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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.

Jail inmates usually return to neighborhoods with limited access to medical care.⁴ Under section 330 of the . . . [Full Text of this Article]

Keith Barton, MD
kbarton@cochs.org
Community Oriented Correctional Health Services
Oakland, California

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