Abstract
BackgroundIn 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.MethodsWe 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.ResultsMost 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.ConclusionsDischarge 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.
Highlights
In the U.S, approximately one in seven Human Immunodeficiency Virus (HIV)-infected individuals experience incarceration at least once in their lifetime
The challenges that HIV-infected formerly incarcerated individuals face is increasingly recognized (Draine et al, 2011; Pontali, 2005; Solomon et al, 2014), there is limited research on the support that HIVinfected formerly incarcerated individuals receive from the Department of Corrections as they are transitioning to their home community
The amount of medication received from the NYSDOCCS while they were being discharged largely varied among participants
Summary
In the U.S, approximately one in seven HIV-infected individuals experience incarceration at least once in their lifetime. It is estimated that 150,000 HIV-infected individuals pass through correctional institutions each year in the United States (Booker et al, 2013) They experience optimal antiretroviral (ART) medication adherence and positive health outcomes while incarcerated, due to poor discharge planning and transitional support, the public health benefits gained during incarceration are often lost once individuals return to their home communities (Stephenson et al, 2005; Wohl et al, 2011). Incarcerated HIV-infected individuals are expected to maintain their prescribed regimen in their home community during a period of considerable challenges They often struggle to manage their condition while attempting to re-establish their lives and pre-incarceration routine (Althoff et al, 2013; Mallik-Kane & Visher, 2008). The importance of identifying potential gaps in services is crucial to developing effective programs designed to improve health outcomes among this vulnerable population
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