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| Health care complexities for HIV-women offenders |
| By Jim Montalto, News Editor |
| Published: 07/10/2006 |
 This month, Brown Medical School's Infectious Diseases in Corrections Report (IDCR) focuses on the issues surrounding how HIV-related services are delivered to incarcerated women, whose population has in the past few years seen an increase in HIV infection. The report states that at the end of 2003, 2.6 percent of female state and federal prison inmates were HV-infected compared to only 1.8 percent of males. According to IDCR “the prevalence of HIV infection among incarcerated women is disproportionately high, when compared to non-incarcerated populations” and the reasons why this population is so impacted by HIV/AIDS are complex. As a result, IDCR examined how factors like race, class, gender affect risk, what HIV-related services are needed, and existing relevant correctional health care policies for incarcerated women. According to the report, black women living in poverty are not only at increased risk for HIV/AIDS, but they are disproportionately incarcerated. In 2004, African American and Hispanic women represented about 25 percent of the U.S. population yet they accounted for about 81percent of the estimated total AIDS diagnoses among women. Regarding the racial composition of the female prison population, two-thirds of women offenders are black, Hispanic or of another non-white ethnic group. IDCR goes on to say that “there are at least two important ways in which the effects of race, poverty and gender converge in the lives of black women: trauma (or the experience of physical or sexual violence) and sexuality. First, the combination of racism, classism and sexism influences the nature and range of violence experienced by poor black women, the male-female gender roles that may promote violence against women, the structure of social institutions that condone this violence, and the extent to which the victims engage in help-seeking behavior. Second, black women's limited control over their own sexuality has direct implications for their ability to protect themselves from contracting HIV/AIDS. For example, they may be less able to insist on condom use or they may feel forced to use their bodies to secure drugs or other desired goods.” Noting the heightened risk of HIV infection among incarcerated women, the report urges more focused prevention approaches that include implementing aggressive HIV prevention services. Primary prevention should be based on HIV prevention education. Secondary prevention should focus on offering infectious disease screening (i.e. screening for sexually transmitted infections [STIs] and HIV/AIDS) to facilitate early detection and intervention. HIV treatment is a tertiary, yet obvious, level that would improve health and reduce the likelihood of further spreading the infection. The Bedford Hills "ACE" prevention program was noted as being a model program because it implements a widely recognized peer education program and “functions as a collaborative effort among inmates, medical and nursing staff, and the facility administration. Participants developed a curriculum of nine education workshops that focus on these issues and draws from the knowledge and experience of educators to empower participants to resolve these problems.” Despite the great promise that programs like ACE hold, IDCR believes much more work needs to be done in this areas. HIV testing must be implemented and continued, while improved prevention techniques, proper health care and discharge planning, and progressive health care policy must all be a focus in order to positively impact and advance the health and well-being of incarcerated women. This is an overview of the technical information and opinions IDCR has to offer. Click here to read the full report. Click here to subscribe to the IDCR monthly report |
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