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[ Recorded presentation ] Recorded presentation

Inmates living with HIV: The need for coordinated services and secondary prevention

Kristen Clements-Nolle, PhD, MPH1, Michael Pendo, MPH2, Charmaine Lastimoso1, Sharon Clodefelter, BS1, Cicily Emerson, MSW3, and Valorie Eckert, MPH4. (1) Department of Health Ecology, University of Nevada, Reno, MS 274, Reno, NV 89557, 775-784-4041 ext. 234, clements@unr.edu, (2) HIV Prevention Section, San Francisco Department Of Public Health, 25 Van Ness, #500, San Francisco, CA 94102, (3) Continuum, 255 Golden Gate, San Francisco, CT 94102, (4) HIV Prevention Research and Evaluation Section, California Dept. of Health Services, Office of AIDS, 1616 Capitol Ave, Suite 74--6616, Sacramento, CA 95814

Background: Inmates share a disproportionate burden of HIV/AIDS in the United States. Determining the risk behaviors and service needs of HIV-positive inmates is essential for planning effective interventions. Methods: A randomized control trial was conducted with 261 HIV-positive inmates in San Francisco to evaluate an enhanced intervention funded through a Special Projects of National Significance grant. Participants completed a baseline interview documenting demographics, incarceration history, service use, HIV medication use, and risk behaviors preceding incarceration. Results: Eighty-three percent of participants were male and 53% were African American. Ninety-nine percent had previously been incarcerated; 50% spent five or more years in correctional settings. HIV service needs and risk behaviors the month preceding incarceration were prevalent. Thirty-three percent had an AIDS diagnosis; of whom, 66% did not take antiretrovirals and 72% were not on the AIDS Drug Assistance Program. Among those taking medications, 62% missed at least one dose. Half of the sample injected drugs and engaged in receptive (27%) and distributive (19%) syringe sharing. Thirty percent of males had sex with males and engaged in unprotected serodiscordant insertive (22%) and serodiscordant receptive (20%) anal sex. Fifty-two percent of males had sex with females; 28% had serodiscordant vaginal sex. Only 35% saw a case manager and 21% discussed their sexual and/or drug risk behaviors with a provider. Conclusions: Lack of HIV medication use and adherence and the high level of risk-taking suggest an urgent need for health and prevention services for HIV-positive inmates. Due to high re-arrest rates, corrections and community services must be coordinated.

Learning Objectives: At the conclusion of the session, the participants will be able to

Keywords: HIV/AIDS, Correctional Institutions

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

[ Recorded presentation ] Recorded presentation

HIV/AIDS Treatment Adherence

The 132nd Annual Meeting (November 6-10, 2004) of APHA