Gender Disparities in HIV Treatment Outcomes Following Release From Jail: Results From a Multicenter Study

• Published in: American journal of public health (1971) 2014-03, Vol.104 (3), p.434-441
• Main Authors: MEYER, Jaimie P, ZELENEV, Alexei, WICKERSHAM, Jeffrey A, WILLIAMS, Chyvette T, TEIXEIRA, Paul A, ALTICE, Frederick L
• Format: Article
• Language: English
• Subjects: Access To Care; Acquired immune deficiency syndrome; Addictive behaviors; Adult; AIDS; Alcohol; Anti-Retroviral Agents - therapeutic use; Antiretroviral drugs; Behavior; Biological and medical sciences; Clinical outcomes; Cohort analysis; Community Health; Comorbidity; Confidence Intervals; Drug therapy; Drug use; Epidemics; Ethnicity; Female; Gender; Gender differences; General aspects; Healthcare Disparities; Heroin; HIV; HIV Infections - complications; HIV Infections - drug therapy; Hiv/Aids; Homeless people; Human immunodeficiency virus; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Imprisonment; Infectious diseases; Intervention; Male; Medical sciences; Mens health; Mental disorders; Middle Aged; Miscellaneous; Odds Ratio; Outcome Assessment (Health Care) - methods; Primary care; Prisoners; Prisons; Prospective Studies; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Recidivism; Research and Practice; Retention; Risk Factors; Sex Factors; Studies; Substance use disorder; Transgender persons; Urban Health; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Women; Women'S Health
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2013.301553

We assessed gender differences in longitudinal HIV treatment outcomes among HIV-infected jail detainees transitioning to the community. 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. 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. 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.