Abstract
Persons living with diagnosed HIV (PLWDH) are overrepresented in correctional settings, as are Latinx including those of Puerto Rican (PR) origin. Little is known about this population's HIV care engagement after incarceration. Semi-structured interviews were conducted with 23 PLWDH of PR origin incarcerated in NYC jails using the Behavioral Model for Vulnerable Populations as the theoretical basis. Most participants described a fragile connection to HIV care and inconsistent antiretroviral therapy adherence due to issues including substance use, poverty (e.g. homelessness), and other factors. Most were satisfied with their current communitybased providers and reported that their PR ethnicity and transnational ties to PR did not impact their HIV care, although some preferred Spanish-speaking providers. Greater access to stable housing and HIV care that is convenient to substance use treatment and other services appear to be the greatest needs of PLWDH of PR origin leaving jail.
Highlights
People who are incarcerated have a higher burden of HIV compared to the general population, and Latinx are disproportionately represented in both the correctional population and those who are living with HIV in the United States
Twenty-three Persons living with diagnosed HIV (PLWDH) of Puerto Rican (PR) origin participated in this study, including thirteen men and ten women
We found that the major challenges to care engagement, a health behavior in our conceptual model [29], were not that different from the challenges of other justice-involved, non-PR populations identified in prior research
Summary
People who are incarcerated have a higher burden of HIV compared to the general population, and Latinx are disproportionately represented in both the correctional population and those who are living with HIV in the United States. A systematic review showed that incarcerated persons have better rates in four of the five HIV Care Continuum (HCC) phases—linkage to care, retention in care, ART adherence, and viral suppression—compared to national averages [4, 5]. These rates fall to levels below the national averages following incarceration [5] likely due to substance use [6,7,8], mental health conditions [9], and housing instability and/or homelessness [10,11,12]. Transitional Care Coordination (TCC) can ameliorate some of the challenges that incarcerated persons experience while transitioning to the
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