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Predictive factors of facilitating linkage to care for HIV-positive detainees in ICE Health Service Corps-staffed
Alexandra M Mishreki1,2, Nicole J Boardman1, Stephanie K Brodine2
1U.S. Immigration and Customs Enforcement (ICE) Health Service Corps (IHSC), 500 12th Street, SW, Washington, DC 20536, USA.
Background:
Persons in ICE detention represent a population about whom limited health-related data is available in the literature. Since ICE detention is generally brief, facilitating linkage to care (FLC) for detainees with chronic diseases, including HIV-positive detainees, is challenging, yet critical to encourage continued treatment beyond custody. Between 2015 and 2017, IHSC-staffed facilities implemented intensive training related to HIV care and FLC and increased clinical oversight and consultations. This study examined the impact of these changes in relation to FLC.
Methods:
Demographic and clinical data for detainees with known HIV-positive diagnoses at IHSC-staffed facilities entering custody in 2015 and 2017 were obtained via electronic health record. Univariate analysis and multiple logistic regressions were performed to identify factors that may increase FLC.
Results:
After adjusting for year of entry into custody, detainees who received an infectious disease (ID) consultation had significantly higher odds (2.4, P < 0.001) of receiving FLC resources compared to those who did not receive an ID consultation. Between 2015 and 2017, the proportion of HIV-positive detainees receiving FLC resources increased from 29 to 62%.
Conclusions:
ID consultations significantly improved FLC for HIV-positive detainees. Continued provider training and education is essential to continue improving the rate of FLC for HIV-positive ICE detainees.
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