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The HIV Prison Paradox: Agency and HIV-Positive Women’s Experiences in Jail and Prison in Alabama.

The HIV Prison Paradox: Agency and HIV-Positive Women’s Experiences in Jail and Prison in Alabama.
Author Information (click to view)

Sprague C, Scanlon ML, Radhakrishnan B, Pantalone DW,


Sprague C, Scanlon ML, Radhakrishnan B, Pantalone DW, (click to view)

Sprague C, Scanlon ML, Radhakrishnan B, Pantalone DW,

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Qualitative health research 2016 Oct 14() pii

Abstract

Incarcerated women face significant barriers to achieve continuous HIV care. We employed a descriptive, exploratory design using qualitative methods and the theoretical construct of agency to investigate participants’ self-reported experiences accessing HIV services in jail, in prison, and post-release in two Alabama cities. During January 2014, we conducted in-depth interviews with 25 formerly incarcerated HIV-positive women. Two researchers completed independent coding, producing preliminary codes from transcripts using content analysis. Themes were developed iteratively, verified, and refined. They encompassed (a) special rules for HIV-positive women: isolation, segregation, insults, food rationing, and forced disclosure; (b) absence of counseling following initial HIV diagnosis; and (c) HIV treatment impediments: delays, interruption, and denial. Participants deployed agentic strategies of accommodation, resistance, and care-seeking to navigate the social world of prison and HIV services. Findings illuminate the "HIV prison paradox": the chief opportunities that remain unexploited to engage and re-engage justice-involved women in the HIV care continuum.

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