a 3 months window) and not necessarily always in the same episode (i.e. In this paper, co-occurring behaviors are defined as behaviors that occur within certain time period (e.g. To effectively target prevention interventions to persons at the greatest risk of HIV infection among this population, it is critically important to understand their risk profiles and quantify which risk behaviors are more likely to co-occur. Thus, correctional-based HIV counseling and testing programs and prevention interventions may help to decrease their risk behaviors following release from the correctional environment and therefore reduce new HIV infections in this as well as the general population.Īlthough studies have documented prevalent (direct and indirect) HIV risk behaviors before entering jail (including heavy drinking, substance abuse, sexual promiscuity, and unprotected sex) there is limited understanding of the interrelationships among these risk factors. Release from correctional facilities might also be a time of high-risk of acquiring or spreading infections as persons re-entered their communities and resumed risk behaviors. The time period preceding incarceration has been shown to be characterized by increased substance use and risky sexual behaviors that increased exposure to HIV, viral hepatitis, and other transmitted diseases. That makes the time of incarceration an important public health opportunity to provide HIV prevention and testing services and linkage to care. Persons who interact with the criminal justice system may be disenfranchised from health services in the community, such as screening programs. The reasons for this increased burden of HIV among populations in correctional settings are multi-factorial and include increased rates of substance abuse, mental illness, poverty and health disparities. The prevalence of HIV infection within jails and prisons was estimated to be about 3 to 6 times higher compared with that among non-incarcerated populations.
Among this population, it was estimated that about 2% was infected with HIV including those unaware of their infection - as a contrast, the prevalence among the US adult population is around 0.3% according to the US Centers for Disease Control and Prevention (CDC). Over seven million people passed through the criminal justice system in the United State (US) in year 2012. HIV risk, Co-occurring behaviors, Correctional facilities, Male jail detainees
Our findings suggest that efficient interventions to reduce HIV infection in this high-risk population may have to target on these behaviors simultaneously and be demographically adapted. Further analyses of risk behaviors and demographic characteristics of the population showed that IDU were more prevalent among middle ages (30-40) and multiple prior incarcerations, and having multiple sex partners was more prevalent among young males younger than 30 years, African American race, and those with low education. From pairwise analyses, we also found that heroin and IDU unprotected sexes with main, with non-main, and in last sexual encounter were mostly co-occurring behaviors. We conducted multivariate analyses of baseline data from an HIV intervention study of ours, and found that: cocaine use, heroin use and multiple sexual partners and heavy drinking and marijuana were often co-occurring among this population. This paper examined the pattern of co-occurring HIV risk behaviors among male jail detainees in the US. People going through the United States (US) criminal justice system often exhibit multiple behaviors that increase their risk of HIV infection and transmission.