Psychosocial, Behavioral, and HIV-Related Health Among Men Living with HIV Who Have a History of Incarceration

Incarceration is intricately linked with the HIV epidemic, with incarcerated individuals exhibiting HIV prevalence rates three times higher than the general population. We used baseline data from the Multicenter AIDS Cohort Study (MACS)/Women's Interagency HIV Study (WIHS) Combined Cohort Study (MWCCS) to describe select health outcomes among men living with HIV (MWH) who have never been incarcerated and with a history of lifetime incarceration, specifically recent (within the past-year) and multiple incarcerations. Participants (N = 526) completed quantitative assessments of self-reported incarceration history, behavioral (e.g., antiretroviral therapy (ART) adherence, stimulant use) and psychosocial factors (e.g., depression, perceived stress), and provided biospecimens to assess immune function (i.e., CD4:CD8 ratio) and quantification of plasma HIV viral load. MWH with a history of any incarceration had significantly higher levels of depressive symptoms, recent stimulant use, detectable HIV viral load, and poorer ART adherence and lower CD4:CD8 ratios compared to MWH who had never been incarcerated. Among MWH with any incarceration, recent incarceration (versus not past-year) was associated with lower CD4:CD8 and poorer ART adherence. Recently incarcerated MWH were less often white and generally younger than MWH who had been incarcerated more than a year earlier, and MWH with multiple incarcerations more often identified as heterosexual compared to MWH who had only been incarcerated once. These findings underscore the critical need for tailored interventions aimed at MWH within a year following release from incarceration, focusing on enhancing mental health and HIV-related health outcomes.