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dc.contributor.authorRozanova, Juliaen_US
dc.contributor.authorBrown, Shan-Estelleen_US
dc.contributor.authorBhushan, Ambikaen_US
dc.contributor.authorMarcus, Ruthanneen_US
dc.contributor.authorAltice, Frederick L.en_US
dc.date.accessioned2016-01-04T19:23:44Z
dc.date.issued2015en_US
dc.identifier.citationRozanova, Julia, Shan-Estelle Brown, Ambika Bhushan, Ruthanne Marcus, and Frederick L. Altice. 2015. “Effect of social relationships on antiretroviral medication adherence for people living with HIV and substance use disorders and transitioning from prison.” Health & Justice 3 (1): 18. doi:10.1186/s40352-015-0030-6. http://dx.doi.org/10.1186/s40352-015-0030-6.en
dc.identifier.issn2194-7899en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:23993589
dc.description.abstractBackground: This paper examines how family and social relations facilitate and inhibit adherence to antiretroviraltherapy (ART) for people living with HIV (PLH) who have underlying substance use disorders and are transitioningto the community post-incarceration. Methods: Combining the methods of inductive close reading and constantcomparison, we analyzed the data from 30 semi-structured interviews of PLH who had recently transitioned to thecommunity within the previous 90 days. Results: Three central themes were anticipated as important socialrelationships post-release: self-reported family, friends and clinicians. Among these, four sub-themes (social isolation, ‘double jeopardy’, search for belonging, and trust and respect) emerged, highlighting how they impacted ART adherence. Post-release, participants returned to resource-poor communities where they experienced socialisolation. ART adherence was enabled by having a purpose in life, which correlated with having robust family support structures. Many former prisoners felt that a chasm between them and their families existed, both because of HIV stigma and their addiction problems. In this context, relationships with untrustworthy friends from their druguse networks led to relapse of drug use and risky behaviors, jeopardizing participants’ ART adherence and persistence. To avoid the double jeopardy, defined as seeking friends for support but who were also the ones who contributed to drug relapse, participants searched for new social anchors, which often included their healthcare providers who represented trusted and respected persons in their life. Conclusions: While some former prisonersperceived doctors as uncaring and their relationships asymmetrical, positive relationships with these providers,when respect and trust was mutual, reinforced the participants’ sense of belonging to what they called ‘the world that don’t do drugs’ and motivated them to adhere to ART.en
dc.language.isoen_USen
dc.publisherSpringer Berlin Heidelbergen
dc.relation.isversionofdoi:10.1186/s40352-015-0030-6en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4684583/pdf/en
dash.licenseLAAen_US
dc.subjectPeople living with HIVen
dc.subjectAddictionen
dc.subjectPrisonersen
dc.subjectAdherenceen
dc.subjectAntiretroviral therapyen
dc.subjectSocial relationshipsen
dc.subjectFamilyen
dc.subjectFriendsen
dc.subjectCliniciansen
dc.subjectQualitative interviewsen
dc.subjectTrust in Physicianen
dc.titleEffect of social relationships on antiretroviral medication adherence for people living with HIV and substance use disorders and transitioning from prisonen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalHealth & Justiceen
dash.depositing.authorBhushan, Ambikaen_US
dc.date.available2016-01-04T19:23:44Z
dc.identifier.doi10.1186/s40352-015-0030-6*
dash.contributor.affiliatedBhushan, Ambika


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