![]() These experiences of both HIV stigma and incarceration stigma converge with social inequities, such as structural racism. 2014 Swan 2016 Brinkley-Rubinstein and Turner 2013 Brinkley-Rubinstein 2015 Dennis et al. ![]() Among reentrants with HIV, HIV stigma operates in conjunction with incarceration stigma, or the stigma of having been sentenced and detained for lawbreaking ( Kemnitz et al. 2018 Monteiro, Villela, and Soares 2013). 2015 Henkel, Brown, and Kalichman 2008 Swan 2016 Brinkley-Rubinstein 2015 Brinkley-Rubinstein and Turner 2013 Sun et al. 2019), or the convergence of multiple forms of stigma and discrimination ( Turan et al. Other studies of HIV stigma have explored reentrants’ experiences of intersectional stigma ( Turan et al. 2014 Brinkley-Rubinstein and Turner 2013). Internalized HIV stigma (belief in the legitimacy of HIV stigma) is associated with increased depression and substance use ( Swan 2016 Kemnitz et al. Enacted (directly experienced) HIV stigma, such as harassment from family and friends, decreases reentrants’ levels of social support ( Swan 2016 Kemnitz et al. Anticipated HIV stigma – the expectation of being excluded because one has HIV – increases reentrants’ fear of HIV disclosure and contributes to avoidance of medical appointments ( Swan 2016 Kemnitz et al. Previous research has exposed how various HIV stigma processes affect both care engagement and factors known to influence care outcomes among reentrants. Underlying all of these factors’ influence on reentrants’ HIV care engagement is stigma, a process of exclusion rooted in broader social inequities ( Parker and Aggleton 2003 Hatzenbuehler, Phelan, and Link 2013 Goffman 1963 Kemnitz et al. 2017 Wildeman and Wang 2017 Golembeski and Fullilove 2005 Bowleg and Raj 2012 Dumont et al. 2015) and socioeconomic instability, which across multiple contexts is shaped by social inequities such as structural racism ( Bailey et al. 2013 Swan 2015) lack of social support ( Rozanova et al. Among these are the combined and separate effects of substance use, mental illness, and housing instability ( Binswanger et al. A complex set of behavioral and social factors constrain HIV care engagement among reentrants. Despite high rates of HIV treatment initiation and retention within detention facilities, individuals’ linkage to community-based clinical care and adherence to antiretroviral therapy (ART) are sub-optimal in the weeks and months following release ( Iroh, Mayo, and Nijhawan 2015 Loeliger et al. Transitioning to the community from incarceration represents a point of vulnerability for people living with HIV.
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