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
