Abstract
AbstractIntroduction
High-quality, patient-centred care is essential for people living with HIV, including their involvement in service development. In prison, healthcare should match community standards, yet incarceration disrupts NHS care principles, particularly affecting HIV care. People in prison with HIV face marginalisation and poorer health outcomes, emphasising the necessity of thoughtfully planned HIV healthcare. Incorporating their experiences and opinions can improve service quality, align prison healthcare with community standards, and address unique challenges.
Methods
This qualitative study, grounded within a constructivist framework, explores experiences of HIV healthcare in prison through semi-structured interviews with 12 participants, including individuals with lived experience and healthcare professionals. One participant contributed via letter from prison. Reflexive thematic analysis was employed to explore and understand their experiences.
Findings
Themes were developed, identifying both positive and negative aspects of HIV healthcare in prison. Benefits included compassionate relationships with professionals and access to care. Challenges included treatment interruptions, limited appointments, poor continuity of care, and stigmatising experiences. These findings identify the need to enhance supportive aspects and address barriers to improve HIV healthcare in prisons.
Recommendations
To improve HIV healthcare in prisons, a patient-centred whole-system approach is essential. Key recommendations include developing national guidelines with standard operating procedures informed by individuals with lived experience to ensure relevant and empathetic care. Formal memoranda of understanding between prison healthcare and local HIV services should outline collaborative care principles and clinical pathways, supported by a comprehensive electronic patient record template and designated team roles, ensuring continuity of care and safe clinical decision-making. Access to peer support, health promotion, and education is central to addressing stigma. Commissioners should fund services based on Inclusion Health principles, emphasising multidisciplinary collaboration. Implementing these strategies can significantly enhance HIV healthcare in prisons and address broader health determinants.
| Date of Award | 11 Oct 2024 |
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| Original language | English |
| Awarding Institution |
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| Supervisor | Jenny Roddis (Supervisor), Sandy Walker (Supervisor) & Rebecca Stores (Supervisor) |