We studied a cohort of 15,620
adults who had experienced at least 1 jail incarceration and 1 homeless shelter
stay in 2001-2003 in New York City to identify trajectories of these events and
tested whether a particular trajectory was associated with all-cause,
drug-related, or human immunodeficiency virus (HIV)-related mortality risk in
2004-2005.
Using matched data on jail time, homeless shelter stays, and vital
statistics, we performed sequence analysis and assessed mortality risk using
standardized mortality ratios (SMRs) and marginal structural modeling. We
identified 6 trajectories. Sixty percent of the cohort members had a temporary
pattern, which was characterized by sporadic experiences of brief incarceration
and homelessness, whereas the rest had the other 5 patterns, which reflected
experiences of increasing, decreasing, or persistent jail or shelter stays.
Mortality risk among individuals with a temporary pattern was significantly
higher than those of adults who had not been incarcerated or stayed in a
homeless shelter during the study period; all-cause and HIV-related SMRs in
other patterns were not statistically significantly different.
When we compared
all 6 trajectories, the temporary pattern was more strongly associated with
higher mortality risk than was the continuously homelessness pattern.
Institutional interventions to reduce recurrent cycles of incarceration and
homelessness are needed to augment behavioral interventions to reduce mortality
risk.
Full article at: http://goo.gl/WyuLRa
More at: https://twitter.com/hiv_insight
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