From Walls to Wellness by Nico Campalans

My host site is Action Wellness, a non-profit agency that specializes in connecting individuals living with chronic illness to a wide range of resources in the Philadelphia area. In addition to linking clients with healthcare providers, the agency coordinates services that address many common barriers to care. These barriers include basic obstacles, like obtaining a valid identification and reliable transportation, and more complex challenges, such as securing employment, housing, and continued education.

The prevalence of HIV in US prisons is roughly 5 to 7 times higher than in the general population, with rates being highest among black incarcerated individuals. In addition, approximately 50% of individuals released from prison in the US are reincarcerated within the following year. This trend is exacerbated by an individual’s HIV status, as those who are positive often have risk factors, such as injection drug use, that increase their risk of recidivism.

To help address this issue, Action Wellness formed the Philadelphia Linkage Program (PLP), which provides medical case management services to individuals living with HIV who are reentering Philadelphia’s neighborhoods following a period of incarceration. For the over 250 annual clients of the Linkage Program, these services help ensure they are supported throughout their transition back into the community. In addition to the PLP, Action Wellness operates the Re-Link program, which serves incarcerated individuals aged 18-26 living with chronic illnesses.

For the past three months, I have served with the agency both from their offices on Arch Street and within Philadelphia’s seven-jail complex that houses most of the city’s incarcerated population. In the jails, I meet with potential clients of the Philadelphia Linkage and Re-Link programs. If a potential client is interested in case managment, then a lengthy and comprehensive interview follows.

To prepare for these types of interactions, my cohort and I underwent a series of pre-service trainings. Our trauma-informed care training was especially insightful for navigating challenging topics, such as sexual violence and abuse. My status as an outsider and stranger complicates an already difficult process of asking clients intimate questions about their medical and personal history. By affording clients as much agency as possible in our interactions, such as by adopting a harm-reduction approach to conversations about sexual activity and drug use, I collaborate with clients to begin the process of building up their autonomy in a carceral environment where it is regularly denied.

Throughout my National Health Corps trainings and service with Action Wellness, I have learned how maintaining a healthy lifestyle and staying out of legal trouble are both influenced by the same set of zip-code-associated factors - education, literacy, housing stability, support networks, and challenges with substance abuse. In addition to targeting these social determinants of health and incarceration, Action Wellness connects clients to a supportive community invested in their positive transformation. In the coming months, I hope to continue learning how to best access and leverage our deeply-seeded instinct to help one another.