Implementation science approaches to addressing the social and structural determinants of health of criminal-legal involved people living with HIV to improve HIV care outcomes

BACKGROUND: People living with HIV in the United States are overrepresented in the criminal-legal system and experience unique barriers to engagement in HIV care postincarceration. Individuals who are criminal-legal involved (CLI) experience worse HIV care outcomes compared to the general population. Interventions aiming to improve engagement and retention in HIV care for CLI populations are urgently needed. This study aims to highlight an array of NIH-funded research projects across the United States leveraging implementation science to investigate and design interventions aimed at addressing social determinants of health and improving HIV care outcomes among CLI populations in the United States. 

SETTING: United States. 

METHODS: In September 2023, the National Institutes of Health funded 47 new implementation research projects as part of the Ending the HIV Epidemic initiative, including 10 projects focused on addressing HIV among CLI populations. This paper highlights several projects that are addressing the social determinants of health affecting CLI populations living with HIV in the United States. 

PROJECT OVERVIEW: The funded projects use innovative, community-engaged approaches to investigate and design interventions to address social determinants of health among CLI populations living with HIV including health care access, legal needs, social support, and holistic needs. 

CONCLUSIONS: We believe these projects will substantially contribute to the evidence base to aid the development of guidelines and the implementation of programs that can be adopted and adapted by a wide range of settings working toward improving the health and wellness of CLI people living with HIV.