Speakers
Description
Authors: Sheridan Sweet (Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States.), Emily Dauria (Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States.), Iris Olson (Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States.), James Egan (Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States.), Janet Myers (Division of Prevention Science, Department of Medicine, University of California, San Francisco, CA, United States.), Marina Tolou-Shams (Department of Psychiatry, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, CA, United States.), Martha Shumway (Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, CA, United States.), Robert Coulter (Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States.)
Background: Young adults surveilled by the US criminal legal system (YA-USCLS) experience disproportionately high rates of substance use (SU) and HIV incidence. Few evidence-based approaches exist to connect YA-USCLS to substance use treatment (SUT) and HIV-related services following detention. Recent US policy shifts have led to increased criminalization of marginalized groups, and reductions in funding for social and health services. This study elicits feedback on an eHealth-enhanced navigator program aimed at improving SU and HIV-related service engagement for YA-USCLS in this shifting landscape.
Methods: We conducted Human Centered Design (HCD) user-testing sessions with substance-using YA-USCLS with HIV vulnerability (proposed n=8; two sessions) and system partners working with YA-USCLS (proposed n=4; one session). Data collection is ongoing. One-hour HCD sessions were conducted via MURAL (collaborative digital whiteboard). Sessions assessed the feasibility and appropriateness of navigation content and elicited feedback on the changing service landscape. Researchers completed debrief forms immediately following each session. Rapid analyses were used to identify common themes to inform intervention refinement.
Results: In response to the shifting service landscape and YA-USCLS needs, system partners and YA-USCLS emphasized the importance of exploring changes in SUT and PrEP availability and insurance payment options. Novel recommendations included incorporating: 1) STI education and testing; 2) How to discuss HIV risk with sexual partners; 3) Fostering a safe environment by incorporating activities alongside difficult conversation topics (e.g., art). System partners identified emergent challenges including: 1) Limited availability of appropriate services (e.g., those that are gender responsive and/or affirming); 2) Increased wait times; 3) Decreased availability of transportation options.
Discussion: Results may improve access to SU and HIV-related services for YA-USCLS. Developing uniquely tailored interventions is particularly important considering the changing socio-political context in the US, where already systemically underserved and multiply marginalized groups are facing increased criminalization and barriers to service access.
| Conflict of interest | None |
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