Linkage to Community-Based Health Services for HIV-Infected Alcohol Users Leaving Jail 公开

Wanjala, Rose Namarome (2011)

Permanent URL: https://etd.library.emory.edu/concern/etds/hh63sw016?locale=zh
Published

Abstract

Background:Alcohol use disorders continue to be a serious public health problem in the U.S. with more than half of the American population aged 12 years or older reporting current alcohol use. Crimes associated with alcohol use range from driving while intoxicated to assault and homicide. Approximately 40% of the inmates in the U.S report to have been under the influence of alcohol at the time of offence. A strong dose-relationship has been reported between alcohol use and increased high risk behaviors for HIV transmission, and poor adherences to HIV medication. If alcohol use is associated with poorer linkage to care upon release from jails, greater efforts to assess and treat alcohol disorders in jail settings may be warranted. This research aims at determining if problematic alcohol use among HIV-infected detainees influences linkage to HIV care in the community upon release from jails.

Methods: The analysis was conducted as part of Enhance Link Initiative a multi-site evaluation project across 10 jail sites. A longitudinal study design was used where data were collected on 348 HIV infected individuals at study enrollment, post release and six month after jail release. A composite score (CS) from the Addiction Severity Index was used to determine the severity of alcohol and drug use. Multivariate logistic regression was used to test the hypotheses. Results: More than half of the participants reported using alcohol in the past 30 days before their incarceration. Among them, 40% reported using alcohol with no drug involvement. There was a trend among the 120 individuals whose alcohol CS was greater than 0.23 to be less likely to link to care but the association was not statistically significant. Significant predictors of linkage included male gender and taking HIV medication in the 7 days before incarceration. Discussion: Findings suggest the need to treat alcohol use disorders among HIV-infected jail detainees in order to enhance linkage to community HIV care .Substance abuse treatment in jail settings tends to focus on availing treatment to people using drugs. HIV infected individuals who abuse alcohol may need alcohol specific services to improve rates of linkage to community health care.

Table of Contents




TABLE OF CONTENTS

BACKGROUND AND LITERATURE REVIEW ........................................................................ 1
Alcohol use and risky behaviors' ................................................................................................ 2
HIV/AIDS in correctional settings .............................................................................................. 4
Linkage to care interventions in jails .......................................................................................... 7
Substance abuse treatment in correctional facilities ................................................................. 11
METHODS ................................................................................................................................... 14
Data collection ....................................................................................................................... 15
Figure 1: The data collection flowchart ................................................................................. 17
Methods of analysis ............................................................................................................... 18
Dependent variable definition ............................................................................................... 19
Independent variable definition ............................................................................................. 19
Statistical analysis.................................................................................................................. 20
RESULTS ..................................................................................................................................... 21
DISCUSSION ............................................................................................................................... 25
REFERENCES ............................................................................................................................. 30
Table1: Baseline characteristics of individuals (N=348) released before March 2010 ............ 41
Table 2: Comparison of inmate characteristics at baseline and for those with 6 month follow-
up evaluation (N=223) .............................................................................................................. 42
Table 3: Bivariate associations with Linkage among HIV-Infected Jail Inmates (N=348) ..... 42
Table 4: Bivariate associations with Linkage among HIV-Infected jail inmates with severe
alcohol problems (N=120) ........................................................................................................ 43
Table 5: Multivariate association with linkage among individuals with baseline and post-
release evaluation data .............................................................................................................. 45
APPENDICES .............................................................................................................................. 45

About this Master's Thesis

Rights statement
  • Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.
School
Department
Subfield / Discipline
Degree
Submission
Language
  • English
Research field
关键词
Committee Chair / Thesis Advisor
Partnering Agencies
最新修改

Primary PDF

Supplemental Files