949s o u n d i n g b o a r d T h e n e w e ng l a n d j o u r na l o f m e dic i n e ELECTION 2012In this election year, U.S. national spending on health care will reach $2.8 trillion, or about 18% of total spending on all goods and services. This high level of spending reduces our ability to invest in other important parts of the economy and also adds to our unsustainable national debt. There is wide agreement that we must find ways to bend the health care cost curve. Taking different approaches, the two articles that follow present a range of options, including reducing both the prices and quantity of services for public and private payers, reducing administrative costs, implementing new market-based incentives, and reforming the tax subsidy for employer-sponsored health insurance. It is our hope that these articles will stimulate discussion and debate on the best ways to address the cost problem and to place our health care system on a more sustainable path.

New York State's prison population has the highest seroprevalence of human immunodeficiency virus (HIV) among incarcerated populations in the United States. Five percent of the State prison inmate population is female. To date there have been few studies of incarcerated females in New York State (NYS). Seroprevalence rates have ranged from 18.9% to as high as 29%. In 1991, counselors from the New York State Department of Health (NYSDOH) AIDS Institute's Criminal Justice Initiative, in collaboration with the State's Department of Correctional Services (NYSDOCS), began to offer educational services and anonymous pretest counseling, HIV antibody testing, and posttest counseling to NYS female prisoners. With preliminary program testing data (N = 216) descriptive and multivariate techniques are used to evaluate the demographic and risk-related behaviors associated with HIV infection among female inmates in this voluntary HIV testing program. Results are discussed in light of previous research findings regarding the correlates of HIV seropositivity among New York State prison inmates and compared to previous blinded epidemiological studies of female inmates in the State. Future research, addressing the limitations of this preliminary study, is proposed.

No abstract

No abstract