Staff perspectives on using long-acting antiretroviral treatment among persons being released from carceral settings in Baltimore, Maryland, USA

TL;DR

This study explores staff views on using long-acting HIV treatment for people leaving prison in Baltimore, highlighting both support and challenges in ensuring continued care.

Contribution

The paper provides new insights into staff perspectives on implementing long-acting antiretroviral treatment for incarcerated individuals during re-entry.

Findings

Staff generally support using long-acting injectable ART for incarcerated individuals.

Challenges include ensuring continuity of care and access to clinics post-release.

Resource limitations in healthcare settings were identified as a major barrier.

Abstract

The prevalence of HIV among individuals who experience incarceration is estimated to be three times higher than that of the general population in the United States. Currently, the standard of care, antiretroviral medications taken daily, is effective in reducing mortality and HIV transmission but individuals experiencing community re-entry face barriers while re-integrating with their community which may make adherence to daily medication challenging. Long acting injectable antiretroviral treatment (LAI ART) may offer an opportunity for individuals experiencing community re-entry to remain in treatment while prioritizing their other needs. Our team conducted 16 interviews with various staff in both community and carceral settings pertaining to the potential administration of LAI ART in prison settings with treatment continuing while individuals are experiencing community re-entry. Many participants were supportive of administering LAI ART in this population, but challenges related to ensuring continuation of care, access to clinics, and the lack of resources in health settings were frequently cited as potential barriers.