Comprehensive Needs Among Justice-Involved People With Substance Use History With or at Risk of Human Immunodeficiency Virus

Abstract

Justice-involved individuals have many cooccurring socioeconomic and medical needs. Here, we characterize the needs of justice-involved individuals with substance use history at risk for or living with human immunodeficiency virus (HIV) in Texas (TX) and Connecticut (CT). All participants are part of a larger trial linking justice-involved people to community-based substance use and HIV services. Comprehensive baseline needs were assessed; frequencies of needs were quantified and compared using chi-square analysis. Participants (N = 356) reported greater socioeconomic than medical needs in both TX (n = 198) and CT (n = 158). Housing, transportation, food, employment, and financial benefits were endorsed by more than 60% of participants. Health needs were emphasized in both states. Demand in TX was higher for health insurance (52.0% vs. 26.6%, p < .01) and identification/documentation (60.6% vs. 46.2%, p < .01), but not naloxone access (25.3% vs. 38.6%, p < .01). Substance use treatment/harm reduction and HIV preexposure prophylaxis were low priorities overall. The prioritization of socioeconomic over medical needs suggests a hierarchy of needs and resources. State-specific differences may reflect different sociopolitical environments and resources. Despite the high risks of living with or acquiring HIV and overdose, most participants reported low need for HIV and/or substance use services.