Women experience worse HIV outcomes than men after release from prison or jail, a U.S.-focused literature review published in AIDS found. Specifically, women were less likely to be engaged in care, adhere to their treatment regimen, or be virally suppressed.
Researchers compared data from 24 studies, all but one of which had been conducted in the U.S. They noted the scarcity of research specific to criminal justice-involved women living with HIV (WLWH), and even less data on transgender women.
Compared to men, women were more likely to have been homeless, used illicit substances, or have a history of past trauma before being arrested, all of which may have increased the HIV outcome gender gap. Mental and physical illnesses more commonly occurred among women as well. Women were also less likely to be imprisoned for violent crimes, and hence served shorter sentences -- a fact that may impair HIV outcomes by causing a greater number of treatment interruptions, researchers suggested.
Study authors noted the disproportionate number of African Americans in the U.S. correctional system as a result of structural racism, economic marginalization, and over-policing of communities of color. Research on the unique vulnerabilities of African-American women leaving prison or jail is needed, they said. In addition, they called for enhanced discharge planning, trauma-informed care, and gender-informed interventions for WLWH.