Report: HIV-Infected Inmates Stop Treatment After Release

GALVESTON, Texas — Most HIV-infected inmates who receive antiretroviral therapy while they are incarcerated do not continue treatment after their release, according to a study by the University of Texas Medical Branch.

The university’s four-year study tracked more than 2,000 inmates with HIV released from Texas Department of Criminal Justice prisons between January 2004 and December 2007, according to the study.

Only 18 percent of inmates filled a prescription for antiretroviral medications within 30 days of release and only 30 percent within 60 days of release, according to data kept by the Texas Department of State Health Services.

“These remarkably high rates of lengthy HIV treatment interruptions are troublesome from a public health perspective,” says Jacques Baillargeon, epidemiologist and lead author of the study.

“Several studies suggest that many released inmates who discontinue antiretroviral therapy also resume high-risk behaviors such as injection drug use or unsafe sex, and this combination may result not only in poor clinical outcomes for these individuals but also in the creation of drug-resistant HIV reservoirs in the general community.”

The study calls the prison system an important front in the fight to treat and control the spread of the virus because many infected people receive tests and treatment for the first time when they are incarcerated.

Infected inmates face many barriers for access to community-based care, which is contributing to the low-rate of continued treatment, according to Dr. David Paar, co-author and director of the clinical virology division of UTMB Correctional Managed Care.

“A solution to this problem will require carefully coordinated efforts between the criminal justice system, public health agencies and community healthcare systems,” Paar says.