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July 8, 2009

Treatment for Individuals With HIV/AIDS Following Release From Prison

JAMA. 2009;302(2):147-148. doi:10.1001/jama.2009.919

To the Editor: Dr Baillargeon and colleagues1 offered compelling evidence of the poor continuity of care for individuals with human immunodeficiency virus (HIV)/AIDS transitioning to community-based health care following release from prison. This study documented discontinuity in antiretroviral therapy, but many other chronic medical conditions are affected by poor transitions of care, including diabetes, asthma, and mental illness. Disenrollment of inmates from Medicaid, Medicare, and veterans' benefits during incarceration means that even those eligible for such benefits face substantial lag time in re-enrollment at release. Former inmates may resort to costly health care utilization to have basic medical needs met,2 resulting in inappropriate use of scarce public resources for health care. Discharge planning through the AIDS Drug Assistance Program may help reduce discontinuities in prescription drug treatment for individuals with HIV/AIDS, but for most inmates with chronic disease, such programs are unavailable. Interruptions in care can result in increased recidivism, medicolegal consequences, and mortality.35

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