Neurological Function and HIV Risk Behaviors of Female Prison Inmates

Ethical, Regulatory, and Investigator Considerations in Prison Research

“…The issue that is not clear, however, is who should pay for healthcare when research shows that medical conditions may be contributing to highrisk behaviors that lead not only to incarceration but also to increasing healthcare needs of inmates. 4,5,6,7,11,12 "The underlying problem is that many people in our country feel that one segment of our population is expendable, so they feel it is reasonable to spend more money on prison construction to house this expendable segment of the population, and less money on housing outside prisons, education, health, and creation of living-wage jobs" 13(p1567) that could potentially decrease expenditures over time. Although arguments could be made against tax increases to fund prison programs, many may not realize that inmates are frequently incarcerated and released after short sentences with limited employment skills, returning to high-risk behaviors in the community where they are at risk for further abuse and could pose increased risks to themselves and society.…”

“…Ethical concerns are raised when more attention and dollars are allocated to prison housing as opposed to prevention interventions based on research evidence that links neurological conditions and childhood abuse and trauma to criminal and other highrisk behaviors prevalent in prisons. 4,5,12 Links have been reported between childhood abuse and high-risk behaviors, leading to recurrent traumatic brain injuries, crime, and infectious disease transmission. 4,5,12 Because of years of recurrent high-risk behaviors and limited healthcare-seeking behaviors while they were in the community, healthrelated needs are astronomical in prison populations.…”

“…4,5,12 Links have been reported between childhood abuse and high-risk behaviors, leading to recurrent traumatic brain injuries, crime, and infectious disease transmission. 4,5,12 Because of years of recurrent high-risk behaviors and limited healthcare-seeking behaviors while they were in the community, healthrelated needs are astronomical in prison populations. In particular, female inmates have been reported to engage in extremely high-risk behaviors for HIV transmission.…”

“…Although arguments could be made against tax increases to fund prison programs, many may not realize that inmates are frequently incarcerated and released after short sentences with limited employment skills, returning to high-risk behaviors in the community where they are at risk for further abuse and could pose increased risks to themselves and society. 4,5 Neurological and neuropsychiatric disorders have been reported in up to 100% of murderers and other predominantly male violent populations and in 95% of randomly selected female inmates. 5,7 Neurological histories reported to be most prevalent in female prison inmates include traumatic brain injuries with loss of consciousness (47%), loss of consciousness for other reasons including choking (34%), memory impairment (60%), and intelligence quotient less than 70 or other learning disability (20%).…”

“…The high prevalence of psychiatric (80%) 2,3 and neurological (96%) conditions reported in female jail and prison inmates [4][5][6][7] could be the result of the shift of care from psychiatric hospitals to community-based services. Negative consequences of changes in mental health services impact the most disadvantaged individuals who end up in prisons with little rehabilitation or treatment 119 120 ADVANCES IN NURSING SCIENCE/APRIL-JUNE 2008 for their conditions.…”