"You're in a World of Chaos'': Experiences Accessing HIV Care and Adhering to Medications After Incarceration
"You're in a World of Chaos'': Experiences Accessing HIV Care and Adhering to Medications After Incarceration
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DOI：
10.1016/j.jana.2015.06.001
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发表时间：
2015-09-01
影响因子：
2
通讯作者：
Golin, Carol E.
中科院分区：
文献类型：
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作者：
Dennis, Alexis C.;Barrington, Clare;Golin, Carol E.
大多数感染艾滋病毒的囚犯出狱时病毒载量受到抑制；然而，许多人在重新进入社区生活时失去了护理和药物依从性。在对46名重新入狱的HIV感染者进行焦点小组（n = 6）和深度访谈（n = 9）的辅助数据分析中，我们使用归纳分析方法来探索个人、人际、社区和结构因素与HIV管理之间的相互作用。参与者描述了在这四个层面上参与和坚持护理的障碍和促进因素，以及艾滋病毒和监禁相关的耻辱和歧视环境。障碍和促进因素交织在一起，在参与者的生活中产生了相互竞争的需求和一种混乱感，导致他们先解决与重返社会有关的基本需求（如住房、食物），然后才是保健需求。需要同时处理多个层面的干预措施，包括增加就业和住房机会、加强社会支持和减少耻辱感。2015年艾滋病护理护士协会
Most HIV-infected inmates leave prison with a suppressed viral load; many, however, become disconnected from care and nonadherent to medications during reentry to community life. In this secondary data analysis of focus groups (n = 6) and in-depth interviews (n = 9) with 46 formerly incarcerated HIV-infected people during reentry, we used an inductive analytic approach to explore the interplay between individual, interpersonal, community, and structural factors and HIV management. Participants described barriers and facilitators to care engagement and adherence at each of these four levels, as well as a milieu of HIV and incarceration-related stigma and discrimination. The constellation of barriers and facilitators created competing demands and a sense of chaos in participants' lives, which led them to address reentry-related basic needs (e.g., housing, food) before health care needs. Interventions that simultaneously address multiple levels, including augmenting employment and housing opportunities, enhancing social support, and reducing stigma, are needed. Copyright (C) 2015 Association of Nurses in AIDS Care