Drug interruptions upon leaving prison could create drug-resistant HIV strains

HIV/AIDS is the number one killer of Texas prison inmates, and TDCJ spends about half its pharmacy budget on HIV medications, but many ex-prisoners don't keep taking the drugs once they get out, according to a new study from UTMB. Reported Reuters:

Results of a new study show that major interruptions in HIV drug treatment occur after release from prison.

Within 60 days of release from prison, just 30 percent of HIV-infected inmates in the Texas Department of Criminal Justice system filled a prescription for antiretroviral drug therapy, researchers report in Wednesday's issue of the Journal of the American Medical Association.

Moreover, 90 percent or more of inmates did not fill a prescription soon enough to avoid an interruption in their antiretroviral therapy, according to the report.

"These remarkably high rates of lengthy HIV treatment interruptions are troublesome from a public health perspective," study investigator Dr. Jacques Baillargeon, from the University of Texas Medical Branch, Galveston, noted in a written statement.

"Several studies suggest that many released inmates who discontinue antiretroviral therapy also resume high-risk behaviors such as injection drug use or unsafe sex," Baillargeon added, "and this combination may result not only in poor clinical outcomes for these individuals but also in the creation of drug-resistant HIV reservoirs in the general community."

The study involved 2115 HIV-infected inmates who were receiving antiretroviral therapy prior to their release from prison between January 2004 and December 2007.

Just 5.4 percent of inmates filled an antiretroviral prescription within 10 days of release, the researchers found.

HIV drugs are expensive so for prisoners with no access to health insurance it's not surprising if most stop taking them. But that also sets the stage for a significant public health crisis.

It's easy to say we shouldn't care about prisoners healthcare, but surely everybody should care about the possible "creation of drug-resistant HIV reservoirs in the general community."

I don't know if the solution is to provide meds to parolees with HIV or how this situation might be addressed, but it'd be a catastrophe of enormous proportions if Texas prisons became the breeding ground for some scary, new drug-resistant HIV strain.