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Bazrafshan A, Rafiei-Rad AA, Bazrafshan MS, Ghalekhani N, Mehmandoost S, SeyedAlinaghi S, Mehrabi F, Khezri M, Mostashari G, Karamouzian M, Sharifi H. Facilitators and Barriers to adherence to antiretroviral therapy among incarcerated people living with HIV in Iran: insights from a qualitative study. Harm Reduct J 2025; 22:4. [PMID: 39773185 PMCID: PMC11708189 DOI: 10.1186/s12954-024-01151-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 12/27/2024] [Indexed: 01/11/2025] Open
Abstract
BACKGROUND Ensuring consistent adherence to antiretroviral therapy (ART) is crucial for effective HIV treatment and achieving viral suppression. Within prisons, the prevalence of HIV is notably high, and incarcerated individuals face an increased risk of transmitting the virus both during and after incarceration. However, facilitators and barriers to ART adherence among these individuals in low- and middle-income countries remain inadequately explored. This study applied the Social Ecological Model (SEM) to investigate how various individual, interpersonal, organizational, community and policy-level factors impact ART adherence among incarcerated populations in Iran during and post-incarceration. METHODS This study employed a phenomenological qualitative approach using semi-structured interviews to gather insights. The research population consisted of people living with HIV (PLHIV) who had experienced incarceration and had been prescribed ART during their latest incarceration. Eleven PLHIV from two prisons located in Kerman and Tehran, Iran, formed the study group. Qualitative findings from the interviews were analyzed using a thematic approach. The findings were organized within the SEM framework to highlight key themes influencing ART adherence during and after incarceration. RESULTS Participants had an average age of 45.1 years (± 5.6). Various factors influence ART adherence during and post-incarceration. Participants highlighted the individual (e.g., HIV knowledge, previous treatment history, mental and physical health), interpersonal (e.g., family, friends, other incarcerated people, and prison health staff), organizational (e.g., ART treatment interventions, methadone maintenance therapy, and other health protocols), community (e.g., stigma, social isolation, discrimination and lack of access to community health services), and policy (e.g., financial interventions, and providing shelters) level factors influence ART adherence during and post-incarceration. CONCLUSIONS This study provides insights into the multi-level approach to ART adherence among PLHIV during and post-incarceration. It recommends implementing public health activities at the proposed multi-levels to maximize the synergies of intervention for the greatest impact.
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Affiliation(s)
- Azam Bazrafshan
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Maliheh Sadat Bazrafshan
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Nima Ghalekhani
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Soheil Mehmandoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mehrabi
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehrdad Khezri
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Epidemiology, New York University School of Global Public Health, New York, NY, United States
| | - Gelareh Mostashari
- United Nations Office on Drugs and Crime, Country Office in the Islamic Republic of Iran, Tehran, Iran
| | - Mohammad Karamouzian
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Centre On Drug Policy Evaluation, St. Michael's Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, USA.
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Wadams M, Grekul J, Lessard S, de Padua A, Caine V. Narrative Coherence and Relational Agency: Unraveling Transitions Into and Out of Alberta Correctional Facilities for People Living With HIV. QUALITATIVE HEALTH RESEARCH 2024:10497323241278537. [PMID: 39499498 DOI: 10.1177/10497323241278537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2024]
Abstract
Incarcerated populations in Canada face significant health and social challenges during transitions into and out of correctional facilities. These transitions around facilities pose disproportionate barriers to care for people living with HIV. Further research is crucial to comprehend these challenges and reimagine care concepts for people who experience structural marginalization. In this article, experiences of transitions into and out of Alberta correctional facilities for people living with HIV are explored using narrative inquiry. Conducted in a Western Canadian city from 2021 to 2022, the inquiry revolved around two men living with HIV and a history of incarceration. Through co-creating field texts and narrative accounts, their unique experiences of transitions were explored through a collaborative process of analysis. Narrative threads from Bruce and Kyle showcased a lack of narrative coherence and the presence of tensions in their lives, while also emphasizing relational agency. The findings provide avenues for health, social, and justice practitioners who support and care for individuals living with HIV and a history of incarceration to think differently about transitions. By highlighting the importance of attending to the unique identities of individuals and relationships from a position of relational agency, the study advances our understanding of transitions. Recommendations for practice and policy include (a) fostering relational agency among practitioners; (b) challenging conventional views of transitions around correctional settings; (c) incorporating peer-based programming into support services; and (d) reconsidering health, justice, and social systems to better support communities disproportionately affected by high rates of incarceration and HIV.
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Affiliation(s)
- Morgan Wadams
- Faculty of Nursing, MacEwan University, Edmonton, AB, Canada
| | - Jana Grekul
- Faculty of Arts, University of Alberta, Edmonton, AB, Canada
| | - Sean Lessard
- Faculty of Education, University of Alberta, Edmonton, AB, Canada
| | - Anthony de Padua
- College of Nursing, University of Saskatchewan, Prince Albert, SK, Canada
| | - Vera Caine
- School of Nursing, University of Victoria, Victoria, BC, Canada
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Erickson M, Krüsi A, Shannon K, Braschel M, Norris C, Buxton J, Martin RE, Deering K. Pathways From Recent Incarceration to Antiretroviral Therapy Adherence: Opportunities for Interventions to Support Women Living With HIV Post Release From Correctional Facilities. J Assoc Nurses AIDS Care 2023; 34:58-70. [PMID: 36656092 PMCID: PMC9869452 DOI: 10.1097/jnc.0000000000000374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
ABSTRACT Women living with HIV are increasingly incarcerated and experience suboptimal HIV health outcomes post release from incarceration. Drawing on cohort data with cisgender and trans women living with HIV (Sexual Health and HIV/AIDS: Women's Longitudinal Needs Assessment), we used path analysis to investigate pathways from recent incarceration to optimal antiretroviral therapy (ART) adherence. We tested direct effects between recent incarceration, mediating variables, and ART adherence, along with indirect effects between incarceration and ART adherence through each mediator. We assessed model fit using chi-square, root-mean-square error of approximation (RMSEA), and comparative fit index (CFI). Our hypothesized model fit well to the data (χ2(1)=1.100; p=.2943; CFI = 1.000; RMSEA = 0.007). Recent experiences of homelessness, criminalized substance use, and gender-based violence each fully mediated the pathway between recent incarceration and optimal ART adherence. Findings highlight the need for safe and supportive housing, supports for criminalized substance use, and trauma and violence-informed care and practice post release from incarceration.
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Affiliation(s)
| | - Andrea Krüsi
- Centre for Gender and Sexual Health Equity, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Kate Shannon
- Centre for Gender and Sexual Health Equity, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | | | - Candice Norris
- Centre for Gender and Sexual Health Equity, Vancouver, Canada
| | - Jane Buxton
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Ruth Elwood Martin
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Kathleen Deering
- Centre for Gender and Sexual Health Equity, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
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4
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Wadams ML. Exploring Moral Categorizations and Symbolic Boundaries Around People Living With HIV in a Correctional Setting. JOURNAL OF FORENSIC NURSING 2022; 18:214-220. [PMID: 35437297 DOI: 10.1097/jfn.0000000000000393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
For people living with HIV, correctional facilities, such as jails, prisons, and remand centers in Canada are complex environments at the intersection of health, justice, social, and criminal systems. Turning toward experiences, I explore my stories and observations of working with people living with HIV as a registered nurse in a large correctional facility in Western Canada. Based upon a narrative understanding of experience, I inquire into these stories and observations through the application of Mary Douglas' theoretical work on purity versus impurity and Michèle Lamont's symbolic boundary work. I engage in a reflective dialogue with the newfound meanings and understandings produced and discuss significant personal, practice-based, social, and policy-based insights within the context of my nurse researcher-practitioner role. This dialogue draws attention and raises questions about social practices, HIV-related stigma, correctional nursing, and the particularities of life evident within correctional facilities. Clinical implications for correctional nurses are discussed.
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Affiliation(s)
- Morgan Lee Wadams
- Author Affiliation: Faculty of Nursing, University of Alberta, Edmonton, Canada
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Blue C, Buchbinder M, Brown ME, Bradley-Bull S, Rosen DL. Access to HIV care in jails: Perspectives from people living with HIV in North Carolina. PLoS One 2022; 17:e0262882. [PMID: 35073350 PMCID: PMC8786150 DOI: 10.1371/journal.pone.0262882] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 01/10/2022] [Indexed: 11/19/2022] Open
Abstract
Most incarcerations for people living with HIV (PLWH) occur in jails, yet studies of HIV care during jail incarceration are limited. As part of a larger study to explore the ethical considerations in extending public health HIV surveillance to jail settings, we conducted semi-structured interviews with twenty-three PLWH with more than 300 distinct jail incarcerations post HIV diagnosis in 21 unique North Carolina jails. Interviews included questions about HIV disclosure in jail, the type of HIV care received in jail, and overall experiences with HIV care in jail. We report on participants' experiences and perspectives in four domains: access to HIV care in jail; impact of jail incarceration on continuity of HIV care; privacy and stigma; and satisfaction with HIV care in jail. Although most participants received HIV medications and saw providers while in jail, almost half reported that their greatest challenge in regard to HIV care was obtaining their HIV medications in the face of limited jail resources or policies that made access to medications difficult. Findings from this study suggest that jail leadership should review internal policies regarding HIV medications to ensure that PLWH can receive them quickly upon entry into jail. Findings also suggest that more external resources are needed, for example from state and local health departments, so that jails can provide timely HIV medications for PLWH incarcerated in their facilities.
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Affiliation(s)
- Colleen Blue
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Mara Buchbinder
- Department of Social Medicine, Center for Bioethics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Mersedes E. Brown
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Steve Bradley-Bull
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - David L. Rosen
- Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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Pettus-Davis C, Kennedy SC, Veeh CA. Incarcerated individuals' experiences of COVID-19 in the United States. Int J Prison Health 2021; 17:335-350. [PMID: 33760428 DOI: 10.1108/ijph-11-2020-0094] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE This study aims to examine steps taken by correctional staff to prevent COVID-19 from spreading through correctional facilities and explores strategies used by incarcerated individuals to reduce their own risk of contracting COVID-19 during confinement. DESIGN/METHODOLOGY/APPROACH Data were drawn from interviews with 327 individuals incarcerated after March 16, 2020, in Midwest1, Midwest2 and Southeast state using a questionnaire developed for this purpose. All study participants were actively involved in a randomized controlled trial of a behavioral health reentry intervention and the human subjects board approved the supplement of this study on COVID-19; interviews were conducted from April 15 to November 19, 2020. FINDINGS Overall, 9.89% of participants contracted COVID-19. Most (68.50%) individuals learned about COVID-19 from television compared to official correctional facility announcements (32.42%). Participants wore face masks (85.02%), washed hands (84.40%) and practiced physical distancing when possible (66.36%). Participants reported that facilities suspended visitation (89.60%) and volunteers (82.57%), provided face masks (83.18%), sanitized (68.20%), conducted temperature checks (55.35%) and released individuals early (7.34%). SOCIAL IMPLICATIONS Longitudinal observational study on the implementation and effectiveness of public health guidelines in prisons and jails may identify best practices for containing the infectious disease. Maximizing transparent communications, as well as COVID-19 prevention and mitigation efforts, are critical to achieving universal best practices for virus containment and amplifying public health. ORIGINALITY/VALUE Data presented indicate the early adoption of many Centers for Disease Control guidelines by individuals and correctional facilities, although broad variation existed. Data support the identification of containment strategies for feasible implementation in a range of correctional spaces.
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Affiliation(s)
| | - Stephanie C Kennedy
- Institute for Justice Research and Development, Florida State University, Tallahassee, Florida, USA
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Buchbinder MH, Blue C, Brown ME, Bradley-Bull S, Rosen DL. Jail-Based Data-to-Care to Improve Continuity of HIV Care: Perspectives and Experiences from Previously Incarcerated Individuals. AIDS Res Hum Retroviruses 2021; 37:687-693. [PMID: 33764187 PMCID: PMC8501464 DOI: 10.1089/aid.2020.0296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Incarceration can disrupt retention in HIV care and viral suppression, yet it can also present an opportunity to reengage people living with HIV (PLWH) in care. Data-to-care (D2C) is a promising new public health strategy that uses HIV surveillance data to improve continuity of care for PLWH. The goal of this study was to examine perspectives on and experiences with D2C among PLWH who had recently been incarcerated in jail. Semistructured, qualitative interviews were conducted with 24 PLWH in community and prison settings about (1) knowledge of and experiences with D2C and (2) attitudes about implementing D2C in the jail setting. Participants who had been contacted for D2C described their interactions with state public health workers favorably, although almost half were not aware that the state performs HIV surveillance and D2C. While most participants indicated they would welcome assistance from the state for reengaging in care, they also framed retention in care as an individual responsibility. Most participants supported the idea of jail-based D2C. A vocal minority expressed adamant opposition, citing concerns about the violation of privacy and the threat of violence in the jail setting. Findings from this study suggest that D2C interventions in jails could be beneficial to reengaging PLWH in care, and acceptable to PLWH if done in a way that is sensitive to the needs and concerns of incarcerated individuals. If implemented, jail-based D2C programs must be designed with care to preserve privacy, confidentiality, and the autonomy of incarcerated individuals.
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Affiliation(s)
- Mara H. Buchbinder
- Department of Social Medicine, Center for Bioethics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Colleen Blue
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Mersedes E. Brown
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Steve Bradley-Bull
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - David L. Rosen
- Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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8
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Erickson M, Shannon K, Ranville F, Pooyak S, Howard T, McBride B, Pick N, Martin RE, Krüsi A. "They look at you like you're contaminated": how HIV-related stigma shapes access to care for incarcerated women living with HIV in a Canadian setting. Canadian Journal of Public Health 2021; 113:282-292. [PMID: 34472049 DOI: 10.17269/s41997-021-00562-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 07/02/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Given the gender disparities in HIV outcomes for women living with HIV (WLWH) who experience incarceration, and the impact of HIV-related stigma on HIV care, this qualitative study investigated how HIV-related stigma within prison settings shapes HIV care for WLWH. METHODS Drawing from SHAWNA (Sexual Health and HIV/AIDS: Women's Longitudinal Needs Assessment), a community-based research project with cisgender and transgender WLWH in Metro Vancouver, peer and community interviewers conducted 19 qualitative interviews (May 2017-February 2018) with recently incarcerated WLWH focused on factors that shape incarceration trajectories. Drawing on socio-ecological frameworks and using participatory analysis, this analysis sought to characterize how HIV-related stigma shapes experiences and access to care for incarcerated WLWH. RESULTS Participants' responses focused predominately on experiences in provincial correctional facilities and the ways through which HIV-related stigma within correctional settings was linked to access to HIV care. Experiences of HIV-related stigma within prisons led to isolation and discrimination for WLWH which was reinforced through institutional processes, compromised privacy, and uncertainty about confidentiality. Experiences of HIV-related stigma informed decisions for some participants to withhold HIV status from healthcare staff, compromising access to HIV treatment during incarceration. CONCLUSION Amid ongoing efforts to improve healthcare delivery within Canadian correctional facilities, these findings have important implications for the provision of HIV care for incarcerated WLWH. Culturally safe, trauma-informed programming focused on reducing HIV-related stigma, improved communication regarding medical privacy, and interventions to change processes that compromise privacy is critical to improve healthcare access in correctional facilities.
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Affiliation(s)
- Margaret Erickson
- Centre for Gender and Sexual Health Equity, 1190 Hornby St, Vancouver, BC, V6Z 2K5, Canada
| | - Kate Shannon
- Centre for Gender and Sexual Health Equity, 1190 Hornby St, Vancouver, BC, V6Z 2K5, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Flo Ranville
- Centre for Gender and Sexual Health Equity, 1190 Hornby St, Vancouver, BC, V6Z 2K5, Canada
| | - Sherri Pooyak
- Canadian Aboriginal AIDS Network, SK, Fort Qu'Appelle, Canada
| | | | - Bronwyn McBride
- Centre for Gender and Sexual Health Equity, 1190 Hornby St, Vancouver, BC, V6Z 2K5, Canada
| | - Neora Pick
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada.,Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, BC, Canada
| | - Ruth Elwood Martin
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Andrea Krüsi
- Centre for Gender and Sexual Health Equity, 1190 Hornby St, Vancouver, BC, V6Z 2K5, Canada. .,Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
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Ismail R, Voss JG, Yona S, Nurachmah E, Boutain D, Lowe C, John-Stewart G, Woods NF. Classifying stigma experience of women living with HIV in Indonesia through the social ecological model. Health Care Women Int 2021; 43:345-366. [PMID: 34379051 DOI: 10.1080/07399332.2021.1929989] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Little is known how stigma theories apply to women living with HIV (WLWH). To apply stigma theories to WLWH, and locate within the dimensions of the Social-Ecological Model (SEM). Using a literature review and a theoretical subtraction to apply stigma forms to the SEM dimensions. WLWH begin to self-stigmatize, receive stigma based on fear from the family and community. Healthcare providers and society stigmatize WLWH by ascribing character flaws to them. The SEM allowed us to locate the dimensions of stigma and identify areas for future interventions for WLWH in Indonesia and other countries.
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Affiliation(s)
- Rita Ismail
- Ministry of Health Republic of Indonesia, Jakarta, Indonesia
| | - Joachim G Voss
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Sri Yona
- Department of Medical Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Elly Nurachmah
- Department of Medical Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Doris Boutain
- Psychosocial and Community Health, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Celia Lowe
- Department of Anthropology, University of Washington, Seattle, Washington, USA
| | - Grace John-Stewart
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Nancy Fugate Woods
- Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle, Washington, USA
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10
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Chimoyi L, Hoffmann CJ, Hausler H, Ndini P, Rabothata I, Daniels-Felix D, Olivier AJ, Fielding K, Charalambous S, Chetty-Makkan CM. HIV-related stigma and uptake of antiretroviral treatment among incarcerated individuals living with HIV/AIDS in South African correctional settings: A mixed methods analysis. PLoS One 2021; 16:e0254975. [PMID: 34329311 PMCID: PMC8323907 DOI: 10.1371/journal.pone.0254975] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 07/07/2021] [Indexed: 11/26/2022] Open
Abstract
Background Stigma affects engagement with HIV healthcare services. We investigated the prevalence and experience of stigma among incarcerated people living with HIV (PLHIV) in selected South African correctional settings during roll-out of universal test and treat. Methods A cross-sectional mixed-methods study design included 219 incarcerated PLHIV and 30 in-depth interviews were conducted with four different types of PLHIV. HIV-related stigma was assessed through survey self-reporting and during the interviews. A descriptive analysis of HIV-related stigma was presented, supplemented with a thematic analysis of the interview transcripts. Results ART uptake was high (n = 198, 90.4%) and most reported HIV-related stigma (n = 192, 87.7%). The intersectional stigma occurring due to individual and structural stigma around provision of healthcare in these settings mostly contributed to perceived stigma through involuntary disclosure of HIV status. Interpersonal and intrapersonal factors led to negative coping behaviours. However, positive self-coping strategies and relationships with staff encouraged sustained engagement in care. Conclusion We encourage continuous peer support to reduce stigmatization of those infected with HIV and whose status may be disclosed inadvertently in the universal test and treat era.
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Affiliation(s)
- Lucy Chimoyi
- Implementation Research Division, The Aurum Institute, Johannesburg, South Africa
- * E-mail:
| | - Christopher J. Hoffmann
- Implementation Research Division, The Aurum Institute, Johannesburg, South Africa
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
| | | | - Pretty Ndini
- Implementation Research Division, The Aurum Institute, Johannesburg, South Africa
| | - Israel Rabothata
- Implementation Research Division, The Aurum Institute, Johannesburg, South Africa
| | | | | | - Katherine Fielding
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Salome Charalambous
- Implementation Research Division, The Aurum Institute, Johannesburg, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Candice M. Chetty-Makkan
- Implementation Research Division, The Aurum Institute, Johannesburg, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Health Economics and Epidemiology Research Office, Johannesburg, South Africa
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11
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Carvalho IDS, Guedes TG, Bezerra SMMDS, Alves FAP, Leal LP, Linhares FMP. Educational technologies on sexually transmitted infections for incarcerated women. Rev Lat Am Enfermagem 2020; 28:e3392. [PMID: 33174996 PMCID: PMC7647417 DOI: 10.1590/1518-8345.4365.3392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/15/2020] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE to analyze in the scientific literature the educational technologies on sexually transmitted infections used in health education for incarcerated women. METHOD an integrative review carried out by searching for articles in the following databases: Scopus, Cumulative Index of Nursing and Allied Health, Education Resources Information Center, PsycInFO, Medical Literature Analysis and Retrieval System Online, Latin American Literature in Health Sciences, Cochrane, and the ScienceDirect electronic library. There were no language and time restrictions. A search strategy was developed in PubMed and later adapted to the other databases. RESULTS a total of 823 studies were initially identified and, after applying inclusion and exclusion criteria, eight articles were selected. Most of them were developed in the United States with a predominance of randomized clinical trials. The technologies identified were of the printed materials type, isolated or associated to simulators of genital organs, videos, and games. CONCLUSION the technologies on sexually transmitted infections used in health education for incarcerated women may contribute to adherence to the prevention of this serious public health problem in the context of deprivation of liberty.
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12
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Culbert GJ, Waluyo A, Earnshaw VA. Exploring the acceptability of HIV partner notification in prisons: Findings from a survey of incarcerated people living with HIV in Indonesia. PLoS One 2020; 15:e0234697. [PMID: 32603363 PMCID: PMC7326233 DOI: 10.1371/journal.pone.0234697] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 06/01/2020] [Indexed: 01/28/2023] Open
Abstract
Assisted HIV partner notification services provide a safe and effective way for people living with HIV (PLHIV) to inform their partners about the possibility of exposure and to offer them testing, treatment, and support. This study examined whether or not PLHIV in prison might be willing to participate in assisted HIV partner notification services and their reasons for and against disclosing their HIV-positive status to their partners. PLHIV (n = 150) recruited from Jakarta's two largest all-male prisons completed an interviewer-administered questionnaire collecting demographic and risk behavior data, and attitudes toward HIV disclosure and partner services. Among those who were sexually active and/or injecting drugs before incarceration, two-thirds (66.4%, 91/137) endorsed provider referral as an acceptable way to notify their sex partners, and nearly three quarters (72.4%, 89/123) endorsed provider referral to notify their drug-injecting partners. Only a quarter (25.1%) of participants reported that their main sex partner had ever received an HIV test. Participants with anticipated stigma were less likely to endorse provider referral for sex partners (adjusted odds ratio [aOR] = 0.58, 95% CI: 0.35, 0.96) and drug-injecting partners (aOR = 0.54, 95% CI: 0.29, 1.00). Relationship closeness was associated with higher odds of endorsing provider referral for drug-injecting partners (aOR = 2.08, 95% CI: 1.25, 3.45). Protecting partners from infection and a moral duty to inform were main reasons to disclose, while stigma and privacy concerns were main reasons not to disclose. Most incarcerated PLHIV have at-risk partners in the community who they would be willing to notify if provided with assistance. Assisted partner notification for prison populations offers a promising public health approach to accelerate diagnosis, treatment, and prevention of HIV infection in the community, particularly among women.
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Affiliation(s)
- Gabriel J. Culbert
- Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, United States of America
- Center for HIV/AIDS Nursing Research, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
- * E-mail:
| | - Agung Waluyo
- Center for HIV/AIDS Nursing Research, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Valerie A. Earnshaw
- Department of Human Development and Family Sciences, University of Delaware, Newark, DE, United States of America
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Huber F, Vandentorren S, Merceron A, Bonifay T, Pastre A, Lucarelli A, Nacher M. Returning to care after incarceration with HIV: the French Guianese experience. BMC Public Health 2020; 20:754. [PMID: 32448209 PMCID: PMC7245866 DOI: 10.1186/s12889-020-08772-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 04/24/2020] [Indexed: 11/10/2022] Open
Abstract
Background HIV prevalence in correctional facilities may be 2 to 10 times higher than in the general adult population. Antiretroviral therapy (ART) interruption is frequent after an incarceration. This, in combination with post-release high-risk behaviors, may have detrimental consequences on the epidemic. Although return to care after release from correctional facilities has been described in many North American settings, data from South America seemed scarce. French Guiana is the only French territory located in South America. In 2014, HIV prevalence was estimated at 1.2% among pregnant women and oscillated around 4% in the only correctional facility. Method HIV-infected adults released from the French Guiana correctional facility between 2007 and 2013 were included in a retrospective cohort survey. The first objective was to describe the cascade of care in the 4 years following release. The secondary objectives were to describe contacts with care and to identify factors associated with return to HIV care, 1 year after release. Results We included 147 people, mostly males (81.6%). The median time before the first ambulatory consultation was 1.8 months. Within 1 year after release, 27.9% came for unscheduled emergency consultations, 22.4% were hospitalized. Within 4 years after release, 40.0–46.5% were in care, 22.4% archieved virological success. Being on ART when incarcerated was associated with HIV care (aIRR: 2.0, CI: 1.2–3.0), whereas being HIV-diagnosed during the last incarceration was associated with poor follow-up (aIRR: 0.3, CI: 0.1–0.9). Conclusion The risk of HIV-follow-up interruption is high, after an incarceration with HIV. ART supply should be sufficient to cover the timespan following release, several months if possible. Those not on ART at the time of incarceration may require special attention, especially those newly HIV-diagnosed while in custody. Comprehensive programs are necessary to support ex-offenders to stay on ART after incarceration.
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Affiliation(s)
- F Huber
- COREVIH Guyane, Centre Hospitalier Andree Rosemon, Cayenne, Guyane Française, France. .,Réseau Kikiwi, Cayenne, Guyane Française, France.
| | - S Vandentorren
- Département d'épidemiologie sociale, INSERM, Sorbonne université, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
| | - A Merceron
- Université des Antilles et de la Guyane, Faculté de Médecine Hyacinthe Basturaud, Pointe-à-Pitre, France
| | - T Bonifay
- UCSA, Centre Hospitalier Andree Rosemon, Cayenne, Guyane Française, France
| | - A Pastre
- UCSA, Centre Hospitalier Andree Rosemon, Cayenne, Guyane Française, France
| | - A Lucarelli
- Hôpital de Jour Adulte, Centre Hospitalier Andree Rosemon, Cayenne, Guyane Française, France
| | - M Nacher
- Inserm CIC Antilles-Guyane INSERM 1424 (Pole Guyane), Universite de Guyane, Cayenne, France
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Kouyoumdjian FG, Lamarche L, McCormack D, Rowe J, Kiefer L, Kroch A, Antoniou T. 90-90-90 for everyone?: Access to HIV care and treatment for people with HIV who experience imprisonment in Ontario, Canada. AIDS Care 2019; 32:1168-1176. [PMID: 31615271 DOI: 10.1080/09540121.2019.1679710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We examined HIV care and treatment in prison and after release for people with HIV in Ontario, Canada, and compared HIV care and treatment with the general population. We used administrative data to identify people with HIV released from provincial prison in 2010 and in the general population. We calculated the proportion of people with HIV who accessed HIV care in prison. We compared HIV care use between people with HIV on prison release and in the general population. We estimated the proportion of people with HIV on antiretroviral therapy in prison as the ratio of the average numbers of people prescribed antiretroviral therapy in prison in 2009/2010 and people with HIV in prison in January 2010. We compared the proportion of people with HIV on public drug benefits that filled an antiretroviral therapy prescription within 6 months for people postrelease and in the general population. Of 344 people with HIV on prison admission, 34.0% received HIV care in prison. Over 1 year, 63.6% of 330 people with HIV on prison release and 67.7% of 15,819 people with HIV in the general population accessed HIV care (p = 0.118), and 43.3% of people with HIV on prison release and 55.2% of people with HIV in the general population had 2 or more HIV care visits (p < 0.001). In prison, 52.4% of people with HIV (39.5/75.4) were on antiretroviral therapy. Of those accessing drug benefits, 60.1% of 226 people with HIV on prison release and 79.6% of 7458 people with HIV in the general population claimed an antiretroviral therapy prescription within 6 months (p < 0.001). Access to HIV care and treatment were suboptimal in prison, and sustained HIV care and treatment were worse for people post-release compared to the general population. Interventions are needed to support HIV care for this population.
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Affiliation(s)
- Fiona G Kouyoumdjian
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada.,ICES, Toronto, ON, Canada.,Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | - Larkin Lamarche
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | | | | | - Lori Kiefer
- Ministry of Community Safety and Correctional Services, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Tony Antoniou
- ICES, Toronto, ON, Canada.,Department of Family and Community Medicine, St. Michael's Hospital and University of Toronto, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
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15
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Culbert GJ, Waluyo A, Wang M, Putri TA, Bazazi AR, Altice FL. Adherence to Antiretroviral Therapy Among Incarcerated Persons with HIV: Associations with Methadone and Perceived Safety. AIDS Behav 2019; 23:2048-2058. [PMID: 30465106 DOI: 10.1007/s10461-018-2344-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
With adequate support, people with HIV (PWH) may achieve high levels of adherence to antiretroviral therapy (ART) during incarceration. We examined factors associated with ART utilization and adherence among incarcerated PWH (N = 150) in Indonesia. ART utilization was positively associated with HIV status disclosure (adjusted odds ratio [aOR] = 5.5, 95% CI 1.2-24.1, p = 0.023), drug dependency (aOR = 3.9, 95% CI 1.2-12.6, p = 0.022), health service satisfaction (aOR = 3.2, 95% CI 1.7-6.2, p < 0.001), and perceived need for medical treatment (aOR = 1.6, 95% CI 1.1-2.5, p = 0.011), and negatively associated with chance locus of control (aOR = 0.3, 95% CI 0.1-0.7, p = 0.013). Most participants utilizing ART (74.5%) reported less than "perfect" ART adherence. ART adherence was independently associated with perceived personal safety (β = 0.21, 95% CI 0.01-0.40, p = 0.032) and methadone utilization (β = 0.84, 95% CI 0.10-1.67, p = 0.047). PWH receiving methadone had a sixfold higher adjusted odds of being highly-adherent to ART (aOR = 6.3, 95% CI 1.1-35.7, p = 0.036). Interventions that increase methadone utilization and personal safety may improve ART adherence among incarcerated PWH.
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Affiliation(s)
- Gabriel J Culbert
- Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, 845 S. Damen Ave. Rm. 910, Chicago, IL, USA.
- Center for HIV/AIDS Nursing Research, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia.
| | - Agung Waluyo
- Center for HIV/AIDS Nursing Research, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Melinda Wang
- Department of Medicine, Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, New Haven, CT, USA
| | - Tissa Aulia Putri
- Center for HIV/AIDS Nursing Research, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Alexander R Bazazi
- Department of Psychiatry, San Francisco School of Medicine, University of California, San Francisco, CA, USA
| | - Frederick L Altice
- Department of Medicine, Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, New Haven, CT, USA
- Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT, USA
- Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
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16
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Farel CE, Golin CE, Ochtera RD, Rosen DL, Margolis M, Powell W, Wohl DA. Underutilization of HIV Testing Among Men with Incarceration Histories. AIDS Behav 2019; 23:883-892. [PMID: 30661215 PMCID: PMC9490788 DOI: 10.1007/s10461-018-02381-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Annual HIV testing is recommended for individuals at high risk of infection, specifically incarcerated populations. Incarcerated men carry a higher lifetime risk of acquiring HIV than the general population, yet little is known about their HIV testing behaviors. We collected Audio Computer Assisted Self Interview data for 819 men entering a state prison in North Carolina. We assessed correlates of previous HIV testing, including stigmatizing attitudes and beliefs, and explored two outcomes: (1) ever HIV tested before current incarceration, and (2) recency of last HIV test. Eighty percent had been HIV tested before; of those, 36% reported testing within the last year. Being African American, having education beyond high school, prior incarceration, and higher HIV knowledge increased odds of ever having tested. Results of this study highlight the need to expand HIV testing and education specific to incarcerated populations. Additionally, efforts should be made to monitor and encourage repeat screening.
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Affiliation(s)
- Claire E Farel
- Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, 130 Mason Farm Road, CB# 7030, Chapel Hill, NC, 27599, USA.
- Center for AIDS Research, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
| | - Carol E Golin
- Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, 130 Mason Farm Road, CB# 7030, Chapel Hill, NC, 27599, USA
- Division of General Internal Medicine and Clinical Epidemiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
- Center for AIDS Research, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Rebecca D Ochtera
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - David L Rosen
- Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, 130 Mason Farm Road, CB# 7030, Chapel Hill, NC, 27599, USA
- Center for AIDS Research, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Marjorie Margolis
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Wizdom Powell
- Health Disparities Institute, University of Connecticut, Hartford, CT, USA
| | - David A Wohl
- Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, 130 Mason Farm Road, CB# 7030, Chapel Hill, NC, 27599, USA
- Center for AIDS Research, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
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Francis-Graham S, Ekeke NA, Nelson CA, Lee TY, Haj SE, Rhodes T, Vindrola C, Colbourn T, Rosenberg W. Understanding how, why, for whom, and under what circumstances opt-out blood-borne virus testing programmes work to increase test engagement and uptake within prison: a rapid-realist review. BMC Health Serv Res 2019; 19:152. [PMID: 30849986 PMCID: PMC6408812 DOI: 10.1186/s12913-019-3970-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 02/21/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Prisons represent a unique opportunity to diagnose blood-borne viruses. Opt-out testing is receiving increasing interest, as a result of mounting evidence to suggest that the manner in which a test offer is delivered, affects test uptake. Although the effectiveness of opt-out testing within the prison setting has been established, robust explanations are required for the variation in outcomes reported. METHODS Rapid-realist review methodology was used to synthesise the literature on prison-based opt-out testing. The review was carried out in three phases. Phase one: An expert panel provided literature relevant to the implementation of opt-out testing within the English prison estate. Unstructured searches were also conducted to identify other social programmes where "opt-out" had been used to increase uptake. Phase two: a systematic search of six peer-review and five grey literature databases was carried out to identify empirical data on opt-out testing within the prison setting. Phase three: Additional non-exhaustive searches were carried out to identify literature that reinforced emergent concepts. The development of programme theory took place with each iteration and was validated in consultation with stakeholders. RESULTS Programme theory was constructed for two outcomes: the proportion of intake offered a test and the proportion offered that accepted testing. The proportion of intake offered testing was influenced by the timing of the test offer, which was often delayed due to barriers to prisoner access. The decision to accept testing was influenced by concerns about confidentiality, fear of a positive diagnosis, a prisoner's personal interpretation of risk, discomfort with invasive procedures, trust in healthcare, and the fidelity of the opt-out offer. CONCLUSIONS This review identified important implementation considerations that moderate the effectiveness of opt-out testing programmes. It also highlighted a lack of appreciation for the theoretical underpinnings of opt-out programmes and tension around how to implement testing in a manner that adheres to both default theory and informed consent. It is anticipated that results will be used to inform the design and implementation of subsequent versions of these programmes, as well as catalyse further in-depth analysis into their operation within the unique context of prison. REVIEW REGISTRATION CRD42017068342 .
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Affiliation(s)
- Seth Francis-Graham
- The National Institute for Health Research: Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections, University College London, London, UK
- The Institute for Global Health, University College London, London, UK
- The Institute for Liver and Digestive Health, Division of Medicine, University College London, London, UK
| | | | | | - Tin Yan Lee
- The Chinese University of Hong Kong, Hong Kong, China
| | | | - Tim Rhodes
- The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections, the London School of Hygiene and Tropical Medicine, London, UK
| | - Cecilia Vindrola
- The Institute of Epidemiology & Health, University College London, London, UK
| | - Tim Colbourn
- The Institute for Global Health, University College London, London, UK
| | - William Rosenberg
- The National Institute for Health Research: Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections, University College London, London, UK
- Royal Free London NHS Foundation Trust, London, UK
- The Institute for Liver and Digestive Health, Division of Medicine, University College London, London, UK
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18
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Gore D, Ferreira M, Khanna AS, Schneider J. Human Immunodeficiency Virus Partner Notification Services Among a Representative Sample of Young Black Men Who Have Sex With Men Demonstrates Limited Service Offering and Potential Benefits of Clinic Involvement. Sex Transm Dis 2018; 45:636-641. [PMID: 29465643 PMCID: PMC6089660 DOI: 10.1097/olq.0000000000000806] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Partner notification (PN) is commonly offered to persons recently diagnosed with human immunodeficiency virus (HIV) to improve linkage to care and prevent onward transmission. Yet, much remains unknown about the factors associated with successful PN participation in populations at highest risk. METHODS Data were collected during the first 2 waves (2013-2015) of "uConnect," a population-based cohort study of young black men who have sex with men in Chicago (N = 618). Participants completed a biobehavioral survey and were tested for HIV. Among HIV-infected participants (N = 187), weighted logistic regression models examined the relationship between participant characteristics and being offered PN and providing partner names. RESULTS 30.3% (n = 187) of the sample was HIV-positive, of which 71.7% (n = 134) were offered PN, including: 8.2% (n = 11) by the city health department; 51.5% (n = 69) by health care providers; and 40.3% (n = 54) by both. Being offered PN was significantly associated with criminal justice involvement history (adjusted odds ratio [aOR], 2.49; 95% confidence interval [CI], 1.38-4.49), volatile nitrates usage (aOR, 2.88; 95% CI, 1.20-6.94), and recent conversations with HIV outreach workers (aOR, 2.68; 95% CI, 1.25-5.77). Providing partner names was significantly associated with intermittent (aOR, 7.26; 95% CI, 1.75-30.07) and heavy (aOR, 11.47; 95% CI, 2.57-51.22) marijuana use, and being offered PN by both the city health department and health care provider (aOR, 8.36; 95% CI, 2.73-25.62). CONCLUSIONS A substantial proportion of HIV-diagnosed individuals were never offered PN. Being offered PN by multiple sources is associated with participation, and improved collaboration within health systems may improve participation rates.
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Affiliation(s)
- Daniel Gore
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL
- Rush Medical College, Rush University Medical Center, Chicago, IL
| | - Matthew Ferreira
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL
| | - Aditya S. Khanna
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL
- Department of Medicine, University of Chicago, Chicago, IL
| | - John Schneider
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL
- Department of Medicine, University of Chicago, Chicago, IL
- Department of Public Health Sciences, University of Chicago, Chicago, IL
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Abel S, Cuzin L, Da Cunha S, Bolivard JM, Fagour L, Miossec C, Pircher M, Thioune M, Césaire R, Cabié A. Reaching the WHO target of testing persons in jails in prisons will need diverse efforts and resources. PLoS One 2018; 13:e0202985. [PMID: 30161176 PMCID: PMC6116985 DOI: 10.1371/journal.pone.0202985] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 08/12/2018] [Indexed: 12/03/2022] Open
Abstract
Background The Caribbean is the second most affected region in the world by human immunodeficiency virus (HIV), and HIV prevalence is significantly higher among persons in jails and prisons than in the free population. The aim of our study was to assess the screening rates of HIV, hepatitis B and C, syphilis and human T cell leukaemia virus type 1 among newly-arrived persons in 2014, at Ducos facility in Martinique and the testing process performance. Methods This is an observational monocentric study conducted within the prison’s health unit. The study population consisted of all individuals incarcerated between 01/01/14 and 31/12/14. At the initial medical visit, HIV and STI testing were proposed to every newcomer. The rate of acceptance was calculated, as well as the screening process performance. Results In 2014 778 new persons were incarcerated, among those, 461 (59.3%) were tested. The main reasons for missing the testing opportunity were due to organization of the judiciary system (persons on electronic monitoring or day parole, transferred or quickly released before completion of the process) or to individual refusal. Finally, 75 persons did not get their results (all of them negative), 41 of them due to the medical staff work overload. Conclusions HIV and STI testing rates among newcomers at Ducos have notable room for improvement. The future availability of combined (HIV, HBV, HCV and syphilis) rapid tests may be very useful in case of short term incarceration, if their cost is not prohibitive. Reaching higher levels of testing will also require more resources.
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Affiliation(s)
- Sylvie Abel
- Prison Medical Unit, Martinique University Hospital, Fort de France, France
- Infectious and Tropical Diseases Unit, Martinique University Hospital, Fort de France, France
| | - Lise Cuzin
- Infectious and Tropical Diseases Unit, Martinique University Hospital, Fort de France, France
- INSERM, UMR 1027, Toulouse, France
- * E-mail:
| | - Séverine Da Cunha
- Prison Medical Unit, Martinique University Hospital, Fort de France, France
| | | | - Laurence Fagour
- Virology Laboratory, Martinique University Hospital, Fort de France, France
| | - Charline Miossec
- Parasitology Laboratory, Martinique University Hospital, Fort de France, France
| | - Mathilde Pircher
- Prison Medical Unit, Martinique University Hospital, Fort de France, France
- Infectious and Tropical Diseases Unit, Martinique University Hospital, Fort de France, France
| | - Marême Thioune
- Prison Medical Unit, Martinique University Hospital, Fort de France, France
- Infectious and Tropical Diseases Unit, Martinique University Hospital, Fort de France, France
| | - Raymond Césaire
- Virology Laboratory, Martinique University Hospital, Fort de France, France
- Antilles University, EA4537, Fort de France, France
| | - André Cabié
- Infectious and Tropical Diseases Unit, Martinique University Hospital, Fort de France, France
- Antilles University, EA4537, Fort de France, France
- Inserm CIC1424, Martinique University Hospital, Fort de France, France
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