Impact of decarceration plus alcohol, substance use, and mental health screening on life expectancies of Black sexual minority men and Black transgender women (BSMM/BTW) living with HIV in the United States: A Simulation Study based on HPTN 061

Details

• Alternative Title:
  J Acquir Immune Defic Syndr
• Personal Author:
  Feelemyer, Jonathan ; Bershteyn, Anna ; Scheidell, Joy D. ; Brewer, Russell ; Dyer, Typhanye V ; Cleland, Charles M ; Hucks-Ortiz, Christopher ; Justice, Amy ; Mayer, Ken ; Grawert, Ames ; Kaufman, Jay S. ; Braithwaite, Scott ; Khan, Maria R
• Description:
  Background
  
  Given the disproportionate rates of incarceration and lower life expectancy (LE) among Black sexual minority men (BSMM) and Black transgender women (BTW) with HIV, we modeled the impact of decarceration and screening for psychiatric conditions and substance use on LE of US BSMM/BTW with HIV.
  
  Methods
  
  We augmented a microsimulation model previously validated to predict LE and leading causes of death in the US with estimates from the HPTN 061 cohort and the Veteran’s Aging Cohort Studies. We estimated independent associations among psychiatric and substance use disorders, to simulate the influence of treatment of one condition on improvement on others. We used this augmented simulation to estimate LE for BSMM/BTW with HIV with a history of incarceration under alternative policies of decarceration (i.e., reducing the fraction exposed to incarceration), screening for psychiatric conditions and substance use, or both.
  
  Results
  
  Baseline LE was 61.3 years. Reducing incarceration by 25%, 33%, 50%, and 100% increased LE by 0.29 years, 0.31 years, 0.53 years, and 1.08 years, respectively, versus no reductions in incarceration. When reducing incarceration by 33% and implementing screening for alcohol, tobacco, substance use, and depression, in which a positive screen triggers diagnostic assessment for all psychiatric and substance use conditions and linkage to treatment, LE increased by 1.52 years compared to no screening or decarceration.
  
  Discussion
  
  LE among BSMM/BTW with HIV is short compared with other people with HIV. Reducing incarceration and improving screening and treatment of psychiatric conditions and substance use could substantially increase LE in this population.
  
  
• Subjects:
  Female HIV Infections Humans Life Expectancy Male Mental Health Sexual And Gender Minorities Substance-Related Disorders Transgender Persons United States
• Keywords:
  Black Sexual Minority Males Black Transgender Women HIV Incarceration Simulation Modeling Veterans
• Source:
  J Acquir Immune Defic Syndr. 95(3):283-290
• Pubmed ID:
  38032748
• Pubmed Central ID:
  PMC10922416
• Document Type:
  Journal Article
• Funding:
  U48 DP006382/DP/NCCDPHP CDC HHSUnited States/ ; UM1 AI069480/AI/NIAID NIH HHSUnited States/ ; R01 DA044037/DA/NIDA NIH HHSUnited States/ ; UM1 AI068619/AI/NIAID NIH HHSUnited States/ ; UL1 RR025008/RR/NCRR NIH HHSUnited States/ ; U24 AA020794/AA/NIAAA NIH HHSUnited States/ ; UM1 AI068617/AI/NIAID NIH HHSUnited States/ ; P30 AI050409/AI/NIAID NIH HHSUnited States/ ; P30 AI087714/AI/NIAID NIH HHSUnited States/ ; U01 AI069496/AI/NIAID NIH HHSUnited States/ ; P01 AA029545/AA/NIAAA NIH HHSUnited States/ ; U01 AI069418/AI/NIAID NIH HHSUnited States/ ; P30 DA011041/DA/NIDA NIH HHSUnited States/ ; U48 DP005008/DP/NCCDPHP CDC HHSUnited States/ ; R21 MH121187/MH/NIMH NIH HHSUnited States/ ; UM1 AI068613/AI/NIAID NIH HHSUnited States/ ; U01 AI069424/AI/NIAID NIH HHSUnited States/ ; P30 AI060354/AI/NIAID NIH HHSUnited States/ ; U01 AI069466/AI/NIAID NIH HHSUnited States/
• Volume:
  95
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:9944c0fad7dc0ee90aed3d05e31c292e4b77a9177712d753af177459670a5a61ef01c1ce2bf3fa31e4ffd784c8679966704b50c7fdc3e86ca3b5eb0f1a5464d1
• Download URL:
  https://stacks.cdc.gov/view/cdc/151624/cdc_151624_DS1.pdf
• File Type:
  [PDF - 706.34 KB ]