Alcohol use disorders and antiretroviral  therapy among prisoners in Argentina.
OBJECTIVE
While Argentina has significantly improved access to HIV care and antiretroviral therapy (ART) for both the general population and prisoners, the prevalence of alcohol use disorders (AUDs) among HIV-infected prisoners and their relationship to accessing ART in Argentina is currently unknown. This study aims to characterize the substance abuse patterns of HIV-infected prisoners in Argentina and to assess the independent correlates of receipt of pre-incarceration ART.


METHODS
An anonymous, cross-sectional survey of 100 HIV-infected federal prisoners was conducted in the Buenos Aires municipality from July-December 2010. AUDs were assessed using the AUDIT scale.


RESULTS
A majority (63 per cent) of participants met criteria for AUDs, 45 per cent of subjects were diagnosed with HIV in prison and one-quarter had initiated ART during the current incarceration. In addition, over one-third (35 per cent) of participants did not receive ART during the pre-incarceration period despite receiving it upon incarceration. This correlated significantly with the presence of having an AUD (AOR 0.20, 95 per cent CI 0.06-0.74, p = 0.016).


CONCLUSIONS
AUDs are prevalent among HIV-infected prisoners in Argentina and are significantly related to negative secondary HIV prevention and treatment outcomes. While Argentina has provided an exemplary model of HIV-related health care reform within its prisons, future efforts to provide screening and treatment for AUDs are needed to improve the health of the nation’s incarcerated population.


CONCLUSIONS
This paper is the first to describe pre-incarceration drug and alcohol use disorders and issues related to access to ART among prisoners in Argentina.
Department of Medicine, Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, New Haven, Connecticut, USA.
Michael
M
Alpert
Jeffrey A
JA
Wickersham
Mariana
M
Vázquez
Frederick L
FL
Altice
D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology*; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D001118:Argentina / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D006801:Humans; D008297:Male; D015995:Prevalence; D011329:Prisoners; D011795:Surveys and Questionnaires; D055815:Young Adult
D044966:Anti-Retroviral Agents