as upper and lower respiratory conditions, influenza, gonorrhea, tuberculosis, hepatitis, and HIV are thought to occur at higher rates in jail populations ( Glaser & Greifinger, 1993; Weiner & Anno, 1992). Those who assume that HIV infection in prisons does not affect those who are not incarcerated are mistaken. As some experts stated, prison walls effectively restrain criminals only for short time spans; they neither delimit nor contain the public health dilemmas of HIV infection. How we care for the incarcerated will in the future have a direct effect on needed clinical and public health services in the community. (Polonsky et al., 1994, p. 621) HIV RISK FACTORS RELATED TO INCARCERATED POPULATIONS It is not surprising that there exists a high rate of HIV infection among correctional populations--a population characterized by heavy illicit drug use. Although the sharing of needles is a well-documented mode of HIV transmission, the use of other illicit drugs is also an associated risk for the disease. This is due in part to the fact that many drug users exchange sex for drugs or money to support their habits, and they do so without the use of condoms ( Polonsky et al., 1994). The Bureau of Justice Statistics ( 1993 ) reported that, in 1991, 79% of prison inmates indicated they had at some time used illicit drugs. Approximately 2.5% of those inmates who reported having tested positive for HIV were drug users, compared to 0.8% of those who had never used drugs. Twelve percent of all inmates and 20% of those who used drugs in the month before their offense reported that they had shared a needle. Needles are available through the black market at exorbitant costs and with no guarantee of safety. As a result, shared needles are often the only ones available to prisoners. In 1995, 97% of the large jail jurisdictions were providing some type of drug counseling and treatment ( Bureau of Justice Statistics, 1998). However, the number of inmates participating in the programs is unknown because attendance data was not collected since 1992. There is probable indication that this rate is low ... |