Predictors of Reincarceration and Disease Progression Among Released HIV-Infected Inmates
Predictors of Reincarceration and Disease Progression Among Released HIV-Infected Inmates
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DOI：
10.1089/apc.2009.0303
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发表时间：
2010-06-01
影响因子：
4.9
通讯作者：
Paar, David P.
中科院分区：
文献类型：
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作者：
Baillargeon, Jacques;Giordano, Thomas P.;Paar, David P.
我们进行了一项回顾性队列研究，以确定2004年1月至2006年3月期间从德克萨斯州监狱系统释放的所有感染艾滋病毒的囚犯（n = 1917）的3年再监禁率。我们还分析了释放后HIV临床状态的变化，这些囚犯随后被重新监禁，在释放和重新监禁时，他们的电子医疗记录中记录了CD4淋巴细胞计数（n = 119）或血浆HIV RNA水平（n = 122）。进行多变量分析以评估再监禁的预测因素和HIV状态的临床变化。在所有感染艾滋病毒的囚犯中，只有20%在释放后3年内再次入狱。女性囚犯（风险比[HR] 0.63； 95%可信区间[CI]， 0.47, 0.84）和在释放时接受抗逆转录病毒治疗的囚犯（风险比0.31；95%可信区间，0.25,0.39）再次入狱的风险降低。非裔美国人（HR 1.58; 95% CI, 1.22, 2.05）、有严重精神障碍的囚犯（HR 1.82; 95% CI, 1.41, 2.34）和假释囚犯（HR 2.86; 95% CI, 2.31, 3.55）再次入狱的风险增加。再监禁囚犯的一个亚组的CD4细胞计数每微升平均减少79.4个淋巴细胞(p
We conducted a retrospective cohort study to determine the 3-year reincarceration rate of all HIV-infected inmates (n = 1917) released from the Texas prison system between January 2004 and March 2006. We also analyzed postrelease changes in HIV clinical status in the subgroup of inmates who were subsequently reincarcerated and had either CD4 lymphocyte counts (n = 119) or plasma HIV RNA levels (n = 122) recorded in their electronic medical record at both release and reincarceration. Multivariable analyses were performed to assess predictors of reincarceration and clinical changes in HIV status. Only 20% of all HIV-infected inmates were reincarcerated within 3 years of release. Female inmates (hazard ratio [HR] 0.63; 95% confidence interval [CI], 0.47, 0.84) and inmates taking antiretroviral therapy at the time of release (HR 0.31; 95% CI, 0.25, 0.39) were at decreased risk of reincarceration. African Americans (HR 1.58; 95% CI, 1.22, 2.05), inmates with a major psychiatric disorder (HR 1.82; 95% CI, 1.41, 2.34), and inmates released on parole (HR 2.86; 95% CI, 2.31, 3.55) were at increased risk of reincarceration. A subgroup of reincarcerated inmates had a mean decrease in CD4 cell count of 79.4 lymphocytes per microliter (p