A qualitative examination of barriers and facilitators to HIV prevention and treatment for people involved with the criminal justice system
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BACKGROUND: In an effort to address health risks for HIV among justice-involved individuals, linkage to community services for HIV and substance use disorder prevention and treatment is critical. Stakeholder feedback informing the development of interventions aimed at linking individuals to care is paramount to ensuring the success of the intervention. The current study examines focus group data collected as part of a 5-year NIDA-funded project and presents this data within an implementation science framework. METHODS: Six focus groups were conducted across four communities in two states. A total of 19 individuals representing 15 agencies, including both corrections and community healthcare providers, participated in the focus groups. A deductive coding strategy was used to code the focus group transcripts using Atlas.ti 9 software. Audio-recorded interviews were transcribed and coded by trained qualitative researchers. RESULTS: The resulting 1,485 quotes were queried and analyzed using the EPIS inner and outer contexts implementation framework for reporting the findings. Inner context themes encompassing organizational characteristics, staffing processes, and leadership highlight the importance of intra-agency communication, as well as the benefit of hiring peer navigators with lived experience. Outer context themes of interest include funding, sociopolitical context, and interorganizational networks, pointing to service barriers related to funding for PrEP and HIV care, legislative regulations, and the importance of communication to connect people with justice involvement to healthcare and other services. CONCLUSIONS: Results support the use of both patient navigation and mobile health unit models to connect justice-involved individuals to healthcare. The themes that emerged during the focus groups helped inform the ACTION study protocol, and the focus group process bolstered the connection between the represented agencies. Ultimately, these focus groups provided valuable information about the communities participating in the study and provided key insights regarding study intervention implementation. TRIAL REGISTRATION: ClinicalTrials.gov, NCT05286879. Registered 25 February 2022. https://clinicaltrials.gov/study/NCT05286879
Criminal justice · Criminology · Economic Justice · Family medicine · Political science · Public health · Qualitative research · Social justice · Social policy · Social science · Sociology · Health Policy Implementation Science · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Law · Medicine · Nursing · Psychology · Social Psychology
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