Qualitative Identification of HIV Care Engagement Challenges and Preferences for Differentiated Care Service Delivery Models Post-Incarceration in South Africa.

Inadequate access and timely linkage to treatment for people recently released from incarceration is a major barrier to HIV care. Differentiated service delivery models (DSDMs) that do not rely solely on clinic attendance need to be utilized, bringing HIV treatment closer to re-entrants and addressing current challenges with treatment attrition post-release from incarceration. DSDMs have demonstrated potential as alternatives to clinic-based treatment collection. We conducted a qualitative study to explore barriers to HIV care linkage and perceptions on the use of DSDMs for HIV treatment following release. We interviewed individuals, released from incarceration while on HIV treatment in Gauteng, South Africa. Participants had to be people recently released from incarceration, above the age of 18 years, living with HIV and taking Antiretroviral Therapy (ART) at their time of release from incarceration. Our results indicate that there was a high degree of enthusiasm among re-entrants for DSDMs. It is important to generate both qualitative and quantitative evidence to support DSDMs as alternatives service delivery models to clinic-based care among re-entrant populations. Based on the findings of this study, DSDM services can be part of the solution to closing the HIV treatment attrition gap among re-entrants as they transition from the prison environment to community-based care.