Abstract
OBJECTIVES: People with HIV (PWH) who transition back into the community after incarceration often experience treatment disruptions, increasing the risk of poor outcomes. We examined factors associated with sustained viral suppression (SVS) after release. METHODS: We analyzed 2015-2022 data from a nationally representative sample of PWH (N = 1012). We used weighted percentages and 95% CIs to describe the characteristics of recently incarcerated PWH by postrelease SVS status. We calculated prevalence ratios (PRs) to identify factors associated with SVS. RESULTS: Among PWH who were incarcerated at least once in the past 12 months, only 30.0% achieved SVS postrelease. PWH aged 18 to 29 years (PR = 1.16; 95% CI, 1.01-1.32) and 30 to 39 years (PR = 1.20; 95% CI, 1.06-1.35) were significantly more likely to not have SVS than PWH aged ≥50 years. PWH released within 180 days (≤60 days: PR = 1.44; 95% CI, 1.29-1.61; 61-180 days: PR = 1.18; 95% CI, 1.03-1.34) were significantly more likely to not have SVS than PWH released after ≥181 days. PWH with ≥3 incarcerations within the past 12 months were significantly more likely to not have SVS than PWH who were incarcerated once (PR = 1.25; 95% CI, 1.12-1.39). PWH with SVS were significantly more likely to be retained in HIV care (PR = 1.55; 95% CI, 1.40-1.70), taking antiretroviral therapy (ART) (PR = 1.20; 95% CI, 1.14-1.28), or adherent to ART (PR = 1.34; 95% CI, 1.15-1.56) than PWH without SVS. CONCLUSIONS: SVS outcomes among recently incarcerated PWH could improve through adherence support, discharge planning, and postrelease support, particularly for young or frequently incarcerated individuals.