Incarceration is a strong predictor of inadequate treatment for HIV/AIDS, according to a study by a postdoctoral fellow in the Department of Family Practice.
Between May 1996 and March 2012, researchers analyzed the incarceration and HIV clinical histories of 657 people who use injection drugs and were HIV-positive. Researchers found they spent approximately 15 per cent of that six-year period in jail.
Participants had a detectable amount of HIV in their bloodstream 83 per cent of the time spent incarcerated, meaning they could transmit the infection to others because they were not taking their medication as prescribed. In comparison, samples taken when they weren’t incarcerated had detectable levels of HIV only 62 per cent of the time. The study found those with detectable levels were nearly twice as likely to share used needles if they had been incarcerated.
“Incarceration facilitates HIV transmission by compromising access to effective treatment for HIV infection and facilitating high-risk behaviour,” said M-J Milloy, lead author of the study and a principal investigator at the B.C. Centre for Excellence in HIV/AIDS (BC-CfE). “There is a critical need to promote the health of prisoners and their home communities by improving HIV treatment and implementing harm reduction programs, such as needle exchanges, within correctional facilities.”
The Treatment as Prevention strategy pioneered by BC-CfE has led to the widespread expansion of highly active antiretroviral therapy (HAART) coverage in British Columbia. Treatment can eliminate progression of HIV infection to AIDS and premature death, and significantly decrease the amount of virus in the blood and sexual fluids, thereby significantly decreasing transmission. HAART is fully funded by Pharmacare in B.C., although access to HIV health care practitioners who can prescribe treatment is limited in correctional facilities.
“This is the first study to demonstrate the correlation between risk behavior and HIV viral load in a prison setting,” said Julio Montaner, Head of the Division of HIV/AIDS and a senior author of the study. “This research underscores the need to expand HIV Treatment as Prevention and evidence-based harm reduction programs within prisons.”
The study was published this month in the peer-reviewed journal BioMedical Central Infectious Diseases.