Department of Social Medicine, Center for Bioethics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
AIDS Res Hum Retroviruses. 2021 Sep;37(9):687-693. doi: 10.1089/AID.2020.0296. Epub 2021 Apr 30.
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.
监禁会干扰艾滋病毒感染者的护理和病毒抑制,但也为重新接触感染艾滋病毒的人(PLWH)提供了机会。数据到护理(D2C)是一种有前途的新公共卫生策略,它利用艾滋病毒监测数据来改善 PLWH 的护理连续性。本研究的目的是调查最近在监狱中被监禁的 PLWH 对 D2C 的看法和经验。采用半结构化定性访谈方法,在社区和监狱环境中对 24 名 PLWH 进行了关于(1)对 D2C 的了解和经验,以及(2)对在监狱环境中实施 D2C 的态度的访谈。与 D2C 联系过的参与者对他们与州公共卫生工作者的互动评价很高,尽管近一半的人不知道州政府进行艾滋病毒监测和 D2C。虽然大多数参与者表示他们欢迎州政府协助重新参与护理,但他们也将护理保留作为个人责任。大多数参与者支持在监狱中开展 D2C 的想法。少数直言不讳的人表示坚决反对,理由是担心侵犯隐私和监狱环境中的暴力威胁。这项研究的结果表明,在监狱中进行 D2C 干预可能有助于重新接触护理中的 PLWH,如果以对被监禁者的需求和关注点敏感的方式进行,那么对 PLWH 来说是可以接受的。如果实施,基于监狱的 D2C 计划必须精心设计,以保护被监禁者的隐私、机密性和自主权。