Exploratory qualitative study examining acceptability of strategies to improve access to substance use treatment and HIV prevention services for young adults on probation in Ukraine
Objective Adults <30 years’ of age experience elevated HIV-rates in Ukraine. Young adults (YA) involved in the criminal justice system (CJS) are at an increased HIV-risk given elevated rates of substance use, engagement in high-risk sexual behaviour and insufficient healthcare access. The obj...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/11/e061909.full |
| _version_ | 1811218302511349760 |
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| author | Lakshmi Gopalakrishnan Emily Dauria Halyna Skipalska Oksana Savenko Liudmyla Sabadash Marina Tolou-Shams Timothy Flanigan Peter Navario Theresa P Castillo |
| author_facet | Lakshmi Gopalakrishnan Emily Dauria Halyna Skipalska Oksana Savenko Liudmyla Sabadash Marina Tolou-Shams Timothy Flanigan Peter Navario Theresa P Castillo |
| author_sort | Lakshmi Gopalakrishnan |
| collection | DOAJ |
| description | Objective Adults <30 years’ of age experience elevated HIV-rates in Ukraine. Young adults (YA) involved in the criminal justice system (CJS) are at an increased HIV-risk given elevated rates of substance use, engagement in high-risk sexual behaviour and insufficient healthcare access. The objective of this exploratory study was to investigate the acceptability of strategies to refer and link CJS-involved YA to HIV-prevention and substance use treatment services from CJS settings.Design We conducted qualitative individual interviews with CJS-involved YA (18–24 years), and CJS stakeholders. Interviews were guided by the Social Ecological Model. Interviews with YA explored substance use and sexual behaviour, and acceptability of strategies to link YA to HIV-prevention and substance use treatment services from CJS. Stakeholder interviews explored system practices addressing HIV-prevention and substance use and addiction. Data were analysed using Inductive Thematic Analysis.Setting Data were collected in three locales, prior to the 2022 Russian–Ukrainian conflict.Participants Thirty YA and 20 stakeholders.Results Most YA were men, reported recent injection drug use and were Mage=23 years. YA were receptive to linkage to HIV-prevention services from CJS; this was shaped by self-perceived HIV-risk and lack of access to HIV-prevention services. YA were less receptive to being referred to substance use treatment services, citing a lack of self-perceived need and mistrust in treatment efficacy. Stakeholders identified multilevel contextual factors shaping acceptability of HIV-prevention and substance use treatment from CJS (eg, stigma).Conclusions Findings should be reviewed as a historical record of the pre-conflict context. In that context, we identified strategies that may have been used to help curtail the transmission of HIV in a population most-at-risk, including CJS-involved YA. This study demonstrates that improving access to substance use treatment and HIV-prevention services via CJS linkage were acceptable if provided in the right conditions (eg, low or no-cost, confidential). |
| first_indexed | 2024-04-12T07:07:23Z |
| format | Article |
| id | doaj.art-91525f66e7a547a7bc3b4c14e0add8bd |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-12T07:07:23Z |
| publishDate | 2022-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-91525f66e7a547a7bc3b4c14e0add8bd2022-12-22T03:42:45ZengBMJ Publishing GroupBMJ Open2044-60552022-11-01121110.1136/bmjopen-2022-061909Exploratory qualitative study examining acceptability of strategies to improve access to substance use treatment and HIV prevention services for young adults on probation in UkraineLakshmi Gopalakrishnan0Emily Dauria1Halyna Skipalska2Oksana Savenko3Liudmyla Sabadash4Marina Tolou-Shams5Timothy Flanigan6Peter Navario7Theresa P Castillo81 NEERMAN, Center for Causal Research and Impact Evaluation, Mumbai, India2 Psychiatry, University of California San Francisco, San Francisco, California, USAHealthRight International, Kyiv, UkraineHealthRight International, Kyiv, UkraineHealthRight International, Kyiv, UkraineDepartment of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California, USABrown University, Providence, Rhode Island, USASchool of Public Health, New York University, New York, New York, USASchool of Public Health, New York University, New York, New York, USAObjective Adults <30 years’ of age experience elevated HIV-rates in Ukraine. Young adults (YA) involved in the criminal justice system (CJS) are at an increased HIV-risk given elevated rates of substance use, engagement in high-risk sexual behaviour and insufficient healthcare access. The objective of this exploratory study was to investigate the acceptability of strategies to refer and link CJS-involved YA to HIV-prevention and substance use treatment services from CJS settings.Design We conducted qualitative individual interviews with CJS-involved YA (18–24 years), and CJS stakeholders. Interviews were guided by the Social Ecological Model. Interviews with YA explored substance use and sexual behaviour, and acceptability of strategies to link YA to HIV-prevention and substance use treatment services from CJS. Stakeholder interviews explored system practices addressing HIV-prevention and substance use and addiction. Data were analysed using Inductive Thematic Analysis.Setting Data were collected in three locales, prior to the 2022 Russian–Ukrainian conflict.Participants Thirty YA and 20 stakeholders.Results Most YA were men, reported recent injection drug use and were Mage=23 years. YA were receptive to linkage to HIV-prevention services from CJS; this was shaped by self-perceived HIV-risk and lack of access to HIV-prevention services. YA were less receptive to being referred to substance use treatment services, citing a lack of self-perceived need and mistrust in treatment efficacy. Stakeholders identified multilevel contextual factors shaping acceptability of HIV-prevention and substance use treatment from CJS (eg, stigma).Conclusions Findings should be reviewed as a historical record of the pre-conflict context. In that context, we identified strategies that may have been used to help curtail the transmission of HIV in a population most-at-risk, including CJS-involved YA. This study demonstrates that improving access to substance use treatment and HIV-prevention services via CJS linkage were acceptable if provided in the right conditions (eg, low or no-cost, confidential).https://bmjopen.bmj.com/content/12/11/e061909.full |
| spellingShingle | Lakshmi Gopalakrishnan Emily Dauria Halyna Skipalska Oksana Savenko Liudmyla Sabadash Marina Tolou-Shams Timothy Flanigan Peter Navario Theresa P Castillo Exploratory qualitative study examining acceptability of strategies to improve access to substance use treatment and HIV prevention services for young adults on probation in Ukraine BMJ Open |
| title | Exploratory qualitative study examining acceptability of strategies to improve access to substance use treatment and HIV prevention services for young adults on probation in Ukraine |
| title_full | Exploratory qualitative study examining acceptability of strategies to improve access to substance use treatment and HIV prevention services for young adults on probation in Ukraine |
| title_fullStr | Exploratory qualitative study examining acceptability of strategies to improve access to substance use treatment and HIV prevention services for young adults on probation in Ukraine |
| title_full_unstemmed | Exploratory qualitative study examining acceptability of strategies to improve access to substance use treatment and HIV prevention services for young adults on probation in Ukraine |
| title_short | Exploratory qualitative study examining acceptability of strategies to improve access to substance use treatment and HIV prevention services for young adults on probation in Ukraine |
| title_sort | exploratory qualitative study examining acceptability of strategies to improve access to substance use treatment and hiv prevention services for young adults on probation in ukraine |
| url | https://bmjopen.bmj.com/content/12/11/e061909.full |
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