The Fortune Society’s Center for Research, Inquiry, and Social Justice (CRIS-J) views research as an integral tool for advancing equity and justice, and it produces research aimed at centering the valuable perspectives of individuals impacted by the criminal legal system. CRIS-J’s work brings together people with diverse experiences, including community members, service providers, advocates and researchers, to ask questions that can create meaningful change. 

The DEST2nation study is one of CRIS-J’s key projects, developed in close collaboration with Dr. Matthew Akiyama from the Albert Einstein College of Medicine and Montefiore Health System. The study represents a shared commitment to community-driven research, and it intends to establish a decentralized, status-neutral model for HIV treatment and prevention within Fortune.  

“HIV treatment and prevention strategies are now very similar,” said Dr. Akiyama. “By working with the same team to coordinate for HIV treatment, prevention, and other reentry services we anticipate our status-neutral intervention will act synergistically to improve health outcomes by providing destigmatized, person-centered care.”

The DEST2nation study is informed by a community advisory board comprised of individuals with lived experience of incarceration and HIV and a stakeholder panel of Fortune staff who provide direct health-related services. The insights provided by the Fortune community ensure that the interventions are attuned to participants’ current health needs while remaining respectful of their dignity and privacy. 

The community advisory board’s unique and insightful perspectives helped craft the Community Health Advocate (CHA) role based on identified needs and concerns. CHAs work closely with Fortune participants to address their needs while meeting them with compassion and understanding.  

“We’re their Fortune attendants,” Jamie, one of Fortune’s CHAs, said. “We help them day-to-day with appointment and medication reminders, refer them to the doctors we work with or help them find another care provider, and we also educate people who are not on medication but practicing risky behaviors about medication.” 

Wil, another CHA, emphasized the immense value of having CHAs available to help participants navigate Fortune’s array of services and manage their competing priorities.  

“Do they spend the day trying to get medication for next week, or do they focus on finding a meal for today instead?” Wil pointed out. “These concerns become their biggest obstacle, so I focus on managing that with them. Part of my job is making sure our participants understand what is available to them here. As an advocate, I give them all the tools they need.” 

The DEST2nation model offers an innovative approach to providing HIV treatment and prevention that addresses the comprehensive health needs of people affected by the criminal justice system. The status-neutral model prevents stigma and avoids separating services based on diagnosis, which can ultimately prevent people from accessing care. The model also focuses on making healthcare accessible, especially for those who have had previously negative experiences. This is crucial for individuals who have recently been released from prison, as they often face many obstacles in finding the healthcare they need. Micaela, Senior Director of Research at Fortune, highlights the intended impact of the study.  

As CRIS-J continues to advance this and other research initiatives, they remain committed to our mission of using community-driven research to make tangible improvements in the lives of individuals impacted by the criminal legal system. The DEST2nation study is an exciting example of how collaborative, community-centered research can lead to innovative solutions that address complex health and structural challenges.