The HIV Care Cascade Before, During, and After Incarceration: A Systematic Review and Data Synthesis

Am J Public Health. 2015 Jul;105(7):e5-16. doi: 10.2105/AJPH.2015.302635. Epub 2015 May 14.

Abstract

We conducted a systematic literature review of the data on HIV testing, engagement in care, and treatment in incarcerated persons, and estimated the care cascade in this group. We identified 2706 titles in MEDLINE, EBSCO, and Cochrane Library databases for studies indexed to January 13, 2015, and included 92 for analysis. We summarized HIV testing results by type (blinded, opt-out, voluntary); reviewed studies on HIV care engagement, treatment, and virological suppression; and synthesized these results into an HIV care cascade before, during, and after incarceration. The HIV care cascade following diagnosis increased during incarceration and declined substantially after release, often to levels lower than before incarceration. Incarceration provides an opportunity to address HIV care in hard-to-reach individuals, though new interventions are needed to improve postrelease care continuity.

Publication types

  • Research Support, N.I.H., Extramural
  • Review
  • Systematic Review

MeSH terms

  • AIDS Serodiagnosis / statistics & numerical data
  • Canada / epidemiology
  • Continuity of Patient Care / organization & administration
  • Continuity of Patient Care / statistics & numerical data
  • HIV Infections / diagnosis
  • HIV Infections / epidemiology
  • HIV Infections / therapy*
  • Humans
  • Prisoners* / statistics & numerical data
  • Prisons / organization & administration
  • Prisons / statistics & numerical data
  • United States / epidemiology