Reducing Postrelease Risk Behavior among HIV Seropositive Prison Inmates: The Health Promotion Program

Abstract

The prevalence of AIDS is five times higher among prison inmates than in the general population. Because recidivism is common and many inmates are serving short sentences for parole violation, HIV-seropositive inmates move frequently between prison and their home communities. We designed an eight-session prerelease intervention for HIV seropositive inmates to decrease sexual and drug-related risk behavior and to increase use of community resources after release. The intervention sessions were delivered at the prison by community service providers. We found that a prerelease risk reduction intervention for HIV seropositive inmates was feasible. Descriptive results support the effectiveness of the program in reducing sexual and drug-related behaviors and in increasing use of community resources after release. Compared with men who signed up for the intervention but were unable to attend, men who received the intervention reported more use of community resources and less sexual and drug-related risk behavior in the months following release. We recommend dissemination and continued evaluation of this risk-reduction intervention.

Economic, Legal, and Social Hardships Associated with HIV Risk among Black Men who have Sex with Men in Six US Cities

“…35,36 There is also evidence that incarceration disrupts stability in men's sexual partnerships. [37][38][39] One potential consequence of this disruption is an increase in casual sexual partnerships and concomitant increases in the likelihood of exposure to STIs. This contention is consistent with data indicating that recent incarceration among men is associated with multiple partnerships (adjusted prevalence ratio: 1.66, 95 % CI 1.43-1.93) and unprotected sex (APR 1.99, 95 % CI 1.45-2.72).…”

Incarceration and High-Risk Sex Partnerships among Men in the United States

“…12,13 After the incarceration, absence of a stable sex partner with stress of reintegration 66 may lead newly released prisoners to engage in increased levels of multiple and concurrent partnerships. 9,[15][16][17][18][19] A number of important study limitations should be noted. First, since this study was cross-sectional, we do not know the temporal relationship between incarceration and sexual risk behavior and hence cannot conclude that incarceration contributed to high-risk sex partnerships.…”

“…[10][11][12][13][14] The absence of a stable partner, together with the stress of reintegration after incarceration, may lead newly released prisoners to engage in increased levels of multiple partnerships, including concurrent partnerships (multiple partnerships that overlap in time). 9,[15][16][17][18][19] Partnership concurrency is considered to be a particularly important determinant of STI/HIV transmission. 20 There is evidence that incarceration history is associated with high-risk sex partnerships including multiple and concurrent partnerships; 15,17,[21][22][23][24][25] however, most studies have been performed in small convenience samples.…”

HIV-Related Sexual Risk among African American Men Preceding Incarceration: Associations with Support from Significant Others, Family, and Friends

“…Such interventions have incorporated individual risk reduction delivered through case management, peer education, and/or motivational interviewing models and many have seen success in prevention of HIV risk [48][49][50][51]. However, the persistently high levels of infection among inmates suggest alternative intervention strategies would strengthen risk reduction efforts during community re-entry.…”