Navigating the HIV and substance use systems of care presents a number of unique challenges, many of which can become more complex depending on a person’s housing, employment, mental health, or economic situation. One system that immediately complicates a person’s access to HIV and/or substance use care is the jail or prison system. This month, the Boston Medical Center Team talks with Dr. Alysse Wurcel, a doctor who provides HIV and substance use care in Massachusetts jails. Among a robust breadth of topics, they cover the complex realities of providing HIV and substance use care for people who are incarcerated; how these complexities are perpetuated and affect a person’s access to care both in and out of the jail and prison system; and how HIV and substance use care in the jail and prison system is slowly starting to change.
“I don’t know if people back in 2016 realized that not having buprenorphine in the jails encourages higher risk activity because there’s always this feeling or this hope for control…when people are upset and sad and isolated, they don't want to be in that reality anymore and when they are withdrawing they’ll do anything to feel better. Providing this is absolutely necessary to keep people healthy not only from the substance use disorder perspective but for tattoos and HIV and for all the things that can be passed in jail" --Dr. Alysse Wurcel