Falling Through the Cracks: Risk Factors for Becoming Lost to HIV Care After Incarceration in a Southern Jail

Yordanos M. Tiruneh, Xilong Li, Benjamin Bovell-Ammon, Princess Iroh, Timothy P. Flanigan, Brian T. Montague, Josiah D. Rich, Ank E. Nijhawan

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Using a retrospective cohort analysis of inmates released from Dallas County Jailbetween January 2011 and November 2013, this study characterizes people living withHIV/AIDS (PLWHA) who are lost to care after release from jail. We used Kaplan-Meieranalysis to estimate the risk of becoming lost to post-release HIV care and a Coxproportional hazards regression model to identify associated factors. The majority ofindividuals (78.2%) were men and 65.5% were black. Of the incarcerations that endedwith release to the community, approximately 43% failed to link to community HIV care.Non-Hispanic Whites were more likely than Hispanics or Blacks to drop out of careafter release. Individuals with histories of substance use or severe mental illness weremore likely to become lost, while those under HIV care prior to incarceration and/or who had adhered to antiretroviral therapy (ART) were more likely to resume care uponrelease. Targeted efforts such as rapid linkage to care and re-entry residenceprograms could encourage formerly incarcerated individuals to re-engage in care.

Original languageEnglish (US)
Pages (from-to)2430-2441
Number of pages12
JournalAIDS and Behavior
Issue number8
StatePublished - Aug 1 2020


  • Incarceration
  • Jail
  • Linkage to care
  • Lost-to-follow-up
  • Re-entry
  • South
  • Texas

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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