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APHA Scientific Session and Event Listing

Daniel G. Karus, BA, MS, Mailman School of Public Health, Columbia University, 100 Haven Ave., Suite 6A, New York, NY 10032, (212)304-5557, dk307@columbia.edu, Victoria H. Raveis, PhD, Dept. of Sociomedical Sciences, Columbia University, 100 Haven Ave., Suite 6D, New York, NY 10032, Margaret Ratcliff, MSW, Volunteers of America, 1660 Duke St., Alexandria, VA 22314, and Irene J. Higginson, MD, PhD, Dept. Palliative Care and Policy, King’s College, Guy’s, King’s and St. Thomas’ School of Medicine, Weston Education Centre, Cutcombe Rd., London, United Kingdom.

Objectives: Although epidemiological data document a high prevalence of HIV/AIDS among inmates of US jails, little is known regarding the health status and service needs of inmates with the disease. Pertinent data are presented from a subset of inmates seriously ill with disease at two large urban jails. Methods: Background information, mental health (MHI-5), symptomatology (MSAS), and service needs of inmates accrued into transitional case management programs for seriously-ill inmates at jails in Los Angeles (LA) and New Orleans (NO) were assessed. Data from inmates seriously-ill with HIV/AIDS (n=34 at LA; n=20 at NO) are described and compared to identify shared characteristics and needs of clients at each site as well as potential differences. Results: A majority of inmates at both sites were poor, Black non-Hispanic men with a history of drug/alcohol addiction substance abuse. MHI-5 scores at both sites were indicative of poor mental health; however, the mean score of inmates at LA was significantly poorer. MHI-5 scores of 65% of inmates at LA (35% at NO) were indicative of recent major depression. On average, inmates at both jails reported more than 10 of the 32 symptoms assessed by the MSAS, with prevalence rates similar to those reported for seriously-ill HIV/AIDS patients in the community receiving palliative care. Clients of both programs reported need for a wide variety of medical and practical/social services; however, this number was particularly high at New Orleans. Conclusions: The findings document the presence of an indentifiable subpopulation of inmates who entered jail as seriously-ill with HIV/AIDS as community residents with the disease who are receiving palliative care. These inmates are in need of medical care and a wide range of supportive services not provided by jails. Efforts are needed to develop and support services that identify and initiate care for such inmates and then facilitate continuity of care as they are either transferred to other settings or returned to the community.

Learning Objectives: At the conclusion of this session, listeners will

• Recognize that there is a subset of inmates with HIV/AIDS in the nation’s jails that is seriously ill with the disease and in need of immediate medical/mental health care and a wide range of practical and support services.
• Identify the range of symptoms most frequently reported by these inmates.
• Identify specific medical and support services most often needed by these inmates.
• Appreciate not only the importance of accessing care for inmates while in jail, but the added importance of assuring continuity of care as they are released to the community or transferred to other facilities.

Keywords: Access to Health Care, Jails and Prisons

Presenting author's disclosure statement:

Any relevant financial relationships? No

Handout (.doc format, 66.0 kb)