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. 2023 Dec;27(12):3916-3926.
doi: 10.1007/s10461-023-04106-z. Epub 2023 Jun 12.

Examining Pre-Release Interventions on HIV Outcomes 12 Months After Release from Louisiana State Corrections

Olivia K Sugarman  1 , Deborah A Wendell  2   3 , Ashley B Wennerstrom  2   4 , Marcus A Bachhuber  4 , William T Robinson  2   3
Affiliations

Examining Pre-Release Interventions on HIV Outcomes 12 Months After Release from Louisiana State Corrections

Olivia K Sugarman et al. AIDS Behav. 2023 Dec.

Abstract

Louisiana has the highest proportion of people living with HIV (PLWH) in state prison custody. Linkage to care programs minimize odds of HIV care drop-off after release. Louisiana has two pre-release linkage to HIV care programs, one implemented through Louisiana Medicaid and another through the Office of Public Health. We conducted a retrospective cohort study of PLWH released from Louisiana corrections from January 1, 2017 to December 31, 2019. We compared HIV care continuum outcomes within 12 months after release between intervention groups (received any vs. no intervention) using two proportion z-tests and multivariable logistic regression. Of 681 people, 389 (57.1%) were not released from a state prison facility and thus not eligible to receive interventions, 252 (37%) received any intervention, and 228 (33.5%) achieved viral suppression. Linkage to care within 30 days was significantly higher in people who received any intervention (v. no intervention, p = .0142). Receiving any intervention was associated with higher odds of attaining all continuum steps, though only significantly for linkage to care (AOR = 1.592, p = .0083). We also found differences in outcomes by sex, race, age, urbanicity of the return parish (county), and Medicaid enrollment between intervention groups. Receiving any intervention increased the odds of achieving HIV care outcomes, and was significantly impactful at improving care linkage. Interventions must be improved to enhance long-term post-release HIV care continuity and eliminate disparities in care outcomes.

Keywords: HIV; Incarceration; Medicaid; Prison; Ryan White.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Population flow charts, overall population (a) and continuum subcohort (b)
Fig. 2
Fig. 2
HIV care continuum of PLWH released from Louisiana state prison custody by year-end 2020, by intervention group (n = 650) *p < .05
See this image and copyright information in PMC

References

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    1. United States Census Bureau. QuickFacts: Louisiana [Internet]. census.gov. 2019 [cited 2021 Apr 17]. Available from: https://www.census.gov/quickfacts/LA.
    1. Supreme Court of the United States. Estelle v. Gamble, 429 U.S. 97. Library of Congress; 1976.

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