Opioid use and HIV treatment services experiences among male criminal justice-involved persons in South Africa: a qualitative study
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Published:2023-07-21
Issue:1
Volume:20
Page:
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ISSN:1477-7517
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Container-title:Harm Reduction Journal
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language:en
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Short-container-title:Harm Reduct J
Author:
An Yangxi,Hoffmann Christopher J.,Bhoora Urvisha,Ndini Pretty,Moyo Derrick,Steiner Laura,Tshuma Sukholuhle,Mabuto Tonderai,Hugo Jannie,Owczarzak Jill,Marcus Tessa S.
Abstract
Abstract
Background
Opioid use disorder (OUD) is overrepresented among people with criminal justice involvement; HIV is a common comorbidity in this population. This study aimed to examine how formerly incarcerated men living with HIV and OUD in South Africa experienced HIV and OUD services in correctional facilities and the community.
Methods
Three focus group discussions were conducted with 16 formerly incarcerated men living with HIV and OUD in Gauteng, South Africa. Discussions explored available healthcare services in correctional facilities and the community and procedural and practice differences in health care between the two types of settings. Data were analyzed thematically, using a comparative lens to explore the relationships between themes.
Results
Participants described an absence of medical services for OUD in correctional facilities and the harms caused by opioid withdrawal without medical support during incarceration. They reported that there were limited OUD services in the community and that what was available was not connected with public HIV clinics. Participants perceived correctional and community HIV care systems as readily accessible but suggested that a formal system did not exist to ensure care continuity post-release.
Conclusions
OUD was perceived to be medically unaddressed in correctional facilities and marginally attended to in the community. In contrast, HIV treatment was widely available within the two settings. The current model of OUD care in South Africa leaves many of the needs of re-entrants unmet. Integrating harm reduction into all primary care medical services may address some of these needs. Successful HIV care models provide examples of approaches that can be applied to developing and expanding OUD services in South Africa.
Funder
US National Institutes of Health Fogarty International Center
Publisher
Springer Science and Business Media LLC
Subject
Psychiatry and Mental health,Public Health, Environmental and Occupational Health,Medicine (miscellaneous)
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