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AIDS Behav. 2019 Sep 4. doi: 10.1007/s10461-019-02666-7. [Epub ahead of print]

Social Determinants of Health and Retention in HIV Care Among Recently Incarcerated Women Living with HIV in Canada.

Author information

1
Faculty of Health Sciences, Simon Fraser University, Blusson Hall Rm 10522, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
2
Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
3
University of Victoria, Victoria, BC, Canada.
4
Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, Australia.
5
Collaborating Centre for Prison Health and Education, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
6
Division of AIDS, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
7
British Columbia Centre on Substance Use, Vancouver, BC, Canada.
8
Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, Canada.
9
Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, Canada.
10
GlassHouse Consultants, Vancouver, Canada.
11
McGill University Health Centre, Montreal, QC, Canada.
12
Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
13
Department of Medicine, University of Toronto, Toronto, ON, Canada.
14
Faculty of Health Sciences, Simon Fraser University, Blusson Hall Rm 10522, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. kangela@sfu.ca.
15
Division of AIDS, Department of Medicine, University of British Columbia, Vancouver, BC, Canada. kangela@sfu.ca.

Abstract

Women living with HIV (WLWH) are over-represented in corrections in Canada, yet little is known about women's experiences post-release. We used CHIWOS cross-sectional data from WLWH to estimate associations between social determinants of health and HIV-related care outcomes among WLWH with recent (within past year) or ever (before past year) incarceration experience. Lifetime incarceration prevalence was 36.9% (6.5% recent; 30.4% ever), with significant differences by province of residence (British Columbia: 10% recent; 52% ever; Ontario: 5%; 24%; Quebec: 6%; 22%; p < 0.001). In adjusted multinomial logistic regression analyses, compared with never incarcerated, recent incarceration was associated with Indigenous ancestry, lower annual income (< $20,000 CAD), unstable housing, current sex work, injection drug use (IDU), and sub-optimal antiretroviral therapy (ART) adherence, while ever incarceration was associated with current sex work, IDU, and experiencing adulthood violence. Our findings have implications regarding supports needed by WLWH in the post-release period, including ART adherence and achieving health and social goals.

KEYWORDS:

Adherence; CHIWOS; HIV; Incarceration; Post-incarceration; Social determinants of health; Women

PMID:
31486006
DOI:
10.1007/s10461-019-02666-7

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