HIV Prevention for People Releasing from Incarceration: A Qualitative Pre-implementation Study

Area of Science:

• Public Health
• Implementation Science
• Infectious Disease Prevention

Background:

• Release from incarceration is a critical period for HIV acquisition.
• Existing efforts to provide HIV prevention, including pre-pre-exposure prophylaxis (PrEP), face significant implementation challenges for justice-involved populations.

Purpose of the Study:

• To investigate the landscape of HIV prevention implementation for individuals transitioning from carceral facilities in Washington State.
• To gather insights from correctional and community organization staff to guide the implementation of effective HIV prevention strategies.

Main Methods:

• A qualitative study employing semi-structured interviews with 15 carceral staff and 20 community-based organization staff.
• Participants were recruited using chain referral sampling.
• Interviews were coded using a mixed inductive-deductive approach informed by the Consolidated Framework for Implementation Research.

Main Results:

• Carceral facilities offered limited HIV prevention programs, with PrEP availability not widespread and focus on acute medical/behavioral health needs.
• Community organizations prioritized basic needs and community building over specific HIV prevention services.
• Key themes included the prioritization of basic needs, the need for new funding for HIV prevention, cultural differences impacting PrEP provision, disconnects between carceral and community providers hindering care linkage, and balancing confidentiality with care coordination.

Conclusions:

• Both carceral institutions and community organizations often focus on substance use disorder treatment, presenting an opportunity to integrate HIV prevention education and interventions.
• Enhanced collaboration between carceral and community organizations could improve care coordination but necessitates adequate staff capacity.