A majority of HIV-positive prison inmates in Texas do not fill their prescriptions in an appropriate amount of time after release, creating a threat to public health, according to a study published Wednesday in the Journal of the American Medical Association, the Houston Chronicle reports. According to researchers from the University of Texas Medical Branch-Galveston, Baylor College of Medicine, and other universities in Texas and other states, the study is the first to track people living with HIV from prison release to care on the outside. Researchers studied 2,115 inmates living with HIV in the Texas Department of Criminal Justice prison system between 2004 and 2007. They found that 5.4% filled their prescriptions within 10 days of release, while 15.5% did so within 30 days and 30% within 60 days (Ackerman, Houston Chronicle, 2/24). According to the researchers, 90% or more of the inmates did not fill a prescription soon enough to avoid interruptions in their treatment regimens. The study also found that black and Hispanic inmates were 60% less likely than white inmates to fill a prescription within 10 days of release, and 30% less likely to do so within 30 days, according to Reuters.
Jacques Baillargeon, one of the study's investigators from UTMB-Galveston, said the "remarkably high rates of lengthy HIV treatment interruptions are troublesome from a public health perspective." He said that studies have suggested that "many released inmates who discontinue antiretroviral therapy also resume high-risk behaviors, such as injection drug use or unsafe sex." Baillargeon added that "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" (Reuters, 2/24).
In the study, researchers said the prison system has become "an important front" in efforts to treat and control the spread of HIV/AIDS, as many people are offered HIV testing for the first time while incarcerated (Houston Chronicle, 2/24). They concluded, "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" (Reuters, 2/24).
An abstract of the study is available online.
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