This empirical study examines
the association between substance abuse, mental illness, health behaviors and
different patterns of homelessness among recently released, HIV-infected jail
detainees. Using longitudinal data from a 10-site study, we examine correlates
of homelessness, transitions to and from stable housing and the effect of
housing on HIV treatment outcomes. Based on our analysis, we found evidence
that the transitions from homelessness are closely associated with a reduction
in the use of alcohol and illicit drugs, a decline in drug addiction severity,
and an improvement in mental health. In addition, we found evidence that
disparities in the housing status contributed substantially to the observed gap
in the HIV treatment outcomes between homeless and non-homeless patients,
including in achievement of virological suppression over time…
A sixth of all people living
with HIV/AIDS (PLWHA) in the United States cycle through prison or jail
annually, with nearly all doing so initially through a jail [14]. Therefore, reducing the vulnerability of the
recently released HIV-infected jail detainees is a crucial component of
coordinating post-release services and promoting optimal HIV treatment
outcomes. Jail detainees, often released without a transitional plan,
frequently face unstable housing circumstances, problems finding employment and
loss of medical and social entitlements. Indeed, compared to their housed
counterparts, homeless HIV-infected individuals who enter jail experience poor
HIV treatment outcomes before incarceration [5]. The interdependence between incarceration and
housing instability, drug and alcohol use, mental health and HIV poses many
challenges for designing effective interventions that result in improved social
and health outcomes [6].
Homelessness and
incarceration are syndemic and mutually reinforcing of poor treatment outcomes.
Depending on location, available estimates suggest that between 23 % and 68 %
of homeless individuals have a history of incarceration [15, 16]. Similarly, among the criminal justice
population, between 10 % and 50 % experienced homelessness at some point in the
year prior to incarceration [17]...
Below: Behavioral model for vulnerable populations: adaptation for homeless outcomes (Color figure online)
Below: Patterns of housing from baseline to 6 months after release from jail (N = 867) (Color figure online)
Full article at: http://goo.gl/1CjR9c
By:
Alexei Zelenev, Section of Infectious Diseases, AIDS Program, Department of Internal
Medicine, Yale University School of Medicine, 135 College Street, Suite 323, New
Haven, CT 06510, USA;
Email: ude.elay@venelez.iexela
More at: https://twitter.com/hiv_insight
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