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"I got so much on my plate": Understanding care discontinuity for HIV and HCV among formerly incarcerated persons

Lauren C Porter1, Alexander Testa2, Meghan Kozerra1

  • 1Department of Criminology and Criminal Justice, University of Maryland, College Park, Maryland, USA.

Health Services Research
|September 16, 2022
PubMed

Insights

Formerly incarcerated individuals face significant barriers to consistent HIV and Hepatitis C care. System navigation, housing instability, and mental health challenges impede their health and healthcare access.

Area of Science:

  • Public Health
  • Health Services Research
  • Infectious Diseases

Background:

  • Formerly incarcerated persons often experience significant health challenges, including high rates of HIV and Hepatitis C (HCV).
  • Continuity of care is crucial for managing these chronic infections but is frequently disrupted post-release.

Purpose of the Study:

  • To explore the barriers to care continuity for formerly incarcerated individuals diagnosed with HIV and/or HCV.
  • To identify both internal and external factors impacting healthcare access and adherence.

Main Methods:

  • Semi-structured interviews were conducted with 30 formerly incarcerated persons and 10 care providers in Baltimore, MD, and Washington, D.C.
  • Data were collected through questionnaires and in-depth interviews, analyzed using qualitative coding methods.

Main Results:

  • Common external barriers included difficulties with system navigation and unstable housing.
  • Internal barriers comprised interconnected issues of mental health, substance use, and feelings of shame or denial.
  • These challenges collectively threaten the health and healthcare engagement of this population.

Conclusions:

  • Formerly incarcerated individuals with HIV/HCV face cumulative, intersecting, and reciprocal barriers to care.
  • Addressing these multifaceted challenges is essential for improving health outcomes and healthcare continuity.
Abstract

Keywords:
HIVhepatitis-Cjustice-involved populationsmental healthsubstance usetreatment discontinuity

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