Research paperUnderstanding interactions of formerly incarcerated HIV-positive men and transgender women with substance use treatment, medical, and criminal justice systems
Section snippets
Setting
The study was carried out in Los Angeles County and involved a direct collaboration between the Division of General Internal Medicine and Health Services Research in the Department of Medicine, UCLA; the Los Angeles County Department of Public Health, Division of HIV and STD Programs (DHSP); and the Los Angeles County Sheriff’s Department (LASD). The latter oversees the LA County Jail (LACJ) system, including its medical services. Generally, jails are short-term facilities housing individuals
Results
The shifting contexts within which individuals found themselves when moving between custody and community settings featured prominently in the interviews. The themes generated describe how systems of substance use treatment, HIV medical care, and criminal justice interact to impact CJI-involved patients’ HIV care and substance use.
Discussion
The marginalized and challenging post-release experiences of CJI HIV-positive people with substance dependence reveal significant institutional deficits. Study participants’ frequent histories of both recurrent incarceration and substance misuse, despite participation in recovery programmes, highlight potentially insufficient treatment modalities and problematic criminal justice policies. Furthermore, the criminal justice system may lessen the effectiveness of substance use treatment received
Author agreement/declaration of submission
This manuscript has not been published previously, and it is not under consideration for publication elsewhere. Its publication is approved by all authors and tacitly or explicitly by the responsible authorities where the work was carried out. If accepted, it will not be published elsewhere in the same form, in English or in any other language, including electronically without the written consent of the copyright-holder. All authors warrant that the manuscript is their original work; and that
Funding source declaration
This work was supported by the National Institutes of Health (NIH)/National Institutes on Drug Abuse (NIDA) [1R01DA030781]; Drs. Amani, Harawa and Cunningham received additional support for this work through NIH/NIMHD [P20 MD000182; U54 MD007598]; NIH/NIMH [P30 MH058107]; NIH/NCRR/NCATS [UL1 TR000124]; NIH/NIDA [R01DA039934]; and the California HIV/AIDS Research Program [RP11-LA-020]. The sponsors did not have any role in the collection, analysis, data interpretation, manuscript writing, or
Acknowledgements
Special thanks to the leadership and staff of the Los Angeles Sheriff’s Department and Department of HIV and STD Programs who helped make this study possible and to those who directly served on the study team: Trista Bingham, Alexis Huynh, Saloniki James, Garrett Cox, Mark Malek, Armidia Miranda, and Nickolay Teophiluv. Additional thanks to Gerald Asare-Bempong and Hope Watkins for manuscript support. The authors accept responsibility for the contents of this manuscript.
Conflict of interest
No
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