Opportunities to Diagnose, Treat, and Prevent HIV in the Criminal Justice System

Department of Medicine, The Alpert Medical School of Brown University, Providence, RI, USA.
JAIDS Journal of Acquired Immune Deficiency Syndromes (Impact Factor: 4.56). 12/2010; 55 Suppl 1(S1):S49-55. DOI: 10.1097/QAI.0b013e3181f9c0f7
Source: PubMed


Persons involved with the criminal justice system are at risk for HIV and other transmissible diseases due to substance use and related risk behaviors. Incarceration provides a public health opportunity to test for HIV, viral hepatitis, and other sexually transmitted infections, provide treatment such as highly active antiretroviral therapy, and link infected persons to longitudinal comprehensive HIV care upon their release for such comorbidities as addiction and mental illness. Delivering health interventions inside prisons and jails can be challenging, yet the challenges pale in comparison to the benefits of interventions for inmates and their communities. This article reviews the current state of delivering HIV testing, prevention, treatment, and transition services to incarcerated populations in the United States. It concludes with summary recommendations for research and practice to improve the health of inmates and their communities.

Download full-text


Available from: Nickolas Zaller,
  • Source
    • "For individuals with HIV/AIDS, early detection and linkage to treatment are essential best practices for managing the disease and reducing the risk of transmission (Centers for Disease Control and Prevention 2003). Unfortunately, HIV services in prisons and jails suffer from lack of adherence to best practices in HIV testing, prevention, and treatment access (Beckwith et al. 2010; Booker et al. 2013; Springer and Altice 2005). Thus, it is important for correctional facilities to close these gaps in service delivery by initiating and maintaining evidence-based programs that improve access to testing for HIV, enhance prevention through education programs, and facilitate linkages to community-based HIV services for individuals exiting confinement. "
    [Show abstract] [Hide abstract]
    ABSTRACT: In the growing field of implementation science, sustainability is a critical component of the implementation process of moving evidence-based treatments to regular practice. This paper is intended to extend our understanding of factors that influence the sustainability of HIV services in correctional settings following an organization-level intervention designed to implement improvements in preventing, detecting, or treating HIV for persons under correctional supervision. Using semi-structured interviews to elicit perceptions from the principal researcher and executive sponsor at each of nine participating sites, this study explores the variations in the sustainability of HIV services in these criminal justice settings following the experimental implementation intervention. In six of the nine sites, changes in HIV services implemented as a result of the organizational intervention were sustained six to nine months following the end of project implementation. Organizational endorsement at multiple levels is likely the principal factor that facilitates sustainability. The factors that result in the sustainability of changes to health services in correctional organizations include elements internal and external to the organization. Implementation strategies, such as the change team model strategy used in this study, are also sustainable and can be used to identify other changes that could be made, or improve other aspects of service delivery.
    12/2015; 3(1). DOI:10.1186/s40352-015-0018-2
  • Source
    • "The HIV prevalence among the Washington, DC DOC population has been estimated to be between 5-6% and among those completing HIV testing upon entrance, close to 1% test positive and among those, 60% represent new HIV diagnoses [11]. These data strongly support the need to apply the Seek, Test, Treat, and Retain strategy [12] to control the HIV epidemic within the DC correctional facilities as part of a broader community strategy to identify persons with HIV, start antiretroviral treatment, and support linkage to and retention in care leading to improved health outcomes and reduced viral load/secondary HIV transmission. To do this effectively, however, new strategies for incarcerated populations are needed [13]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The United States has the world's highest prison population, and an estimated one in seven HIV-positive persons in the USA passes through a correctional facility annually. Given this, it is critical to develop innovative and effective approaches to support HIV treatment and retention in care among HIV-positive individuals involved in the criminal justice (CJ) system. Information and communication technologies (ICTs), including mobile health (mHealth) interventions, may offer one component of a successful strategy for linkage/retention in care. We describe CARE+ Corrections, a randomized controlled trial (RCT) study now underway in Washington, that will evaluate the combined effect of computerized motivational interview counseling and postrelease short message service (SMS) text message reminders to increase antiretroviral therapy (ART) adherence and linkage and retention in care among HIV-infected persons involved in the criminal justice system. In this report, we describe the development of this ICT/mHealth intervention, outline the study procedures used to evaluate this intervention, and summarize the implications for the mHealth knowledge base.
    AIDS research and treatment 07/2013; 2013(5):547381. DOI:10.1155/2013/547381
  • Source
    • "The criminal justice setting provides vast opportunities for early diagnosis, prevention, and treatment of HIV [1, 2]. One in seven people living with HIV in the United States passes through the criminal justice system (CJS) each year [3], and incarceration is considered an independent risk factor for HIV infection [4]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The criminal justice system bears a disproportionate burden of the HIV epidemic. Continuity of care is critical for HAART-based prevention of HIV-related morbidity and mortality. This paper describes four major challenges to successful management of HIV in the criminal justice system: relapse to substance use, homelessness, mental illness, and loss of medical and social benefits. Each of these areas constitutes a competing priority upon release that demands immediate attention and diverts time, energy, and valuable resources away from engagement in care and adherence to HAART. Numerous gaps exist in scientific knowledge about these issues and potential solutions. In illuminating these knowledge deficits, we present a contemporary research agenda for the management of HIV in correctional systems. Future empirical research should focus on these critical issues in HIV-infected prisoners and releasees while interventional research should incorporate evidence-based solutions into the criminal justice setting.
    AIDS research and treatment 07/2011; 2011(2090-1240):680617. DOI:10.1155/2011/680617
Show more