ABSTRACT Incarceration and HIV are a syndemic for US women, yet very few women who have experienced incarceration use pre-exposure prophylaxis (PrEP) for HIV. We conducted semi-structured interviews with 32 participants recruited by women who have experienced incarceration from their social networks, informed by the modified social ecological model for PrEP. Emergent themes from the interviews included individual-level (low personal HIV risk assessment, personal responsibility for HIV prevention, and decisions in addiction versus recovery), network-level (influential sex partners and the importance of trust, supportive treatment peers, and high-risk but indifferent drug use networks), community-level (stigma, and mitigation of stigma in supportive substance use disorder treatment environments), and public policy-level (incarceration and PrEP cost and access) determinants. PrEP interventions for women who have experienced incarceration and their networks will need to incorporate contingency planning into HIV risk assessment, navigate complex network dynamics, and be situated in trusted contexts to address structural barriers.
Keyphrases
- men who have sex with men
- hiv testing
- hiv positive
- mental health
- polycystic ovary syndrome
- antiretroviral therapy
- hiv aids
- healthcare
- risk assessment
- hiv infected
- human immunodeficiency virus
- pregnancy outcomes
- hepatitis c virus
- cervical cancer screening
- decision making
- public health
- climate change
- pregnant women
- human health
- heavy metals
- type diabetes
- social support
- adipose tissue
- physical activity
- social media
- network analysis
- drug induced