Most HIV-infected ex-prison inmates delay treatment

Galveston, Texas, February 25: Prisoners infected with HIVdefine often discontinue treatment after their release from the prison, reveals the latest research by the US researchers.

Due to lack of private or public health insurance cover, majority of prison inmates find difficulty in getting antiretroviral therapy to keep the virus in control. The researchers found that this increases the risk of virus becoming more infectious and resistant to drugs.

“Many inmates are offered HIVdefine testing for the first time while incarcerated, and three-quarters of inmates with HIV infection initiate treatment during incarceration,” said Dr. Jacques Baillargeon, the study’s lead author and an epidemiologist at the University of Texas Medical Branch at Galveston.

“Lengthy HIV treatment interruptions are troublesome from a public health perspective,” stated investigator Baillargeon.

“Many released inmates who discontinue therapy also resume high-risk behaviors, a combination that may result not only in poor clinical outcomes, but also in the creation of drug-resistant HIV reservoirs in the general community,” he added.

Published in Feb. 24 issue of the Journal of the American Medical Association, the report is the first to track HIV infected prisoners in Texas and other states, after their release to take care of them outside.

The researchers studied 2,115 HIV-infected inmates in the Texas Department of Criminal Justice prison system between January 2004 and December 2007. The findings revealed that just 5.4 percent filled their prescriptions within 10 days of release; 15.5 percent within a month; and only 30 percent within a period of two months of their release.

HIV prevalence in Texas prisons, the country's largest state system, was consistently 1.5 percent or higher during the four-year study period.

The research further indicated that at least 90 percent of the former inmates had experienced an interruption in their treatment, which lasted between 30 days to more than 60 days.

“These exceedingly high rates of treatment interruption suggest that most inmates face significant administrative, socioeconomic, or personal barriers to accessing antiretroviral therapy when they return to their communities,” researchers said.

“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 researchers maintained.

The researchers felt that the prison system has become ‘an important front’ to treat and prevent AIDS from spreading. Urging about the health of ex-prison inmates, the findings also point towards the need for the state intervention to prevent a possible public health crisis.

“Greater coordination between state and local agencies, health-care institutions, and community-based organizations is needed to reduce this high rate of treatment interruption among newly released inmates,” the researchers stated in the Journal.

HIV has affected nearly 33 million people across the world and has claimed 25 million lives.