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. 2023 Aug;58(4):865-872.
doi: 10.1111/1475-6773.14067. Epub 2022 Oct 4.

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

Lauren C Porter  1 , Alexander Testa  2 , Meghan Kozerra  1 , Cassandra Philippon  1 , Lizabeth Remrey  1 , Phyllis Bijole  3 , Sarah Kattakuzhy  4 , Carla S Alexander  4 , Elana Rosenthal  4
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"I got so much on my plate": Understanding care discontinuity for HIV and HCV among formerly incarcerated persons

Lauren C Porter et al. Health Serv Res. 2023 Aug.

Abstract

Objective: To explore barriers to care continuity among formerly incarcerated persons with HIV and/or hepatitis C.

Data sources and study setting: We draw on data from semi-structured interviews conducted in 2018-2019 with 30 formerly incarcerated persons and 10 care providers. Data were collected across two clinics in Baltimore, Maryland, and Washington, D.C.

Study design: We recruited participants using a combination of nonprobability sampling techniques. Participants completed closed-ended questionnaires and took part in semi-structured interviews related to treatment barriers and incentives.

Data collection/extraction methods: Interviews were transcribed using Express Scribe software and transcriptions were open coded using NVivo 12 software. An iterative process was used to relate and build upon emergent themes in interviews.

Principal findings: Our study illuminates both internal and external barriers to care continuity. The most common external barriers were system navigation and housing instability. Internal barriers consisted of overlapping issues related to mental health, substance use, and feelings of shame and/or denial.

Conclusion: An overarching theme is that formerly incarcerated persons with HIV and/or HCV are grappling with numerous challenges that can threaten their health and health care. These barriers are cumulative, intersecting, and reciprocal.

Keywords: HIV; hepatitis-C; justice-involved populations; mental health; substance use; treatment discontinuity.

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Figures

FIGURE 1
FIGURE 1
Barriers to continuity in care for formerly incarcerated persons: A conceptual model
See this image and copyright information in PMC

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