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Influence of Jail Incarceration and Homelessness Patterns on Engagement in HIV Care and HIV Viral Suppression among New York City Adults Living with HIV/AIDS

Sungwoo Lim; Denis Nash; Laura Hollod; Tiffany G. Harris; Mary Clare Lennon; Lorna E. Thorpe

Title:
Influence of Jail Incarceration and Homelessness Patterns on Engagement in HIV Care and HIV Viral Suppression among New York City Adults Living with HIV/AIDS
Author(s):
Lim, Sungwoo
Nash, Denis
Hollod, Laura
Harris, Tiffany G.
Lennon, Mary Clare
Thorpe, Lorna E.
Date:
Type:
Articles
Department(s):
Epidemiology
Sociomedical Sciences
Volume:
10
Persistent URL:
Book/Journal Title:
PLoS ONE
Geographic Area:
New York (State)--New York
Abstract:
Objectives Both homelessness and incarceration are associated with housing instability, which in turn can disrupt continuity of HIV medical care. Yet, their impacts have not been systematically assessed among people living with HIV/AIDS (PLWHA). Methods We studied a retrospective cohort of 1,698 New York City PLWHA with both jail incarceration and homelessness during 2001–05 to evaluate whether frequent transitions between jail incarceration and homelessness were associated with a lower likelihood of continuity of HIV care during a subsequent one-year follow-up period. Using matched jail, single-adult homeless shelter, and HIV registry data, we performed sequence analysis to identify trajectories of these events and assessed their influence on engagement in HIV care and HIV viral suppression via marginal structural modeling. Results Sequence analysis identified four trajectories; 72% of the cohort had sporadic experiences of both brief incarceration and homelessness, whereas others experienced more consistent incarceration or homelessness during early or late months. Trajectories were not associated with differential engagement in HIV care during follow-up. However, compared with PLWHA experiencing early bouts of homelessness and later minimal incarceration/homelessness events, we observed a lower prevalence of viral suppression among PLWHA with two other trajectories: those with sporadic, brief occurrences of incarceration/homelessness (0.67, 95% CI = 0.50,0.90) and those with extensive incarceration experiences (0.62, 95% CI = 0.43,0.88). Conclusions Housing instability due to frequent jail incarceration and homelessness or extensive incarceration may exert negative influences on viral suppression. Policies and services that support housing stability should be strengthened among incarcerated and sheltered PLWHA to reduce risk of adverse health conditions.
Subject(s):
Homelessness
Imprisonment
HIV-positive persons--Medical care
Epidemiology
Medicine
Public health
Immunology
Publisher DOI:
https://doi.org/10.1371/journal.pone.0141912
Item views
66
Metadata:
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Suggested Citation:
Sungwoo Lim, Denis Nash, Laura Hollod, Tiffany G. Harris, Mary Clare Lennon, Lorna E. Thorpe, , Influence of Jail Incarceration and Homelessness Patterns on Engagement in HIV Care and HIV Viral Suppression among New York City Adults Living with HIV/AIDS, Columbia University Academic Commons, .

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