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Comprehensive Needs Among Justice-Involved People With Substance Use History With or at Risk of Human

Jae H Choi¹, Shruti Patil¹, Ralph Brooks²

¹University of Texas Southwestern Medical School, Dallas, Texas, USA.

Journal of Correctional Health Care : the Official Journal of the National Commission on Correctional Health Care

|September 16, 2025

Summary

Justice-involved individuals with substance use history face significant socioeconomic needs, often overshadowing medical requirements. This highlights a critical gap in addressing essential support services for this vulnerable population.

Keywords:

HIV PrEP justice involvement needs assessments preexposure prophylaxis substance use

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Area of Science:

Public Health
Health Services Research
Social Epidemiology

Background:

Justice-involved individuals frequently experience complex co-occurring socioeconomic and medical challenges.
Understanding these needs is crucial for effective linkage to community-based care, particularly for those at risk for or living with human immunodeficiency virus (HIV).

Purpose of the Study:

To characterize the socioeconomic and medical needs of justice-involved individuals with a history of substance use in Texas (TX) and Connecticut (CT).
To compare the reported needs between participants in TX and CT within a larger trial focused on linking individuals to substance use and HIV services.

Main Methods:

A comprehensive baseline assessment of needs was conducted among 356 justice-involved participants.
Frequencies of reported needs were quantified, and comparisons between states were performed using chi-square analysis.

Main Results:

Participants reported greater socioeconomic needs (housing, transportation, food, employment, financial benefits) than medical needs in both states, with over 60% endorsing key socioeconomic factors.
While health needs were significant, demand varied by state, with higher needs for health insurance and identification in TX compared to CT.
Access to naloxone was lower in TX than CT, and overall, substance use treatment, harm reduction, and HIV pre-exposure prophylaxis were low priorities.

Conclusions:

Socioeconomic needs appear to be prioritized over medical needs among this population, suggesting a hierarchy influenced by available resources and sociopolitical contexts.
State-specific differences in needs may reflect variations in local environments and resource availability.
Despite high risks for HIV and overdose, there is a reported low demand for HIV and substance use services, indicating a potential disconnect between risk and perceived need for specialized care.