HIV outcomes at a Canadian remand centre
International Journal of Prisoner Health
ISSN: 1744-9200
Article publication date: 12 September 2016
Issue publication date: 12 September 2016
Abstract
Purpose
The purpose of this paper is to assess the impact of short-term incarceration on antiretroviral therapy (ART) adherence, virologic suppression, and engagement and retention in community care post-release.
Design/methodology/approach
A retrospective chart review of patients who attended the human immunodeficiency virus (HIV) Outreach Clinic at a Canadian remand center between September 2007 and December 2011 was carried out. Data extraction included CD4 lymphocyte count, HIV viral load, ART prescription refills, and community engagement and retention during and one-year pre- and post-incarceration.
Findings
Outpatient engagement increased by 23 percent (p=0.01), as did ART adherence (55.2-70.7 percent, p=0.01), following incarceration. Retention into community care did not significantly improve following incarceration (22.4 percent pre-incarceration to 25.9 percent post-release, p=0.8). There was a trend toward improved virologic suppression (less than 40 copies/ml; 50-77.8 percent (p=0.08)) during incarceration and 70. 4 percent sustained this one-year post-incarceration (p=0.70).
Originality/value
The impact of short-term incarceration in a Canadian context of universal health coverage has not been previously reported and could have significant implications in optimizing HIV patient outcomes given the large number of HIV-positive patients cycling through short-term remand centers.
Keywords
Acknowledgements
The authors would like to acknowledge the significant clinical contributions and support of Kory Sloan, Domina Hoang, Jeff Mackowecki, Barbara Moreland, and Dr S. Houston. The authors would also like to acknowledge the support of Alberta Justice and Solicitor General in the implementation of this clinic.
Citation
Subramanian, Y., Khan, M.N., Berger, S., Foisy, M., Singh, A., Woods, D., Pyne, D. and Ahmed, R. (2016), "HIV outcomes at a Canadian remand centre", International Journal of Prisoner Health, Vol. 12 No. 3, pp. 145-156. https://doi.org/10.1108/IJPH-12-2015-0041
Publisher
:Emerald Group Publishing Limited
Copyright © 2016, Emerald Group Publishing Limited