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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.2009.920

To the Editor: Dr Baillargeon and colleagues1 tracked the continuity of HIV therapy in a cohort of inmates in Texas following their release from prison, finding that a high percentage had gaps in HIV therapy, predisposing them to viral resistance and disease progression. Serious as these findings are, there is a much greater collective experience with inmates released from county jails, which process an estimated 12 million admissions and releases a year.2 Many jails do not test for HIV infection.3 My observation is that HIV treatment provided in jail is frequently interrupted after inmates are released from custody. This sets the stage for a more virulent and expensive epidemic than if HIV testing were a consistent part of booking procedures and if health care in jails were linked to health care in communities.

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