In Texas, newly released offenders are welcomed to their freedom with a warm cup of coffee - and a session of HIV/AIDS awareness training. At a storefront a block away from the inmate release center in Huntsville, offenders – who have just been HIV tested – can learn about the disease and how to remain healthy.

This session is the last step in Project Wall Talk, a disease awareness program for inmates, which hopes to change offenders' perceptions about the disease.

“I think that [inmates] initially come in seeing diseases like AIDS and HIV in a certain way. But when they come in and get this information they change their attitudes. And they pass that change along,” says Allen Barrett, Project Coordinator for Project Wall Talk. “Inmates that come in with preconceptions about homosexuality have entirely different opinions after this program. They realize these diseases are not limited to one sexual orientation.”

Project Wall Talk, a program of Houston's AIDS Foundation, started off as a peer-to-peer education project that centered on reducing prisoner cases of HIV and AIDS. But after the in-prison program began, inmates started asking for more information - and PWT peer educators expanded their programs to include Sexually Transmitted Infections (STIs), Hepatitis, Tuberculosis and Staphylococcus as well as other diseases. 

According to PWT officials, the need for this program was great based on the number of inmates at risk for contracting HIV. In 2002, Bureau of Justice statistics showed the inmate population was 3.5 times more at risk for HIV/AIDS infection than the general population. PWT took these numbers and focused its efforts on peer-to-peer education, which it believes is effective in prisons because it spreads information quickly, and improves inmate morale.

“I see these peer educators on the front line,” says Barrett. “First of all, I see a change in self esteem for most of these educators once the sessions begin – other inmates look up to them and learn from them. Secondly, I see walls being broken down – disease education really extends across race and gang lines. When we start training offenders to become educators on day one, and then see them on day five – the transformation is amazing.”

Peer-to-Peer Education

According to PWT organizers, inmates respond positively to the information and cannot wait to share it with others.

“It's amazing what I see in these facilities now that inmates have this knowledge,” Barrett says. “There are guys writing home to their children, about these diseases. They want to share this information with everyone; they want to educate their own families.”

Inmates are qualified to become peer educators after they complete a 40-hour training course. The training lasts for about a week, and includes a 223-page curriculum. After completion, the inmates reach the rest of the offender population by holding information sessions and passing their knowledge along to other inmates informally.

“Initially, we had concerns,” says Kelly McCann, Project Director for Project Wall Talk. “We were worried that inmates might not be interested in the program because it might be too intimate and personal. But frankly, the opposite is true. So far, we have trained over 1100 offenders to become peer trainers and we continue to grow.”

Once the program took hold, inmates began to expand the PWT program in their own ways. Bi-lingual inmates translated the lessons into Spanish for other offenders, and specific programs were developed by inmates to address male and female heath issues separately. While the male aspect of the program focuses on issues such as testicular cancer, the female program focuses on issues such as menopause.

“Our results so far have been encouraging, to say the least,” says McCann. “We have seen a large increase in inmates who are voluntarily being tested for HIV and AIDS, and we are partnering with other disease-prevention organizations to implement this project state-wide and beyond.”

Program Success and Inmate Response

PWT has received positive responses from the upper-level prison administration at the Texas Department of Criminal Justice (TDCJ), and the TDCJ has requested that PWT programs expand to cover new prison rape regulations. Additionally, PWT was awarded a three-year grant for $1.3 million dollars by the Health Resources and Services Administration (HRSA) to help with project expansion. Part of that went to establish the store-front HIV/AIDS education center, which has been well received by inmates.

“Establishing the Huntsville store-front operation was mostly to inform inmates one more time before release,” says McCann. “We have a brief intervention before they board the bus and head home – we give them condoms, talk about health issues and give them a chance to talk about their health concerns.”

The PWT program has grown so popular that it recently expanded to include 66 prison facilities and many other states have shown an interest in the program. New grants have been awarded to PWT in order to fund a training site facility because prisons are reporting that they have a waiting list for peer education training due to the overwhelming response of inmates who want to become leaders and educators.

McCann and Barrett say that they plan to take the concept nation-wide if demand continues to be high.

“We are making connections outside of Texas,” says McCann. “We have already spoken with Louisiana, Oklahoma, New York and California about this program. This is something we really want to share with other states. We believe this concept is public domain.”

Although PWT has not yet developed a way to track offenders post release due to state regulations, they say anecdotal results of the program show a positive effect in released offenders.

“Several of our peer educators have gone on to work in community-based programs like this in their hometowns,” says McCann. “A recently released peer educator came back to work as a keynote speaker for every one of our conferences this year. Imagine what an accomplishment that was – to come back into a facility as a keynote speaker rather than an inmate.”