, Katherine; Pollock, Brad H.; Paar, David P.

In: JAMA - Journal of the American Medical Association, Vol. 301, No. 8, 25.02.2009, p. 848-857.

Research output: Contribution to journalArticle

Baillargeon, J, Giordano, TP, Rich, JD, Wu, ZH, Wells, K, Pollock, BH & Paar, DP 2009, 'Accessing antiretroviral therapy following release from prison', JAMA - Journal of the American Medical Association, vol. 301, no. 8, pp. 848-857. https://doi.org/10.1001/jama.2009.202
Baillargeon, Jacques ; Giordano, Thomas P. ; Rich, Josiah D. ; Wu, Z. Helen ; Wells, Katherine ; Pollock, Brad H. ; Paar, David P. / Accessing antiretroviral therapy following release from prison. In: JAMA - Journal of the American Medical Association. 2009 ; Vol. 301, No. 8. pp. 848-857.
@article{70df5d0936df44f18a94452d412ac210,
title = "Accessing antiretroviral therapy following release from prison",
abstract = "Context: Interruption of antiretroviral therapy (ART) during the first weeks after release from prison may increase risk for adverse clinical outcomes, transmission of human immunodeficiency virus (HIV), and drug-resistant HIV reservoirs in the community. The extent to which HIV-infected inmates experience ART interruption following release from prison is unknown. Objectives: To determine the proportion of inmates who filled an ART prescription within 60 days after release from prison and to examine predictors of this outcome. Design, Setting, and Participants: Retrospective cohort study of all 2115 HIV-infected inmates released from the Texas Department of Criminal Justice prison system between January 2004 and December 2007 and who were receiving ART before release. Main Outcome Measure: Proportion of inmates who filled an ART prescription within 10, 30, and 60 days of release from prison. Results: Among the entire study cohort (N=2115), an initial prescription for ART was filled by 115 (5.4{\%}) inmates within 10 days of release (95{\%} confidence interval [CI], 4.5{\%}-6.5{\%}), by 375 (17.7{\%}) within 30 days (95{\%} CI, 16.2{\%}-19.4{\%}), and by 634 (30.0{\%}) within 60 days (95{\%} CI, 28.1{\%}-32.0{\%}). In a multivariate analysis of predictors (including sex, age, race/ethnicity, viral load, duration of ART, year of discharge, duration of incarceration, parole, and AIDS Drug Assistance Program application assistance), Hispanic and African American inmates were less likely to fill a prescription within 10 days (adjusted estimated risk ratio [RR], 0.4 [95{\%} CI, 0.2-0.8] and 0.4 [95{\%} CI, 0.3-0.7], respectively) and 30 days (adjusted estimated RR, 0.7 [95{\%} CI, 0.5-0.9] and 0.7 [95{\%} CI, 0.5-0.9]). Inmates with an undetectable viral load were more likely to fill a prescription within 10 days (adjusted estimated RR, 1.8 [95{\%} CI, 1.2-2.7]), 30 days (1.5 [95{\%} CI, 1.2-1.8]), and 60 days (1.3 [95{\%} CI, 1.1-1.5]). Inmates released on parole were more likely to fill a prescription within 30 days (adjusted estimated RR, 1.3 [95{\%} CI, 1.1-1.6]) and 60 days (1.5 [95{\%} CI, 1.4-1.7]). Inmates who received assistance completing a Texas AIDS Drug Assistance Program application were more likely to fill a prescription within 10 days (adjusted estimated RR, 3.1 [95{\%} CI, 2.0-4.9]), 30 days (1.8 [95{\%} CI, 1.4-2.2]), and 60 days (1.3 [95{\%} CI, 1.1-1.4]). Conclusion: Only a small percentage of Texas prison inmates receiving ART while incarcerated filled an initial ART prescription within 60 days of their release.",
author = "Jacques Baillargeon and Giordano, {Thomas P.} and Rich, {Josiah D.} and Wu, {Z. Helen} and Katherine Wells and Pollock, {Brad H.} and Paar, {David P.}",
year = "2009",
month = "2",
day = "25",
doi = "10.1001/jama.2009.202",
language = "English (US)",
volume = "301",
pages = "848--857",
journal = "JAMA - Journal of the American Medical Association",
issn = "0002-9955",
publisher = "American Medical Association",
number = "8",

}

TY - JOUR

T1 - Accessing antiretroviral therapy following release from prison

AU - Baillargeon, Jacques

AU - Giordano, Thomas P.

AU - Rich, Josiah D.

AU - Wu, Z. Helen

AU - Wells, Katherine

AU - Pollock, Brad H.

AU - Paar, David P.

PY - 2009/2/25

Y1 - 2009/2/25

N2 - Context: Interruption of antiretroviral therapy (ART) during the first weeks after release from prison may increase risk for adverse clinical outcomes, transmission of human immunodeficiency virus (HIV), and drug-resistant HIV reservoirs in the community. The extent to which HIV-infected inmates experience ART interruption following release from prison is unknown. Objectives: To determine the proportion of inmates who filled an ART prescription within 60 days after release from prison and to examine predictors of this outcome. Design, Setting, and Participants: Retrospective cohort study of all 2115 HIV-infected inmates released from the Texas Department of Criminal Justice prison system between January 2004 and December 2007 and who were receiving ART before release. Main Outcome Measure: Proportion of inmates who filled an ART prescription within 10, 30, and 60 days of release from prison. Results: Among the entire study cohort (N=2115), an initial prescription for ART was filled by 115 (5.4%) inmates within 10 days of release (95% confidence interval [CI], 4.5%-6.5%), by 375 (17.7%) within 30 days (95% CI, 16.2%-19.4%), and by 634 (30.0%) within 60 days (95% CI, 28.1%-32.0%). In a multivariate analysis of predictors (including sex, age, race/ethnicity, viral load, duration of ART, year of discharge, duration of incarceration, parole, and AIDS Drug Assistance Program application assistance), Hispanic and African American inmates were less likely to fill a prescription within 10 days (adjusted estimated risk ratio [RR], 0.4 [95% CI, 0.2-0.8] and 0.4 [95% CI, 0.3-0.7], respectively) and 30 days (adjusted estimated RR, 0.7 [95% CI, 0.5-0.9] and 0.7 [95% CI, 0.5-0.9]). Inmates with an undetectable viral load were more likely to fill a prescription within 10 days (adjusted estimated RR, 1.8 [95% CI, 1.2-2.7]), 30 days (1.5 [95% CI, 1.2-1.8]), and 60 days (1.3 [95% CI, 1.1-1.5]). Inmates released on parole were more likely to fill a prescription within 30 days (adjusted estimated RR, 1.3 [95% CI, 1.1-1.6]) and 60 days (1.5 [95% CI, 1.4-1.7]). Inmates who received assistance completing a Texas AIDS Drug Assistance Program application were more likely to fill a prescription within 10 days (adjusted estimated RR, 3.1 [95% CI, 2.0-4.9]), 30 days (1.8 [95% CI, 1.4-2.2]), and 60 days (1.3 [95% CI, 1.1-1.4]). Conclusion: Only a small percentage of Texas prison inmates receiving ART while incarcerated filled an initial ART prescription within 60 days of their release.

AB - Context: Interruption of antiretroviral therapy (ART) during the first weeks after release from prison may increase risk for adverse clinical outcomes, transmission of human immunodeficiency virus (HIV), and drug-resistant HIV reservoirs in the community. The extent to which HIV-infected inmates experience ART interruption following release from prison is unknown. Objectives: To determine the proportion of inmates who filled an ART prescription within 60 days after release from prison and to examine predictors of this outcome. Design, Setting, and Participants: Retrospective cohort study of all 2115 HIV-infected inmates released from the Texas Department of Criminal Justice prison system between January 2004 and December 2007 and who were receiving ART before release. Main Outcome Measure: Proportion of inmates who filled an ART prescription within 10, 30, and 60 days of release from prison. Results: Among the entire study cohort (N=2115), an initial prescription for ART was filled by 115 (5.4%) inmates within 10 days of release (95% confidence interval [CI], 4.5%-6.5%), by 375 (17.7%) within 30 days (95% CI, 16.2%-19.4%), and by 634 (30.0%) within 60 days (95% CI, 28.1%-32.0%). In a multivariate analysis of predictors (including sex, age, race/ethnicity, viral load, duration of ART, year of discharge, duration of incarceration, parole, and AIDS Drug Assistance Program application assistance), Hispanic and African American inmates were less likely to fill a prescription within 10 days (adjusted estimated risk ratio [RR], 0.4 [95% CI, 0.2-0.8] and 0.4 [95% CI, 0.3-0.7], respectively) and 30 days (adjusted estimated RR, 0.7 [95% CI, 0.5-0.9] and 0.7 [95% CI, 0.5-0.9]). Inmates with an undetectable viral load were more likely to fill a prescription within 10 days (adjusted estimated RR, 1.8 [95% CI, 1.2-2.7]), 30 days (1.5 [95% CI, 1.2-1.8]), and 60 days (1.3 [95% CI, 1.1-1.5]). Inmates released on parole were more likely to fill a prescription within 30 days (adjusted estimated RR, 1.3 [95% CI, 1.1-1.6]) and 60 days (1.5 [95% CI, 1.4-1.7]). Inmates who received assistance completing a Texas AIDS Drug Assistance Program application were more likely to fill a prescription within 10 days (adjusted estimated RR, 3.1 [95% CI, 2.0-4.9]), 30 days (1.8 [95% CI, 1.4-2.2]), and 60 days (1.3 [95% CI, 1.1-1.4]). Conclusion: Only a small percentage of Texas prison inmates receiving ART while incarcerated filled an initial ART prescription within 60 days of their release.

UR - http://www.scopus.com/inward/record.url?scp=61449162171&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=61449162171&partnerID=8YFLogxK

U2 - 10.1001/jama.2009.202

DO - 10.1001/jama.2009.202

M3 - Article

C2 - 19244192

AN - SCOPUS:61449162171

VL - 301

SP - 848

EP - 857

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0002-9955

IS - 8

ER -