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"Healing a Broken System: Veterans Battling Addiction and Incarceration."
http://www.drugpolicy.org/docUploads/DPA_IssueBrief_Veterans.pdf

CDC HIV Testing Implementation Guidance for Correctional Settings is now available. This document provides background statistics on HIV/AIDS in correctional facilities and covers issues relating to inmate privacy and confidentiality, opt-out HIV screening in correctional medical clinics, HIV testing procedures, and HIV/AIDS case reporting.


A new 200-page resource, "HIV/AIDS and HCV in Prisons: A Select Annotated Bibliography," has now become available on the Internet at http://www.hc-sc.gc.ca/ahc-asc/pubs/int-aids-sida/hiv-vih-aids-sida-prison-carceral_e.html , in both English and French.
 

Michigan provides case management transition for individuals about to be released from prison through collaboration with the Department of Corrections. AIDS Partnership Michigan www.aidspartnership.org now coordinates this.

Michigan Legislation

Yahoo - mail list for HIV and Hepatitis C in Prison. This is a list for anyone who is interested in posting and receiving information on hepatitis C, HIV coinfection and HIV in prison. To sign up go to HCVPRISONNEWS at
http://groups.yahoo.com/group/HCVPRISONNEWS.

The Canadian HIV/AIDS Legal Network series of 13 info sheets on HIV/AIDS in Prisons (revised 2001) is now available at:
http://www.aidslaw.ca/Maincontent/infosheets.htm#isohaap

Correctional HIV Consortium - National organization providing services related to HIV/AIDS and TB in corrections. http://www.silcom.com/~lwalker


Prison HCV Treatment Guidelines

The National Hepatitis C Prison Coalition website, www.hcvinprison.org, includes a collection of the Department of Corrections HCV Treatment Guidelines for 20 states, with more anticipated. The website also includes a listing of useful links for hepatitis C information and contact information for coalition members.

Women and HIV/AIDS in Prisons booklet
The National Minority AIDS Council is proud to announce that the Women and HIV/AIDS in Prisons booklet is completed and available today, per request. As a response to the increasing number of women prisoners affected by or infected with HIV/AIDS, NMAC has developed, and published, this informative booklet, which summarizes the impact of HIV/AIDS on women prisoners, as well as describe programs specifically designed to meet their needs. The mission of this booklet is to provide service providers, advocates, community-based organizations (CBOs) and prisoners, themselves, with the information necessary to establish effective and quality services for addressing HIV/AIDS among women prisoners.

Download a copy of Women and HIV/AIDS in Prison http://www.nmac.org/publications/treatpubs/pdf/Women_in_Prison.pdf or to acquire a hard copy of the Women and HIV/AIDS in Prison booklet, and/or any other NMAC publications, contact the Communications Division of NMAC by telephone at (202) 483-6622; or by e-mail publications@nmac.org .

Additional NMAC Prison Publications:

  • Incarcerated Youth and HIV/AIDS
    (pre-order available)
  • Mental Health and Substance Abuse among Prisoners Living with HIV/AIDS
  • Hitting the Bricks: Working with Recently Released Former Prisoners Living with HIV/AIDS
  • First Steps: Understanding the Culture of Corrections
  • What You Need to Know about HIV and Hepatitis in Prisons
  • Pushing for Progress
    (limited quantities available)
  • Technical Assistance Publications

For additional information or questions regarding publications, visit NMAC online; or contact NMAC writer-editor, Simone Jordan, by telephone: (202) 483-6622, or e-mail: sjordan@nmac.org .

News

Following is news and information regarding incarcerated populations. Links to the Kaiser Daily HIV/AIDS Report summaries at the Kaisernetwork web site and briefly from the CDC HIV/STD/TB Prevention News Update. Note: Links to Kaisernetwork take you outside this site.

Almost 30% of HIV-positive New York prison inmates may not know their status
Two new studies in the Journal of Acquired Immune Deficiency Syndromes call attention to the challenges associated with encouraging inmates in US prisons to undergo HIV testing and receive appropriate health care. Read More >>

Michigan Officials Push to Remove Food Service Ban for Positive Prisoners
POZ News (11.2.09)
The Michigan Department of Corrections (MDOC) is working to revamp a contested policy that bars HIV-positive prisoners from working in prison food service jobs, The Michigan Messenger reports. A new policy could lift the ban by early December. http://www.poz.com/articles/mdoc_food_service_hiv_1_17503.shtml
 

UNITED STATES:
"Study Highlights HIV/AIDS Challenge in American Prison System"
Science Daily , (09.30.2009)
HIV/AIDS is nearly five times more prevalent in US prisons than in the general population. Though adherence to antiretroviral treatment (ART) can be strictly monitored in correctional settings, clinical monitoring becomes problematic upon prisoners’ release.

Over a nine-year period, Dr. Nitika Pant Pai of the Research Institute of the McGill University Health Center and colleagues studied 512 HIV-positive repeat offender inmates from the San Francisco County jail system. They found that just 15 percent continuously took ART between incarcerations or after their releases. Inmates on intermittent therapy were 1.5 times more likely to have higher viral loads than those on continuous therapy, while those who never received ART were three times more likely to have a higher viral load.

“Taking ART intermittently is a problem because it depletes the CD4 count — the immunizing cells that fight infection — and increases the probability of developing resistance to the virus,” said Pant Pai. “The risk for rapid disease progression becomes higher and presents a risk for public health transmission of HIV to their partners.”

Study co-author Dr. Milton Estes, medical director of the San Francisco-based Forensic AIDS Project, said ensuring continuous ART is essential to controlling the US epidemic. “To achieve this we must work on various aspects of the prisoners’ lives, such as marginalization, psychiatric problems and drug use, both before and after their departure from prison,” he said.

The study “demonstrates the need for effective community transition and prison release programs to optimize ART given in jails,” the researchers concluded.

The report, “The Impact of Antiretroviral Therapy in a Cohort of HIV Infected Patients Going in and out of the San Francisco County Jail,” was published online in the journal Public Library of Science ONE (2009;4(9):e7115.doi:10.1371/journal.pone.0007115).

 

Study Highlights HIV/AIDS Challenge In American Prison System
ScienceDaily (Sep. 29, 2009) — HIV/AIDS is up to five times more prevalent in American prisons than in the general population. Adherence to treatment programs can be strictly monitored in prison. http://www.sciencedaily.com/releases/2009/09/090929133246.htm

Decision To Allow HIV-Positive Inmates In Alabama To Participate In Work-Release Program Makes 'Significant Statement," Editorial Says http://smtp01.kff.org/t/2599/324924/1974/0/
 

"Screening Male Prisoners for Chlamydia trachomatis: Impact on Test Positivity Among Women from Their Neighborhoods Who Were Tested in Family Planning Clinics"
Sexually Transmitted Diseases Vol. 36; No. 7; P. 425-429, (07..2009) Thomas A. Peterman; Daniel R. Newman; Martin Goldberg; Greta L. Anschuetz; Melinda Slamon; Catherine L. Satterwhite; Stuart M. Berman
“Chlamydia trachomatis screening test positivity among women in the United States has remained high, leading researchers to suggest that programs should also screen men,” explained the authors of the current study. Philadelphia prisons have screened male inmates since 2002. Similar to jails in other jurisdictions, the Philadelphia facilities’ median duration of incarceration was 17 days. The authors examined whether chlamydia screening and treatment among male inmates influenced infection among women living in the communities they return to. CDC NPIN Summary in Medical News (August)
 

UNITED STATES:
"Characteristics and Behaviors Associated with HIV Infection Among Inmates in the North Carolina Prison System"  CDC NPIN Summary
American Journal of Public Health Vol. 99; No. 6: P. 1123-1130, (06.09.2009) David L. Rosen, PhD; Victor J. Schoenbach, PhD; David A. Wohl, MD; Becky L. White, MD; Paul W. Stewart, PhD; Carol E. Golin, MD
The study authors “identified factors associated with testing HIV-positive in a prison system performing voluntary HIV testing on inmates and estimated the number of undetected HIV cases to evaluate the efficacy of risk-factor-based HIV testing.”

Logistic regression was employed to estimate associations between HIV serostatus and HIV risk behaviors, mental health, co-infection status, and sociodemographic characteristics for prisoners entering the North Carolina Department of Corrections from January 2004 through May 2006. The authors estimated the number of undetected HIV cases on the basis of age-, gender-, and race-specific HIV prevalences among inmates and in the state.

Almost 3.4 percent (718/21,419) of prisoners tested were HIV-positive, with the strongest risk factors for infection among men being sex with men (odds ratio [OR]=8.0), black race (OR=6.2), other non-white race (OR=7.4), and ages 35-44 (OR=4.1). Among women, the strongest risk factor was black race (OR=3.8). Sixty-five percent of HIV-positive prisoners were also co-infected with hepatitis C virus. An estimated 223 to 1,101 HIV cases (24 percent, 61 percent, respectively) remained undetected.

“The associations between HIV serostatus and a variety of factors highlight the potential limitations of risk-factor-based HIV testing in prisons, as do the high number of potential undetected HIV cases,” concluded the authors.

 

HIV Transmission in a State Prison System, 1988-2005
CDC NPIN Abstract (6/5/09)
HIV prevalence among state prison inmates is estimated to be more than five time higher than for the general US population, the study authors noted. However, data on transmission, risk modification after diagnosis, transmission networks, and antiretroviral (ARV) resistance within large state prison systems are sparse. In the current study, investigators analyzed 88 HIV seroconversions reported during 1988-2005 among male prison inmates in Georgia. The authors analyzed medical and administrative records to determine HIV testing histories, and they performed a case-crossover analysis of HIV risks before and after diagnosis. Seroconverters’ HIV strains were studied to identify genetically related transmission clusters and ARV resistance. Among all seroconverters, 41 (47 percent) were diagnosed when voluntary annual HIV testing was offered, from July 2003 to June 2005. Compared to before their diagnoses, HIV seroconverters were less likely after diagnosis to report sex (odds ratio [OR]=0.02, 95 percent confidence interval [CI]: 0-0.10) and tattooing (OR=0.03, 95 percent CI: less than 0.01-0.20) in prison. Of 67 seroconverters’ specimens tested, 33 (49 percent) fell into one of 10 genetically related clusters. Among these, 25 (76 percent) reported sex in prison before their diagnosis. The viral strains of eight out of 13 (61 percent) ARV-naïve prisoners were ARV-resistant, as were 21 out of 52 (40 percent) ARV-experienced prisoners. “Half of all HIV seroconversions were identified when routine voluntary testing was offered, and seroconverters reduced their risks following their diagnosis,” concluded the authors. “Most genetically related seroconverters reported sex in prison, suggesting HIV transmission through sexual networks. Resistance testing before initiating antiretroviral therapy is important for newly diagnosed inmates.” Source http://www.plosone.org 

Authors:Krishna Jafa; Peter McElroy; Lisa Fitzpatrick; Craig B. Borkowf; Robin MacGowan; Andrew Margolis; Ken Robbins; Ae Saekhou Youngpairoj; Dale Stratford; Alan Greenberg; Jennifer Taussig; R. Luke Shouse; Madeleine LaMarre; Eleanor McLellan-Lemal; Walid Heneine; Patrick S. Sullivan

 

Public Health Leaders Praise the Release of Nine Men Imprisoned for Their Sexual Orientation, Call for Laws Against Homosexuality to be Repealed
23 April 2009 (Geneva, Switzerland) – The International AIDS Society (IAS) today praised the release of nine Senegalese men who had been found guilty of “membership of a criminal organization and engaging in acts against the order of nature” on 8 January this year. The men’s convictions were overturned by the Dakar Court of Appeal on 20 April after defense lawyers argued that the accused had not been engaged in homosexual acts when arrested, but rather had been arrested based predominantly on anonymous tip-offs.
 

Overcrowding, Drug Use in Prisons Poses Risk for Spread of HIV, U.N. Official Says http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=58090


Canceled Canadian Prison Tattoo Program Reduced Risk of HIV, Report Says
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=58066
 

NEW YORK:
"Study Criticizes Health Care in State’s Prisons"
Journal News (White Plains) , (03.13.2009) Jay Gallagher CDC NPIN summary
New York State prisons should improve inmate health care, especially for those with AIDS and chronic diseases, according to a study issued by the Correctional Association of New York. Improvements might include the addition of health care staff, the provision of more routine care, and state Health Department monitoring, CANY said. The watchdog group acknowledged that significant improvements have taken place since its first report nine years ago.

The CANY report was based on visits to 19 prisons over three years and reviews of corrections documents. CANY found a shortage of physicians, pharmacists, and other medical professionals. While some prison facilities have one doctor for every 400 inmates, others have only one for every 600-800 inmates, said Jack Beck, author of the report. Routine care required wait times of a few weeks to a few months, and the report found medication shortages for chronic conditions.

New York has about 3,700 inmates with HIV, more than any other prison system in the United States, representing 20 percent of the nation’s HIV-infected prisoners, Beck said. New York also has about 8,400 inmates with hepatitis C virus.

“More than 95 percent of these patients will return to their communities, and the effectiveness of [Department of Correctional Services’ (DOC)] efforts to provide meaningful patient education and adequate care will determine not only the inmates’ medical future, but the health of their communities,” Beck said.

The state spends $5,883 for each of its 61,586 inmates, up from $4,825 for each of the 64,500 inmates four years ago, said Erik Kriss, a DOC spokesperson. AIDS care is monitored by an outside agency, he said. Over the last five years DOC has transferred 5,000 inmates to ensure proper medical care was available. The state prisoner mortality rate is actually lower than for the general population, he added. As for state Health Department monitoring, DOC believes it has enough oversight already, Kriss said.

 

House Approves Bill That Aims To Reduce Spread of HIV in Prisons
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=57536

Georgia Senate Passes Bill Requiring HIV Testing Among Prison Inmates Prior to Release
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=57433

Majority of Ex-Inmates in Texas Delay HIV Treatment, Study Finds
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=57148
 

New Orleans Program Will Provide HIV, STI Testing, Treatment to Inmates
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=56881

UNITED STATES:
"Distribution of Condoms Behind Bars Will Decrease Spread of HIV, Experts Say"
New York Amsterdam News , (11.27.2008) Glenn Townes  CDC NPIN Summary
“The spread of HIV behind bars is exacerbated by the lack of condoms in US prisons and jails,” Lovisa Stannow, the head of the California-based nonprofit Just Detention International (JDI), said recently.

Despite widespread prohibitions against sex behind bars, a number of jails in Vermont and some major cities - New York City, Los Angeles, San Francisco, Philadelphia, and the District of Columbia - distribute condoms to inmates. And in California, while Gov. Arnold Schwarzenegger has twice vetoed legislation to distribute condoms in state prisons, he did allow a one-year pilot distribution program at California State Prison-Solano. That program launched in September.

According to Stannow, inmates in coercive or protective pairings could protect themselves against the transmission of STDs like HIV if condoms were available. Protective pairings, whereby a vulnerable inmate receives protection from a stronger inmate in exchange for sex, are common in prison, she said.

“Public health agencies including the National Commission on Correctional Health have consistently endorsed condom distribution as a harm-reduction strategy,” Stannow noted.

“Sex in prison is forbidden,” said Felecia Ponce, spokesperson for the Federal Bureau of Prisons. “Condoms are not distributed at any of the [FBP] facilities across the country.”


Advocates Urge Canada To Implement Needle-Exchange Programs in Prisons To Prevent HIV Transmission
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=53315
 

NPR Program Features Discussions on Efforts To Promote Condom Distribution in Prisons To Reduce Spread of HIV http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=52180
 

"Highly Active Antiretroviral Therapy Use and HIV Transmission Risk Behaviors Among Individuals Who Are HIV Infected and Were Recently Released from Jail" Am Journal of Public Health Vol. 98; No. 4: P. 661-666,
The authors evaluated highly active antiretroviral therapy (HAART) use and risk behaviors among 177 inmates who were HIV-infected and were released and then re-incarcerated in San Francisco jails during a 12-month period. A quarter of the adults who are HIV-infected in the United States pass through correctional facilities annually. CDC Summary in Medical Briefs April

U.S. Prisons Missing Opportunities To Provide HIV Testing, Education, Prevention, Panel Says http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=51690
 

Black Religious Leaders, Public Health Officials in North Carolina Urge HIV Testing for Prison Inmates
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=51525
 

AP/Montgomery Advertiser Examines Debate Over Segregating HIV-Positive Inmates From General Prison Population
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=51039

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