Public Health/corrections Collaborations: Prevention and Treatment of HIV/AIDS, STDs, and TB

By Hammett, Theodore M. | Corrections Forum, September/October 1998 | Go to article overview

Public Health/corrections Collaborations: Prevention and Treatment of HIV/AIDS, STDs, and TB


Hammett, Theodore M., Corrections Forum


Correctional populations have higher rates of HIV/AIDS, STDs, TB, and more risk factors for these diseases than the general population. Virtually all inmates return to the community, where they may place themselves and others in danger by engaging in high-risk behaviors.

Collaborations between public health and correctional agencies may help fill gaps in programs foi the prevention and treatment of HIV/AIDS, STDs, and TB, thereby benefiting an at-risk and underserved population as well as overall public health.

Key findings

According to NIJ/CDC survey responses, virtually all correctional systems have at least some collaboration with public health agencies.

Site visits identified numerous collaborations in disease surveillance, testing and screening, follow-up, education and prevention programs, staff training, treat ment services, and legislation and policy development, but found fewer collaborations in discharge planning and transitional services for people being released.

Most existing collaborations involve public health departments providing funds, staff, or direct services in correctional facilities.

Programs in Rhode Island and New York State exemplify more comprehensive collaborations.

Key factors in successful collaborations include:

- Availability of data on disease bur den or dramatic events such as out breaks demonstrating the need for collaborations. - Organizational, legislative, or regulatory provisions such as health department responsibility for provision of health services in correctional facilities; or legislation or regulations requiring oversight mechanisms, screening, or disease reporting.

- Attitudes and philosophies such as commitment to collaboration at agency and facility levels; correctional agency willingness to open its facilities to outside organizations; and mutual sensitivity to concerns, priorities, and perspectives of corrections and public -health personnel

- Health department funding of programs in correctional facilities and operational features such as the presence of health department personnel in correctional facilities, liaison staff in correctional and public health agencies, formal agreements for collaboration (such as MOUs), and long-standing Inter agency relationships

- Communication and information exchange such as correctional representation on HIV Prevention Planning Groups, service on joint committees, regularly held meetings at leadership and operational levels, and the exchange of important information about patients.

Recommendations

The key recommendations of the NIJ/CDC study involve implementing the following four key facilitators of collaboration: Public health agency collection and dissemination of data on the burden of infectious disease in inmate populations.

Including correctional representation on all HIV Prevention Planning Groups.

Public health agency initiation or expansion of funding for services and staff in correctional facilities.

Public health and correctional agency recognition of the importance and potential benefits of intenventions in correctional settings to the health of the larger community.

The Rhode land Model

Rhode island has developed a tate of-the-art model of collaboration involving the State Department of Health, the State Department of Corrections, an academic medical center (Miriam Hospital, affiliated with Brown University), and approximately 40 community-based organizations and service agencies. The organizational chart of Rhode Island's AIDS Services After Prison ASAP) program, a centerpiece of the State's collaborative efforts, is displayed in exhibit 2.

Meetings and interactions between all of the organizational partners in the Rhode Is land collaboration take place regularly. The partners also work together on disease surveillance, policies, legislative proposals, and union issues in the facilities. There is a demonstrable commitment to working together. …

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