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Expert stakeholders' perspectives on a Data-to-Care strategy for improving care among HIV-positive individuals incarcerated in jails.

Authors
  • Buchbinder, Mara1
  • Blue, Colleen2
  • Juengst, Eric1
  • Brinkley-Rubinstein, Lauren3
  • Rennie, Stuart1
  • Rosen, David L4
  • 1 Department of Social Medicine, Center for Bioethics, UNC Chapel Hill School of Medicine, Chapel Hill, NC, USA.
  • 2 Institute for Global Health and Infectious Diseases, UNC Chapel Hill, Chapel Hill, NC, USA.
  • 3 Department of Social Medicine, Center for Health Equity Research, UNC Chapel Hill School of Medicine, Chapel Hill, NC, USA.
  • 4 Division of Infectious Diseases, Department of Medicine, UNC Chapel Hill, School of Medicine, Chapel Hill, NC, USA.
Type
Published Article
Journal
AIDS care
Publication Date
Sep 01, 2020
Volume
32
Issue
9
Pages
1155–1161
Identifiers
DOI: 10.1080/09540121.2020.1737641
PMID: 32160760
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Data-to-Care (D2C) uses surveillance data (e.g., laboratory, Medicaid billing) to identify out-of-care HIV-positive persons to re-link them to care. Most US states are implementing D2C, yet few studies have explored stakeholders' perspectives on D2C, and none have addressed these perspectives in the context of D2C in jail. This article reports findings from qualitative, semi-structured interviews conducted with expert stakeholders regarding their perspectives on the ethical challenges of utilizing D2C to understand and improve continuity of care among individuals incarcerated in jails. Participants included 47 professionals with expertise in ethics and privacy, public health and HIV care, the criminal justice system, and community advocacy. While participants expressed a great deal of support for extending D2C to jails, they also identified many possible risks. Stakeholders discussed many issues specific to D2C in jails, such as heightened stigma in the jail setting, the need for training of jail staff and additional non-medical community-based resources, and the high priority of this vulnerable population. Many experts suggested that the actual likelihood of benefits and harms would depend on contextual details. Implementation of D2C in jails may require novel strategies to minimize risk of disclosing out-of-care patients' HIV status.

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