Factors associated with HIV testing and treatment among young Black MSM and trans women in three jail systems

ABSTRACT

Black men who have sex with men (BMSM) and transgender women (BTW) are disproportionately affected by incarceration and HIV. We assessed factors associated with HIV testing and viral suppression among 176 incarcerated BMSM and BTW in Chicago, IL; Los Angeles, CA; and Houston, TX. In multivariable logistic regression, having a sexual orientation of bisexual, heterosexual, or other vs. gay or same-gender loving was associated with higher odds of testing in custody (aOR 8.97; 95% CI 1.95 - 41.24). Binge drinking (aOR 0.19; 95% CI 0.04 - 0.92) and being unemployed prior to incarceration (aOR 0.03; 95% CI 0.00 - 0.23) were associated with lower odds of testing; participants in Los Angeles were also more likely to be tested than those in Chicago. Being housed in protective custody (aOR 3.12; 95% CI 1.09-9.59) and having a prescription for ART prior to incarceration (aOR 2.58; 95% CI 1.01-6.73) were associated with higher odds of viral suppression when adjusted for site and duration of incarceration, though the associations were not statistically significant in the full multivariable model. Future research should examine structural and process level factors that impact engagement in HIV testing and treatment among detained BMSM and BTW.

KEYWORDS:

• Men who have sex with men
• transgender women
• HIV testing
• ART adherence
• jail health care
• black/African American

Acknowledgments

This work was supported by the [blinded]. We would like to acknowledge the Harris County Sheriff’s Office for their collaboration with this project. We would also like to thank all of the participants for sharing their time and experiences with us.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Declaration of interest

The authors declare they have no conflict of interest.

Author contribution statement

NA conceptualized the analysis plan with JS and AH, critically interpreted the results, and wrote the first draft of the manuscript. RF critically evaluated the results and significantly revised the initial version, and all following edits of the manuscript. NH obtained funding for the study, served as PI for the Los Angeles site, designed the survey, and critically reviewed the manuscript. NDV conducted the statistical analysis, created the final tables, wrote the statistical analysis section, and contributed to the interpretation of the results. RI managed the data for the three study sites, contributed to the statistical analysis, and contributed to the interpretation of the results. KF obtained funding for the study, served as PI for the Houston site, designed the survey, and critically reviewed the manuscript. AK served as a co-I for the Chicago site and contributed to the survey development. ADP led the data collection and management for the Houston site. JS obtained funding for the study, served as PI for the Chicago site, designed the survey, conceptualized the analysis plan, and critically reviewed the manuscript. AH conceptualized the analysis plan, oversaw the statistical analyses, and critically revised the first and subsequent drafts of the manuscript.

Additional information

Funding

This work was supported by National Institute on Drug Abuse: [Grant Number R01 DA039934]. NTH's time was also supported on grants from the California HIV/AIDS Research Program (grants: OS17-LA-003 and H21PC3466); the UCLA Clinical and Translational Science Institute's National Center for Advancing Translational Sciences, and by the Center for HIV Identification, Prevention, and Treatment (CHIPTS) National Institute of Mental Health grant P30MH058107. JS was also supported by the NIDA Justice Community Opioid Intervention Network (JCOIN) grant U2C DA050098. ASK was also supported by Public Health CADRE at Brown University (P20 GM 130414) and the Providence/Boston CFAR (P30 AI 042853).