“It’s like I was out there by myself”: The receipt of reentry support among HIV-infected formerly incarcerated individuals in New York City

Abstract

Background: In the U.S., approximately one in seven HIV-infected individuals experience incarceration at least once in their lifetime. While HIV-infected individuals experience positive health outcomes during periods of incarceration, they tend to experience treatment disruption as they return to their community after custody which results in poor health outcomes. The purpose of this study was to explore the transitional support received from the Department of Corrections during the reentry period. Methods: We conducted in-depth interviews with 20 HIV-infected formerly incarcerated individuals in New York City. Interviews were audio recorded and transcribed. Three researchers performed line-by-line reading of the transcripts to identify dominant codes and themes that emerged. A mixture of deductive and inductive techniques was used to identify patterns that emerged in the data.Results: Most of the participants were male and racial and ethnic minorities. There were five dominant themes that emerged during our analysis: 1) variations in the quantity of antiretroviral medication received during transition; 2) linkages to community-based physical health care providers was not well-coordinated; 3) insufficient housing and social resources; 4) structural and social challenges to post-release well-being; and 5) family as a source of resilience.Conclusions: Discharge support planning should include sufficient medication to prevent treatment disruption and a more comprehensive approach to linkage to community-based healthcare services. Such planning should also include thorough pre-release assessments to identify appropriate levels of support needed, including employment and housing assistance, which will be useful for resource allocation. Broadening public health partnerships may also increase availability and promote accessibility to the most appropriate healthcare services and programs, which may provide better opportunities to receive coordinated care and ensure continuity of care. Finally, ties to family members and other loved ones should be leveraged to help facilitate the achievement of optimal health outcomes among this population.

The impact of carceral churn and healthcare organizations on HIV/AIDS incidence in Arkansas

“…Individuals with HIV/AIDS who have been previously incarcerated often experience relapsed drug use, which disrupts their medical treatment and makes the potential of re-incarceration for substance use more likely ( Swan, 2015 ). Drawing from interviews with HIV-infected formerly incarcerated individuals in New York, Rowell-Cunsolo et al (2020) , find that study participants vary in how much antiretroviral medication they are provided by their prison upon their release—over a third received an amount that would last them less than a month. Sidibe et al (2015) and Solomon et al (2014) similarly find that HIV-infected individuals experience obstacles to maintaining care and antiretroviral therapy once they are released from prison.…”

Addressing Treatment Outcomes and Substance Use Among Formerly Incarcerated Individuals Living with HIV

“…Structural factors such as unstable housing, gaps in health insurance coverage, stigma associated with having HIV, and a history of incarceration may limit the ability of formerly incarcerated individuals to engage in HIV care and maintain optimal ART adherence (Baillargeon et al, 2009;Booker et al, 2013;Dennis et al;DiPrete et al, 2019;Fu et al, 2013;Haley et al;Katzen, 2011;Loeliger et al, 2018;Rich et al, 2013;Stephenson et al, 2005;Westergaard et al, 2013). Accessing providers in a timely manner to prevent treatment disruption during their return to the community has been identified as a primary concern among formerly incarcerated PLWH (Loeliger et al, 2018;Rowell-Cunsolo et al, 2020b;Wohl et al, 2011). Additionally, substance use challenges, which are commonly experienced by formerly incarcerated people who use drugs (Chamberlain et al, 2019;Owens et al, 2018), compound and complicate the ability to overcome many of these structural and community-level barriers (Dennis et al, 2015).…”