Released inmates who are infected with Mycobacterium tuberculosis are at high risk for not completing therapy. This study describes reasons for postrelease behavior in a cohort of participants from a randomized trial. We interviewed 230 participants after the primary trial endpoint (visit to the tuberculosis [TB] clinic within 30 days of release) had occurred. Those participants who, in jail, thought they would have social support for continuing therapy but after jail indicated they did not have such support were half as likely to have gone to the TB clinic (odds ratio 0.5, 95% confidence interval 0.2 to 0.9), controlling for drug/alcohol problems and factors significant in the original randomized trial (study group and recent immigrant status). The disruption of incarceration alters postrelease life, and inmates who find social support has changed after release may be nonadherent. Information gathered from incarcerated persons may not predict postrelease reality.
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