Pulitzer Zoe, Box Maria, Hansen Laura, Tiruneh Yordanos M, Nijhawan Ank E
Department of Internal Medicine, Division of Infectious Diseases and Geographic Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
Department of Emergency Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA.
Health Justice. 2021 Dec 2;9(1):37. doi: 10.1186/s40352-021-00161-7.
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.
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.
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.
在全球范围内，美国的人均监禁率最高。每年有成千上万的人从美国惩教设施获释，其中许多人受到艾滋病毒感染和物质使用障碍（SUD）的影响，这两种疾病经常合并出现，在重新进入社会时带来多重挑战。涉及合并SUD的感染艾滋病毒的司法涉入者（PWH）的重新进入社会和护理参与研究在很大程度上局限于获释者的视角。为了制定针对这一人群的有效干预措施，以维持健康并减少累犯，从有重新进入社会第一手经验的前被监禁者以及重新进入社会框架内的其他行为者那里收集数据至关重要。在重新进入社会系统中工作的医疗和法律服务提供者的见解有可能解决关键的实施问题。为了为旨在帮助最近获释的PWH和SUD个体的干预措施提供信息，我们进行了一项定性研究，从医疗、法律和重新进入社会服务的不同消费者和提供者的角度评估社区重新进入社会的障碍和促进因素。
XXX县的15名利益相关者参与了面对面访谈。结果表明：1）患者/客户比医疗和法律参与者更强调心理社会支持和个人态度，医疗和法律参与者主要关注财务、住房和交通等后勤因素；2）患者/客户在重新进入社会期间表达了医疗和法律需求，尽管医疗提供者和法律实体的参与者主要表达了仅限于各自工作范围的担忧；3）所有三个参与者群体都强调需要一种低门槛、协作、以患者为中心的重新进入社会方法，目标是实现自给自足。
研究结果支持并扩展了现有文献中关于成功重新进入社会的障碍和促进因素的内容。我们的研究结果强调了这样一种观念，即有效的重新进入社会干预措施既要满足医疗和法律需求，包括一种纳入心理社会需求的个性化方法，又要注重建立自给自足。
