Linkage to and retention in medical care is a concern for HIV-positive individuals leaving custody settings in the United States. The minimal existing research points to low rates of entry into care in the months following release and lapsed viral control among releasees who are subsequently reincarcerated. We conducted seven small focus group discussions with 27 HIV-positive individuals who were recently incarceration in a California State prison to understand those factors that facilitated linkage to and retention in HIV care following their release. We used a consensual approach to code and analyze the focus group transcripts. Four main themes emerged from the analysis: 1) interpersonal relationships, 2) professional relationships, 3) coping strategies and resources, and 4) individual attitudes. Improving HIV-related outcomes among individuals after their release from prison requires strengthening supportive relationships, fostering the appropriate attitudes and skills, and ensuring access to resources that stabilize daily living and facilitate the process of accessing care.
Traveling homeless youth (i.e., youth who migrate from city to city, after a short period of time) exhibit elevated levels of risky substance use behaviors compared to non-traveling youth. Using sociometric data, we examined the characteristics of homeless youth who are connected to at least one traveler and how at least one connection to travelers was associated with substance use of travelers and non-travelers. Data were collected from 386 homeless youth at two drop-in centers in Los Angeles, CA. Results indicated that, comparing to what would be expected by chance, youth who reported at least one connection to travelers were more likely to use substances, more travelers reported at least one tie to another traveler, and more substance-using travelers reported at least one tie to other substance-using travelers. Multivariate analyses revealed that binge drinking and marijuana use were associated with homeless youth reporting connections to at least one substance-using traveler. Injection drug use was associated with reporting at least one connection to an injection drug user, regardless of traveler status, once we controlled for demographic characteristics and traveler status. We suggest the need for substance-using traveler-specific services using brief one-on-one interventions to prevent further engagement in risky substance use.
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