Jaimie P Meyer1, Alexei Zelenev, Jeffrey A Wickersham, Chyvette T Williams, Paul A Teixeira, Frederick L Altice. 1. Jaimie P. Meyer, Alexei Zelenev, Jeffrey A. Wickersham, and Frederick L. Altice are with the AIDS Program, Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT. Jaimie P. Meyer is also with Chronic Disease Epidemiology, Yale University School of Public Health, New Haven. Chyvette T. Williams is with University of Illinois at Chicago School of Public Health. Paul A. Teixeira is with New York City Department of Health and Mental Hygiene, New York, NY. Frederick L. Altice is also with Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, and Centre of Excellence on Research in AIDS, University of Malaya, Kuala Lumpur, Malaysia.
Abstract
OBJECTIVES: We assessed gender differences in longitudinal HIV treatment outcomes among HIV-infected jail detainees transitioning to the community. METHODS: Data were from the largest multisite prospective cohort study of HIV-infected released jail detainees (n = 1270)-the Enhancing Linkages to HIV Primary Care and Services in Jail Setting Initiative, January 2008 and March 2011, which had 10 sites in 9 states. We assessed baseline and 6-month HIV treatment outcomes, stratifying by gender. RESULTS: Of 867 evaluable participants, 277 (31.9%) were women. Compared with men, women were more likely to be younger, non-Hispanic White, married, homeless, and depressed, but were similar in recent alcohol and heroin use. By 6 months postrelease, women were significantly less likely than men to experience optimal HIV treatment outcomes, including (1) retention in care (50% vs 63%), (2) antiretroviral therapy prescription (39% vs 58%) or optimal antiretroviral therapy adherence (28% vs 44%), and (3) viral suppression (18% vs 30%). In multiple logistic regression models, women were half as likely as men to achieve viral suppression. CONCLUSIONS: HIV-infected women transitioning from jail experience greater comorbidity and worse HIV treatment outcomes than men. Future interventions that transition people from jail to community-based HIV clinical care should be gender-specific.
OBJECTIVES: We assessed gender differences in longitudinal HIV treatment outcomes among HIV-infected jail detainees transitioning to the community. METHODS: Data were from the largest multisite prospective cohort study of HIV-infected released jail detainees (n = 1270)-the Enhancing Linkages to HIV Primary Care and Services in Jail Setting Initiative, January 2008 and March 2011, which had 10 sites in 9 states. We assessed baseline and 6-month HIV treatment outcomes, stratifying by gender. RESULTS: Of 867 evaluable participants, 277 (31.9%) were women. Compared with men, women were more likely to be younger, non-Hispanic White, married, homeless, and depressed, but were similar in recent alcohol and heroin use. By 6 months postrelease, women were significantly less likely than men to experience optimal HIV treatment outcomes, including (1) retention in care (50% vs 63%), (2) antiretroviral therapy prescription (39% vs 58%) or optimal antiretroviral therapy adherence (28% vs 44%), and (3) viral suppression (18% vs 30%). In multiple logistic regression models, women were half as likely as men to achieve viral suppression. CONCLUSIONS:HIV-infectedwomen transitioning from jail experience greater comorbidity and worse HIV treatment outcomes than men. Future interventions that transition people from jail to community-based HIV clinical care should be gender-specific.
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