title: Correlates of retention on extended-release naltrexone among persons living with HIV infection transitioning to the community from the criminal justice system.
abstract: The acceptability of and retention on extended-release naltrexone (XR-NTX), an FDA-approved medication for the treatment of alcohol and opioid use disorders, among persons living with HIV disease (PLH) under criminal justice setting (CJS) supervision has not been evaluated to date.
  
  
  
  Two double-blind placebo-controlled randomized trials of XR-NTX for inmates with HIV disease transitioning to the community with (1) alcohol use disorders (AUDs) or (2) opioid use disorders, are underway. Reasons for not accepting XR-NTX and an evaluation of differences in demographic features between those who were retained on study drug and those who did not return for their second injection post-release are discussed.
  
  
  
  70% of eligible persons consented to participate; almost 90% received their first injection; and almost 60% returned for their first injection after release. Variables found to be associated (p<0.10) with returning for the second injection included: not meeting criteria for hazardous drinking (p=0.035; OR 0.424 (CI 0.191-0.941)); being prescribed antiretroviral therapy (p=0.068; OR 2.170 (CI 0.943-4.992)); expressing experiencing serious depression 30 days prior to incarceration (p=0.068; OR 1.889 (CI 0.955-3.737)); not having a positive cocaine urine screen on the day of release (DOR) (p=0.011; OR 0.258 (CI 0.091-0.729)); and not meeting criteria for an AUD plus any substance use disorder (p=0.068; OR 0.521 (CI 0.259-1.048)). Only positive cocaine urine test on DOR was statistically significant after multivariate regression analyses (p=0.005; OR 0.207 (CI 0.068-0.623)).
  
  
  
  CJS based XR-NTX programs are highly acceptable among PLH, however retention on XR-NTX after release is negatively impacted by relapse to cocaine use.
authors.affiliation: Yale AIDS Program, Yale School of Medicine, Section of Infectious Disease, 135 College Street, Suite 323, New Haven, CT 06511, United States. Electronic address: sandra.springer@yale.edu.
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Springer
authors.affiliation: Yale AIDS Program, Yale School of Medicine, Section of Infectious Disease, 135 College Street, Suite 323, New Haven, CT 06511, United States.
authors.forename: Shan-Estelle
authors.initials: SE
authors.lastname: Brown
authors.affiliation: Yale AIDS Program, Yale School of Medicine, Section of Infectious Disease, 135 College Street, Suite 323, New Haven, CT 06511, United States.
authors.forename: Angela
authors.initials: A
authors.lastname: Di Paola
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Altice
mesh_terms: D000328:Adult; D057237:Criminals / Q000523:psychology*; D003692:Delayed-Action Preparations / Q000008:administration & dosage; D004311:Double-Blind Method; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D007267:Injections / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000379:methods / Q000523:psychology*; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000523:psychology / Q000652:urine; D010349:Patient Compliance / Q000523:psychology*; D000069341:Transitional Care
chemical_list: D003692:Delayed-Action Preparations; D009292:Narcotic Antagonists; D009271:Naltrexone
keywords: Alcohol use disorders; Criminal justice system; Extended-release naltrexone; HIV; Opioid use disorders; Vivitrol