Gender disparities in HIV treatment outcomes following release from jail: results from a multicenter study.
Gender disparities in HIV treatment outcomes following release from jail: results from a multicenter study.
复制标题
DOI：
10.2105/ajph.2013.301553
复制
发表时间：
2014-03
影响因子：
12.7
通讯作者：
Altice FL
中科院分区：
文献类型：
--
作者：
Meyer JP;Zelenev A;Wickersham JA;Williams CT;Teixeira PA;Altice FL
我们评估了过渡到社区的艾滋病毒感染监狱在押人员纵向艾滋病毒治疗结果的性别差异。数据来自2008年1月和2011年3月在9个州有10个地点的关于艾滋病毒感染者获释监狱被拘留者的最大多地点前瞻性队列研究(n=1270)--加强与监狱环境中艾滋病毒初级护理和服务的联系倡议。我们评估了基线和6个月的HIV治疗结果，按性别分层。在867名可评估参与者中，277名(31.9%)为女性。与男性相比，女性更有可能是年轻、非西班牙裔白人、已婚、无家可归和抑郁，但最近酒精和海洛因的使用情况相似。到6个月后，女性经历最佳艾滋病毒治疗结果的可能性明显低于男性，包括(1)保留在护理中(50%比63%)，(2)抗逆转录病毒治疗处方(39%比58%)或最佳抗逆转录病毒治疗依从性(28%比44%)，以及(3)病毒抑制(18%比30%)。在多个Logistic回归模型中，女性实现病毒抑制的可能性是男性的一半。与男性相比，从监狱过渡过来的艾滋病毒感染妇女有更大的共病和更糟糕的艾滋病毒治疗结果。未来将人们从监狱转移到以社区为基础的艾滋病毒临床护理的干预措施应该是针对性别的。
We assessed gender differences in longitudinal HIV treatment outcomes among HIV-infected jail detainees transitioning to the community. Data were from the largest multisite prospective cohort study of HIV-infected released jail detainees (n = 1270)—the Enhancing Linkages to HIV Primary Care and Services in Jail Setting Initiative, January 2008 and March 2011, which had 10 sites in 9 states. We assessed baseline and 6-month HIV treatment outcomes, stratifying by gender. Of 867 evaluable participants, 277 (31.9%) were women. Compared with men, women were more likely to be younger, non-Hispanic White, married, homeless, and depressed, but were similar in recent alcohol and heroin use. By 6 months postrelease, women were significantly less likely than men to experience optimal HIV treatment outcomes, including (1) retention in care (50% vs 63%), (2) antiretroviral therapy prescription (39% vs 58%) or optimal antiretro-viral therapy adherence (28% vs 44%), and (3) viral suppression (18% vs 30%). In multiple logistic regression models, women were half as likely as men to achieve viral suppression. HIV-infected women transitioning from jail experience greater comorbidity and worse HIV treatment outcomes than men. Future interventions that transition people from jail to community-based HIV clinical care should be gender-specific.