Reduction in Recidivism of Incarcerated Women through Primary Care, Peer Counseling, and Discharge Planning

Article · May 1999with47 Reads
DOI: 10.1089/jwh.1999.8.409 · Source: PubMed
Prior to release from the Rhode Island state prison, women at the highest risk for reincarceration and HIV infection are assigned to the Women's HIV/Prison Prevention Program (WHPPP), a discharge program designed to reduce the likelihood of reincarceration and HIV infection. Candidates for the WHPPP must meet at least one of three criteria: intravenous drug use or crack use, commercial sex work, or a history of prison recidivism with poor educational history and poor employment prospects. While incarcerated, the program participant develops a relationship with a physician and a social worker and establishes an individualized discharge plan. After release, the same physician and social worker continue to work with the client and assist an outreach worker in implementing the discharge plan. Data were collected from questionnaires administered to 78 women enrolled in the WHPPP between 1992 and 1995. The population in this program was primarily composed of ethnic minorities (55%), 25-35 years of age (55%), unmarried (90%), had children (72%), and displayed a variety of HIV risk behaviors. The WHPPP recidivism rates were compared with those of a mostly white (65%), similarly aged (51% were between 25 and 35 years of age) historical control group of all women incarcerated in Rhode Island in 1992. The intervention group demonstrated lower recidivism rates than the historical control group at 3 months (5% versus 18.5%, p = 0.0036) and at 12 months (33% versus 45%, p = 0.06). Assuming that recidivism is a marker for high-risk behavior, participation in the WHPPP was associated with a reduction in recidivism and in the risk of HIV disease in this very high risk group of women.
  • ...At the population level, higher rates of incarceration have been associated with adverse health outcomes such as sexually transmitted infections and teen pregnancies [67]. The factors that lead to incarceration and subsequent recidivism, or repeat offence, are tightly linked to factors that affect health and wellbeing, and addressing underlying long-term health problems has been shown to reduce recidivism686970 and play a significant role in successfully reentering the community alongside other factors [71]. Finally, the right to health and health care is enshrined in international human rights documents [72, 73]. ...
  • ...When applying this to individuals cycling in and out of prison, keeping them healthy may lower the likelihood of committing future crime. Indeed, research demonstrates that this is the case for specific types of criminals, like substance users or HIV positive individuals (Dixon et al., 1993; Farley et al., 2000; Flanigan et al., 1996; Gaes et al., 1999; Kim et al., 1997; Vigilante et al., 1999; Visher and Courtney, 2007; Wexler et al., 1999). Lastly, as the number of individuals in the neighborhood having contact with the criminal justice system grows there is a higher likelihood that those individuals are spreading infectious diseases and straining health care organizations currently in place (Hipp et al., 2010 ). ...
  • ...First, based on the centrality of other prisoners within incarcerated women's support networks, more formalized peer-to-peer programs could help women to develop healthy social supports. Peer support—along with other supports and discharge planning—has been shown to be particularly effective for incarcerated women with HIV (Boudin et al., 1999; Klein, O'Connell, Devore, Wright, & Birkhead, 2002; Vigilante et al., 1999 ). Implementing similar programs for those not affected by HIV could help a broader population of incarcerated women and help facilitate the transition postrelease . ...
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