Prisons and Jails
In this section are materials that address HIV in correctional settings as it relates to testing, treatment access, harm reduction, youth, immigrants, disability benefits, and other related human rights concerns. At the end of 2006, 1.6% of male inmates and 2.4% of female inmates in state and federal prisons were HIV-positive. Although the number of HIV-positive male inmates has gradually decreased over time, the number of HIV-positive female inmates continues to grow. For many inmates, the behaviors and circumstances that contributed to their HIV infection are those that led to their incarceration (e.g., drug use, sex work, domestic abuse, mental illness, poverty). For others, infection with HIV occurred during incarceration, either by coerced or consensual sex, or by sharing needles for injecting drugs. Response to the critical need for health care interventions and prevention efforts in correctional facilities have a direct impact on the health of the communities to which prisoners return.
Comments on CDC Draft Guidance for HIV Testing in Correctional Facilities
Center for HIV Law and Policy et al.
In response to a CDC request for comments, 35 organizations endorsed comments submitted to CDC regarding its draft implementation guidance for HIV testing expansion in correctional settings. The Center for HIV Law and Policy, Lambda Legal, and the AIDS Foundation of Chicago drafted the comments following consultation with individuals familiar with the health care and HIV/AIDS-related needs of incarcerated populations. Click here to download.
Sex, Drugs, Prisons, and HIV
Critics of U.S. penal policies contend that incarceration has exacerbated the HIV epidemic among blacks, who are disproportionately represented in the prison population, accounting for 40% of inmates. This New England Journal of Medicine article examines the facts, perceptions, and some proposed solutions to the HIV epidemic—and the behaviors and policies that drive it—occurring behind bars. Both the World Health Organization (WHO) and the Joint United Nations Program on HIV/AIDS (UNAIDS) have recommended for more than a decade that condoms be made available to prisoners and that measures for clean needles be implemented. Several Western European countries, as well as Canada, Australia, Indonesia, and Iran, have adopted some or all of these harm reduction approaches and have seen no increase in drug use or new cases of HIV infection. In the United States, only a handful of jurisdictions have made condoms available to prison or jail inmates, despite the evidence of their efficacy.
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Making the Case for Health Interventions in Correctional Facilities
Theodore M. Hammett
In this journal article, a long-time expert on HIV in corrections and a vice-president at government and business consulting firm Abt Associates, elaborates on what he considers the three essential points to effective advocacy for health care services in prisons and jails: (1) correctional facilities are important settings for health care interventions because populations there typically bear a disproportionately heavy disease burden; (2) successful health interventions are possible among inmate populations; and (3) successful interventions benefit not only inmates, their families, and partners, but the public at large, particularly the urban communities from which most inmates come.
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