Patient, medical and legal perspectives on reentry: the need for a low-barrier, collaborative, patient-centered approach

Abstract

Background Worldwide, the United States has the highest incarceration rate per capita. Thousands of people are released from US correctional facilities each year, including many who are impacted by HIV infection and substance use disorder (SUD), two frequently comorbid conditions that present multiple challenges upon reentry. Reentry and care engagement research involving justice-involved people with HIV (PWH) with comorbid SUD has been largely limited to the perspective of those released. To formulate effective interventions for this population aimed at maintaining health and reducing recidivism, it is crucial to collect data from formerly incarcerated individuals with firsthand experience of the reentry process as well as other actors within the reentry framework. Insights from medical and legal service providers working in reentry systems have the potential to address key implementation concerns. To inform an intervention aimed at helping recently-released individuals PWH and SUD, we conducted a qualitative study to assess barriers and facilitators to community reentry from the perspectives of diverse consumers and providers of medical, legal, and reentry services. Results Fifteen stakeholders within XXX County participated in in-person interviews. Results indicated that 1) Patients/clients emphasized psychosocial support and individual attitude more than medical and legal participants, who chiefly focused on logistical factors such as finances, housing, and transportation; 2) Patients/clients expressed both medical and legal needs during the reentry period, though medical providers and participants from legal entities mainly expressed concerns limited to their respective scopes of work; 3) All three participant groups underscored the need for a low-barrier, collaborative, patient-centered approach to reentry with the goal of achieving self-sufficiency. Conclusions Findings support and extend existing literature detailing the barriers and facilitators to successful reentry. Our findings underscore the notion that an effective reentry intervention addresses both medical and legal needs, includes an individualized approach that incorporates psychosocial needs, and focuses on establishing self-sufficiency.

Interventions Designed to Improve HIV Continuum of Care Outcomes for Persons with HIV in Contact with the Carceral System in the USA

“…The time immediately following periods of detention represents a high-risk period for discontinuation of ART and failure to link with community-based HIV providers. Competing social and health-related priorities including securing housing and employment, reinstating health insurance, and managing requirements resulting from their carceral contact (e.g., meeting with a probation or parole officer, attending court appointments, community service) are challenges to seeking out and engaging in HIV-related medical care [ 22 – 24 ]. Therefore, the time following release from a carceral setting, often referred to as “community-reentry,” needs to be prioritized for intervention to sustain HIV treatment services.…”

Correction to: Patient, medical and legal perspectives on reentry: the need for a low-barrier, collaborative, patient-centered approach

“…Following the publication of the original article (Pulitzer et al, 2021 ) the authors noticed that the published version of the manuscript has blinded citations.…”