HIV-infected inmates are more likely to participate in drug treatment and not engage in risky sexual behavior six months after release if they're met at the gate of the correctional facility by a case manager, according to a study by Emory University public health researchers.
The study is published in the Aug. 3 issue of the Journal of Health Care for the Poor and Underserved. It offers moderate support for the important role that post-release case management services may play in the health-seeking behaviors of HIV-infected ex-offenders.
"When you're an HIV positive inmate, transitioning from a correctional facility to the community can be tough, particularly if your resources are limited," says Kimberly Jacob Arriola, PhD, MPH, study co-author and assistant professor of behavioral sciences and health education at Emory's Rollins School of Public Health. "We expect that if ex-offenders have a strong support system and the resources they need to survive such as housing, medical care and employment, then they'll be less likely to engage in criminal and high-risk behavior."
The study examined quantitative data from five participating U.S. public health departments, including Georgia, the city of Chicago, Florida, Massachusetts and New Jersey. The research offers preliminary evidence that the interaction between ex-offenders and their case managers must be immediate to be most effective in meeting the medical and social service needs of ex-inmates.
"One month out might be too late. Even one week out might be too late," Dr. Arriola says. "We need case managers that can help inmates get support services immediately."
The study is part of a larger, multi-site evaluation called the Corrections Demonstration Project (CDP) that began in 1999 and sought to develop and implement effective medical and social service programs for HIV-infected inmates.
Correctional facilities are faced with a disproportionate burden of HIV/AIDS. The AIDS case rate among U.S. prison inmates is five times that of the U.S. general population.
It has been argued that the criminalization of drug addiction, the presence of high concentrations of individuals who engage in high-risk behavior, the underutilization of harm-reduction techniques such as needle exchange and condom availability, and the limited availability of primary and secondary HIV prevention services contribute to the problem of HIV in correctional facilities, Dr. Arriola notes.
"The reality is that almost all inmates eventually come home," Dr. Arriola says. "We need to create support systems to encourage a healthy transition for ex-offenders with HIV or it can negatively impact the communities to which they're returning."
The study article is titled "Post-release case management services and health-seeking behavior among HIV-infected ex-offenders."