Delays, copays and stigma. These are three common experiences for people living with HIV who are detained in county or local jails, according to recent research.

Colleen Blue, MPH, of the University of North Carolina at Chapel Hill, and colleagues interviewed 23 people with HIV in North Carolina who were in custody in local jails or had previously been incarcerated. The participants were mostly middle-aged Black men who had been living with HIV for more than a decade; several had been in jail multiple times.

When the researchers asked folks about their experience of care while in jail, only 30% said it was satisfactory. Nearly two thirds reported delays in getting access to their HIV medications. Most eventually did see providers and receive HIV meds—in some cases thanks to family members bringing them their pills—but not everyone gained access. Some did not receive HIV care because it required a copay they couldn’t afford. Others elected not to take their medications due to inadequate food to take with their pills or because of gastrointestinal side effects. Almost all participants kept their HIV status private from other incarcerated people, and some kept it from guards and other jail staff for fear of stigma or violence.

“Jail leadership should review internal policies regarding HIV medications to ensure that PLWH [people living with HIV] can receive them quickly upon entry into jail,” the study authors wrote. “More external resources are needed—for example, from state and local health departments—so that jails can provide timely HIV medications for PLWH incarcerated in their facilities.”