Sociodemographic and Clinical Characteristics Associated With Recent Incarceration Among People With HIV, United States, 2015-2017

Objectives: We examined sociodemographic, clinical, and behavioral factors associated with previous incarceration among people with diagnosed HIV to inform HIV care efforts for this population.

Methods: We used 2015-2017 data from a cross-sectional, nationally representative sample of US adults with diagnosed HIV (N = 11 739). We computed weighted percentages and 95% CIs to compare the characteristics of people with HIV incarcerated in the past 12 months (ie, recently) with people with HIV not recently incarcerated. We used adjusted prevalence ratios (aPRs) with predicted marginal means to examine associations between selected factors and incarceration status.

Results: Adults with HIV who were recently incarcerated, when compared with those who were not, were more likely to be aged 18-29 years (prevalence ratio [PR] = 2.51), non-Hispanic Black (PR = 1.39), less educated (<high school diploma; PR = 1.41), unemployed (PR = 1.32), or living at or below the federal poverty level (PR = 1.64); to have recently experienced homelessness (PR = 4.56); and to have recently used drugs (PR = 1.68). Clinically, they were more likely to have been diagnosed with HIV in the past 5 years (aPR = 1.26), have lower CD4 counts (aPR = 1.45), have recently used the emergency department (aPR = 1.15), and have experienced severe anxiety (aPR = 1.50) and less likely to be retained in care, be recently virally suppressed, or have sustained viral suppression.

Conclusions: Among people with HIV, recent incarceration was associated with increased health risks and worse health outcomes. Pre- and postrelease linkage-to-care interventions and reentry services might improve the health of recently incarcerated people with HIV.