title: Preliminary Evidence of Significant Gaps in Continuity of HIV Care among Excarcerated Populations in Puerto Rico.
abstract: OBJECTIVE
  Puerto Rico has high HIV prevalence and incidence rates, including a large prison population living with HIV. While HIV treatment is available within the prisons, there are no linkages to care or treatment preparedness interventions following release.
  
  
  METHODS
  In an effort to assess the risk of treatment discontinuity in this group, we examined data from an ongoing epidemiological study in the largest, publicly funded HIV/sexually transmitted infection (STI) treatment center in the San Juan area.
  
  
  RESULTS
  Among the newly enrolled, HIV-positive patients with a history of incarceration, there was an average 4-year gap in reengagement in treatment. Drug and sexual risk behaviors were prevalent, as was evidence of significant immune impairment (including high viral load and low CD4 count).
  
  
  CONCLUSIONS
  Treatment discontinuity may contribute to poor health outcomes in this group and also fuel new infections. There is an urgent need for interventions to retain HIV-positive inmates in community HIV care following release.
authors.affiliation: 1School of Public Health, University of Puerto Rico, San Juan, PR, USA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Clatts
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Rodriguez-Díaz
authors.forename: Hermes
authors.initials: H
authors.lastname: García
authors.forename: Ricardo L
authors.initials: RL
authors.lastname: Vargas-Molina
authors.forename: Gerardo G
authors.initials: GG
authors.lastname: Jovet-Toledo
authors.forename: Lloyd A
authors.initials: LA
authors.lastname: Goldsamt
mesh_terms: D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D011647:Puerto Rico; D012309:Risk-Taking; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology