Interruptions in HIV therapy common in ex-inmates

Results of a new study show that major interruptions in HIV drug treatment occur after release from prison.

Within 60 days of release from prison, just 30 percent of HIV-infected inmates in the Texas Department of Criminal Justice system filled a prescription for antiretroviral drug therapy, researchers report in Wednesday's issue of the Journal of the American Medical Association.

Moreover, 90 percent or more of inmates did not fill a prescription soon enough to avoid an interruption in their antiretroviral therapy, according to the report.

"These remarkably high rates of lengthy HIV treatment interruptions are troublesome from a public health perspective," study investigator Dr. Jacques Baillargeon, from the University of Texas Medical Branch, Galveston, noted in a written statement.

"Several studies suggest that many released inmates who discontinue antiretroviral therapy also resume high-risk behaviors such as injection drug use or unsafe sex," Baillargeon added, "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 involved 2115 HIV-infected inmates who were receiving antiretroviral therapy prior to their release from prison between January 2004 and December 2007.

Just 5.4 percent of inmates filled an antiretroviral prescription within 10 days of release, the researchers found.

Hispanic and African American inmates were 60 percent less likely than white inmates to fill a prescription within 10 days, and 30 percent less likely to do so within 30 days.

"Adequately addressing a public health crisis of this scale and complexity will require carefully coordinated efforts between academic institutions, the criminal justice system, and public health agencies," the researchers conclude.

SOURCE: Journal of the American Medical Association, February 25, 2009.