Article

Harzke AJ, Ross MW, Scott DP. Predictors of postrelease primary care utilization among HIV-positive prison inmates: a pilot study

WHO Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, 77030, USA.
AIDS Care (Impact Factor: 1.6). 06/2006; 18(4):290-301. DOI: 10.1080/09540120500161892
Source: PubMed

ABSTRACT The primary aims of this exploratory pilot study were (1) to determine the proportion of a sample of HIV-positive inmates utilizing primary care after recent release, and (2) to identify variables associated with utilization of primary care at the time of a post-release interview. Sixty HIV-positive, male and female state prison inmates were interviewed approximately three months prior to release, and 30 were interviewed again between seven and 21 days after release. Variables associated with having utilized primary care at the time of a post-release interview (chi(2) p-values < 0.20) included: taking anti-HIV medications at the time of release, no alcohol use since release, living in the same place as before incarceration and rating of housing situation as 'comfortable' or 'very comfortable'. For exploratory purposes, these variables were entered into a logistic regression model. The model correctly classified 80% of cases overall. Future studies are required to ascertain whether these results would obtain with a statistically adequate sample size.

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    • "For HIV-infected inmates leaving prison, continuity of HIV care is only part of community reentry (Rich et al., 2011). Most returning inmates face numerous reintegration challenges, including financial burdens and disorganized lifestyles , such as homelessness, poverty, mental illness, substance abuse, lack of medical coverage, unemployment, inadequate social support, and physical health issues (Baillargeon et al., 2009; Harzke, Ross, & Scott, 2006; Keuroghlian et al., 2011; Mellins, Kang, Leu, Havens, & Chesney, 2003; Springer, Azar, & Altice, 2011). These challenges often present conflicting demands, and priorities often shift depending on immediate needs. "
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    • "Studies have found that 26 % of HIV-infected inmates reported unprotected sexual activity within 45 days after release (Stephenson et al., 2006). Forty percent of HIV-infected prison releasees had not accessed medical care by six weeks post-release (Harzke, Ross, and Scott, 2006) and decreased CD4 lymphocyte counts and increased plasma HIV RNA levels are common in releasees (Spring, et al., 2004; Stephenson et al., 2005). Depression has been linked to disease progression in HIV-infected individuals, probably through multiple mechanisms, including poor medication adherence and risky sexual behaviors, however depressive symptoms have been found to be linked to disease progression even after controlling for medication adherence and clinical and demographic factors (Boarts, Sledjeski, Bogart, and Delahanty, 2006; Evans et al., 2002; Ickovics et al., 2001; Lima et al., 2007; Olatunji, Mimiaga, O'Cleirigh, and Safren, 2006; Perdue, Hagan, Thiede, and Valleroy, 2003; Reynolds et al., 2004; Vanable, Carey, Blair, and Littlewood, 2006). "
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    ABSTRACT: High rates of both HIV and depression are seen in prison populations; depression has been linked to disease progression in HIV, risky behaviors, and medication non-adherence. Despite this, few studies have examined HIV-infected inmates with depression. We therefore conducted an exploratory study of a sample of HIV-infected inmates in North Carolina prisons (N=101) to determine what proportion of this sample screened positive for depression and whether depression was associated with different pre-incarceration characteristics or post-release needs. A high proportion of HIV infected inmates (44.5%) screened positive for depression. Depressed inmates were significantly more likely have low coping self-efficacy scores (180 vs. 214), to report having had resource needs (OR=2.91) prior to incarceration and to anticipate needing income (OR=2.81), housing (OR=4.07), transportation (OR=9.15), and assistance with adherence (OR=8.67) post-release. We conclude by discussion the implications of our findings for prison based care and effective prison release planning for HIV infected inmates.
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    • "Studies have found that 26 % of HIV-infected inmates reported unprotected sexual activity within 45 days after release (Stephenson et al., 2006). Forty percent of HIV-infected prison releasees had not accessed medical care by six weeks post-release (Harzke, Ross, and Scott, 2006) and decreased CD4 lymphocyte counts and increased plasma HIV RNA levels are common in releasees (Spring, et al., 2004; Stephenson et al., 2005). Depression has been linked to disease progression in HIV-infected individuals, probably through multiple mechanisms, including poor medication adherence and risky sexual behaviors, however depressive symptoms have been found to be linked to disease progression even after controlling for medication adherence and clinical and demographic factors (Boarts, Sledjeski, Bogart, and Delahanty, 2006; Evans et al., 2002; Ickovics et al., 2001; Lima et al., 2007; Olatunji, Mimiaga, O'Cleirigh, and Safren, 2006; Perdue, Hagan, Thiede, and Valleroy, 2003; Reynolds et al., 2004; Vanable, Carey, Blair, and Littlewood, 2006). "
    [Show abstract] [Hide abstract]
    ABSTRACT: High rates of both HIV and depression are seen in prison populations; depression has been linked to disease progression in HIV, risky behaviors, and medication non-adherence. Despite this, few studies have examined HIV-infected inmates with depression. We therefore conducted an exploratory study of a sample of HIV-infected inmates in North Carolina prisons (N = 101) to determine what proportion of this sample screened positive for depression and whether depression was associated with different pre-incarceration characteristics or post-release needs. A high proportion of HIV infected inmates (44.5%) screened positive for depression. Depressed inmates were significantly more likely have low coping self-efficacy scores (180 vs. 214), to report having had resource needs (OR = 2.91) prior to incarceration and to anticipate needing income (OR = 2.81), housing (OR = 4.07), transportation (OR = 9.15), and assistance with adherence (OR = 8.67) post-release. We conclude by discussion the implications of our findings for prison based care and effective prison release planning for HIV infected inmates.
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