Opioid use and HIV treatment services experiences among male criminal justice-involved persons in South Africa: a qualitative study

Harm Reduction Journal

Research

Derrick Moyo¹  Pretty Ndini¹  Tonderai Mabuto¹  Jill Owczarzak²  Tessa S. Marcus³  Urvisha Bhoora⁴  Jannie Hugo⁴  Sukholuhle Tshuma⁵  Yangxi An⁶  Laura Steiner⁷  Christopher J. Hoffmann⁸ 

[1] Aurum Institute, Johannesburg, South Africa;Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA;Community Oriented Primary Care Research Unit, University of Pretoria, Tshwane, South Africa;Department of Family Medicine, University of Pretoria, Tshwane, South Africa;Community Oriented Substance Use Programme, Tshwane, South Africa;Community Oriented Primary Care Research Unit, University of Pretoria, Tshwane, South Africa;Department of Family Medicine, University of Pretoria, Tshwane, South Africa;Community Oriented Substance Use Programme, Tshwane, South Africa;Department of Family Medicine, University of Pretoria, Tshwane, South Africa;Krieger School for the Arts and Sciences, Johns Hopkins University, Baltimore, USA;School of Medicine, Johns Hopkins University, 1550 Orleans St, CRBII 1M11, 21207, Baltimore, MD, USA;School of Medicine, Johns Hopkins University, 1550 Orleans St, CRBII 1M11, 21207, Baltimore, MD, USA;Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA;Aurum Institute, Johannesburg, South Africa;

关键词: HIV;    Opioid use disorder;    Harm reduction;    Correctional services;    South Africa;   

DOI  :  10.1186/s12954-023-00834-6

 received in 2022-09-17, accepted in 2023-07-17,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundOpioid 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.MethodsThree 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.ResultsParticipants 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.ConclusionsOUD 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.

【 授权许可】

CC BY   
© The Author(s) 2023