HIV Care and Management in Incarcerated Populations
Summary
Correctional settings concentrate individuals at elevated risk of HIV infection due to pre-existing social vulnerabilities, injection drug use and unprotected sexual activity. Prisons and jails offer unique opportunities for diagnosis, initiation of antiretroviral therapy (ART) and structured adherence support. However, overcrowding, insufficient medical staffing and stigma can undermine prevention and treatment. Continuity of care during the transition from incarceration to community release remains a persistent challenge: many formerly incarcerated people experience interruptions in ART, loss of viral suppression and barriers to re-engagement in care, driven by unstable housing, competing social needs and limited access to health insurance. Comprehensive strategies therefore span early testing, voluntary counselling, condom and syringe provision, initiation of ART in custody, linkage to community services on release and peer-based adherence support. Educational interventions, case management and digital health approaches have shown promise in addressing knowledge gaps and enhancing retention. In pursuing global targets for viral suppression and epidemic control, integration of evidence-based HIV services into correctional health systems is pivotal, with potential spill-over benefits for public health beyond prison walls.
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HIV Care and Management in Incarcerated Populations publication trend
The graph below shows the total number of articles in hiv care and management in incarcerated populations across all publications each year (not limited to Nature Index journals).
Technical terms
Preexposure prophylaxis (PrEP): Antiretroviral medication taken by HIV-negative individuals to prevent acquisition of HIV.
Antiretroviral therapy (ART): Combination of drugs used to suppress HIV replication and restore immune function.
Viral suppression: Reduction of HIV RNA in the bloodstream to undetectable levels, minimising disease progression and transmission risk.
Linkage to care: Systematic process of connecting people living with HIV to sustained medical and support services post-diagnosis or post-release.
Self-efficacy: Individual’s confidence in their ability to adhere to HIV treatment and maintain health behaviours.
Stigma: Negative attitudes, discrimination or social disapproval directed at individuals living with HIV, impeding access to prevention and treatment.
References
- HIV Risk and Interest in Preexposure Prophylaxis in Justice-Involved Persons - Volume 30, Supplement—March 2024 - Emerging Infectious Diseases journal - CDC. Emerging Infectious Diseases (2024).
- Effect of a board game on imprisoned women’s knowledge about sexually transmitted infections: a quasi-experimental study. BMC Public Health (2023).
- Multilevel challenges to engagement in HIV care after prison release: a theory-informed qualitative study comparing prisoners’ perspectives before and after community reentry. BMC Public Health (2014).
- A systematic review and meta-analyses on initiation, adherence and outcomes of antiretroviral therapy in incarcerated people. PLOS ONE (2020).
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