Abstract
OBJECTIVES: Nascent research reflects the promise of yoga as a complementary treatment for substance use. While putative mechanisms behind yoga's impact on substance use have been proposed, the research is limited. This manuscript aims to determine how a hatha yoga intervention impacts the substance use of people who are in reentry from prison or jail (returning citizens), and living with HIV and substance use problems. DESIGN: Semi-structured interviews were conducted with 28 returning citizens who participated in a yoga intervention. Guided by a qualitative descriptive methodology, thematic analysis was used to identify themes that answered how yoga impacted participant substance use. SETTING: A community organization in Philadelphia, PA, USA that connects people to health services, provides education and supportive services, and advocates for people with criminal justice involvement. INTERVENTION: A 90-minute hatha yoga class offered once a week for 12 weeks. RESULTS: Fourteen participants reported that yoga either reduced substance use or maintained non-use, via the mechanisms of purposeful distraction, stress coping (by cultivating mindfulness and reducing physical discomfort), social support and confidence. Eleven participants reported that yoga did not impact their substance use. Three participants did not discuss it. CONCLUSIONS: By providing purposeful distraction, increased stress coping, social support and confidence; yoga may reduce substance use and maintain engagement in recovery. These mechanistic actions provide guidance for themes to highlight in yoga classes that aim to impact substance use among returning citizens living with HIV.