Online Program

Attitudes and Experiences of Health Care Service Delivery among HIV Positive Puerto Ricans in New York City Jails

Monday, November 2, 2015 : 2:50 p.m. - 3:10 p.m.

Janet Wiersema, MPH, Correctional Health Services, Transitional Health Care Coordination, NYC Department of Health and Mental Hygiene, Rikers Island, NY
Paul Teixeira, DPH, MA, Department of Healthcare Policy and Research, Weill Cornell Medical School, New York, NY
Jacqueline Cruzado-Quinones, Correctional Health Services, Transitional Health Care Coordination, NYC Department of Health and Mental Hygiene, Rikers Island, NY
Skye Ross, BA, Transitional Health Care Coordination, Department of Health and Mental Hygiene Correctional Health Services, Rikers Island, NY
Cameron Paine-Thaler, Bureau of Correctional Health Services, NYC Department of Health and Mental Hygiene, Division of Prevention and Primary Care, Riker's Island, NY
Alison O. Jordan, LCSW, Correctional Health Services' Transitional Health Care Coordination, New York City Department of Health and Mental Hygiene, East Elmhurst, NY

The New York City (NYC) Department of Health and Mental Hygiene’s Transitional Health Care Coordination (THCC) provides transitional care services to persons with chronic health conditions returning to the community after incarceration. Among HIV positive Latinos: 67% are linked and 33% are retained in care, 37% begin antiretroviral therapy (ART), and 26% are virally suppressed. Little data exists specific to Puerto Ricans.


THCC interviewed 14 HIV Puerto Rican patients to examine their attitudes and experiences of health care service delivery. Researchers asked about patient diagnosis, engagement in healthcare, ART adherence, social support, and stigma. Interviews in English and Spanish were recorded and transcribed; themes were coded, synthesized and analyzed.


Ten men and four women were interviewed. All reported alcohol/drug use and 10 reported mental health issues. Most reported better ART adherence in jail due to a structured, drug-free environment. Substance use and homelessness were barriers to medication adherence in the community, while facilitators included convenience of care and adherence counseling. Motivations for health included age, pain, family, seeing others die, and not wanting to die in jail. Some experienced stigma from healthcare providers related to HIV status and/or incarceration.


HIV patients of Puerto Rican origin in NYC jails have substantial barriers to community healthcare access and medication adherence. Primary needs at release include substance abuse treatment, mental health care, case management, and benefits reactivation. Training of healthcare providers, case managers, and other practitioners is needed to engage patients in culturally appropriate care and to reduce stigma.

Learning Areas:

Assessment of individual and community needs for health education
Diversity and culture
Planning of health education strategies, interventions, and programs
Public health or related research

Learning Objectives:
Explain how prior healthcare experiences influence intended healthcare use after incarceration; Identify factors influencing healthcare seeking behaviors of HIV positive Puerto Ricans in NYC jails; Describe the health and other needs of HIV positive Puerto Ricans in NYC jails.

Keyword(s): Criminal Justice, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am director/coordinator of the project this formative evaluation supports that targets HIV positive Puerto Ricans. I conducted several of the interviews and oversaw analysis of data. I have presented at prior national conferences and I am currently a public health doctoral student.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.