The HIV Prison Paradox: Agency and HIV-Positive Women's Experiences in Jail and Prison in Alabama. (August 2017)

• Record Type: Journal Article
• Authors: Sprague, Courtenay; Scanlon, Michael L.; Radhakrishnan, Bharathi; Pantalone, David W.
• Is Part Of: Qualitative health research. Volume 27:Number 10(2017)
• Page Start: 1427
• Page End: 1444
• Publication Date: 2017-08
• Subjects: agency -- HIV -- prison -- women's health -- stigma -- health care-seeking -- social construction -- adherence -- US South -- qualitative method -- interpretive research; Health -- Periodicals; Health behavior -- Periodicals; Health -- Research -- Methodology -- Periodicals; Health behavior -- Research -- Methodology -- Periodicals; 610.7205
• DOI: 10.1177/1049732316672640
• Languages: English
• ISSNs: 1049-7323

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.