Online Program

Incarceration among HIV-infected and at-risk women in the U.S

Monday, November 2, 2015 : 3:10 p.m. - 3:30 p.m.

Nicola Lancki, MPH, Hekteon Institute/Women's Interagency HIV Study Chicago Consortium, Chicago, IL
Kathleen Weber, RN, Departments of Medicine/CORE Center at John H. Stroger Jr Hospital of Cook County, Cook County Health & Hospital System, Chicago, IL
Michael W. Plankey, PhD, Department of Medicine / Division of Infectious Diseases, Georgetown University Medical Center, Washington, DC
Jennifer Cohen, MPA, Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, CA
Joel Milam, PhD, Los Angeles WIHS Center, University of Southern California, Los Angeles
Susan Holman, RN, MS, SUNY Downstate Medical Center, Brooklyn, NY
Kemi Sosanya, Bronx WIHS Center, Montefiore Medical Center, Bronx, NY
Mardge H. Cohen, MD, Departments of Medicine/CORE Center at John H. Stroger Jr Hospital of Cook County, Cook County Health & Hospital System, Chicago, IL
Goal: To describe experiences of incarceration among U.S. women infected and at-risk for HIV and

assess the impact on mortality.

Method: We used logistic regression and cox proportional-hazards regression to determine factors

associated with incarceration and mortality among women enrolled in the Women’s Interagency HIV

Study with data collected between 2007 and 2014.

Results: Among 2520 women (HIV+1798/HIV-722, 59% African-American, median age 44 years (IQR: 38-

50)), 37% reported incarceration; of those, 29% were incarcerated once; 43% reported 2-5

incarcerations; 28% reported > 5 incarcerations. Median days in jail per incarceration was 10 (IQR: 2-

60). HIV-infected women did not continue HIV medications during 42% of incarceration periods. Factors

associated with incarceration included less than high school education (aOR 1.43, 95%CI 1.10-1.87),

unemployment (aOR 1.44, 95%CI 1.14-1.81), unstable housing (aOR 1.93, 95%CI 1.47-2.53),

crack/cocaine/heroin use (aOR 1.88, 95%CI 1.47-2.42), injection drug use (aOR 1.63, 95%CI 1.06-2.50),

transactional sex (aOR 3.17, 95%CI 2.53-3.97), and Hepatitis C (aOR 2.16, 95%CI 1.66-2.81). HIV status

was not significantly associated with incarceration (aOR 0.93, 95%CI 0.73-1.18). Survival time was

significantly shorter for HIV-infected women who were incarcerated compared to women who were not

incarcerated (cHR, 2.53, 95%CI 1.7-3.7). This association was attenuated after adjusting for age,

Hepatitis C, CD4 count and viral load (aHR 1.59, 95%CI 0.97-2.59).

Conclusion: Incarceration has negative impact on the health and quality of life of women with and at-

risk for HIV and strategies to reduce incarceration rates should be pursued.

Learning Areas:

Public health or related public policy
Social and behavioral sciences

Learning Objectives:
Identify factors associated with incarceration among a cohort of HIV infected and at-risk women and assess the impact of incarceration on mortality.

Keyword(s): HIV/AIDS, Criminal Justice

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the PI on the WIHS in Chicago since 1994 and have reviewed all the data in this presentation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.