Many women at particular risk for HIV and AIDS – women who use drugs, women who trade sex for money or drugs, homeless women and women with mental illness – eventually will cycle through jail. Research has shown that women in correctional settings have even higher HIV infection rates than their male counterparts.
Most female jail detainees return to their communities within days of arraignment. Thus, there is an acute public health need to provide HIV and AIDS education to these women during their incarceration, says Gary M. McClelland, assistant professor of psychiatry and behaviorial sciences at The Feinberg School of Medicine.
McClelland, a researcher in the Psycholegal Studies Program at Northwestern University, and colleagues published the results of the first comprehensive study of AIDS risk behavior of women in a correctional setting in the May issue of the American Journal of Public Health.
The study, which was part of a larger study of psychiatric disorders among female jail detainees and funded by the National Institute of Mental Health, examined the sexual and injection drug use HIV and AIDS risk behaviors of 950 women in the Cook County Department of Corrections in Chicago.
According to McClelland, the study showed that HIV and AIDS risk behaviors are extremely prevalent among women in jail and that there are distinct markers for women at greatest risk:
- Women arrested for misdemeanors and nonviolent crimes, such as drug crimes, prostitution and theft, women with substance abuse disorders and non-Hispanic white women are at high risk for both sexually and drug-transmitted HIV infections and AIDS.
- Older women in jail are at particular risk for injection drug use-transmitted HIV infection and AIDS. Overall, 19 percent of all the women in the study reported having injected drugs, and 9 percent said that they had shared needles.
- Women with severe mental illness have the most extreme sexual risk behaviors. Severe mental disorder also was associated with higher injection drug-use risk behaviors.
The study also found that Hispanic women were least likely to report ever using protection for vaginal and oral sex.
"More women are arrested and jailed each year. We have found that these women are at great risk for HIV infection, and most will return to the community within days of arrest. For these reasons, interventions targeting AIDS risk behaviors among women in jail will reduce AIDS in the community," McClelland said.
"The Cook County Bureau of Health Services has been very committed to this population. We have developed an extensive health education program over the past 10 years to address many of these concerns," said James McAuley, M.D., Medical Director of Cermak Health Services of Cook County, Ill., and adjunct associate professor of preventive medicine at the Feinberg School.
"Our current challenge is to evaluate these efforts, determine what works best to change behavior and help empower these women to protect themselves," McAuley said.
McClelland’s co-researchers were Linda A. Teplin, professor of psychiatry and behavioral sciences and director of the Psycholegal Studies Program; Karen M. Abram, assistant professor, psychiatry and behavioral sciences; and Naomi Jacobs.
KEYWORDS: HIV, AIDS, health risk behaviors, health risks in jails
Journal
American Journal of Public Health