182330 High Risk HIV Transmission Behavior in Prison: Does a Fatalistic Model Exist?

Wednesday, October 29, 2008

Titilayo C. Abiona, MD, FMCPH , HIV/AIDS Research and Policy Institute, Chicago State University, Chicago, IL
Adedeji Adefuye, MD, MPH , HIV/AIDS Research and Policy Institute, Chicago State University, Chicago, IL
Joseph A. Balogun, PT, PhD, FACSM , College of Health Sciences, Chicago State University, Chicago, IL
Patricia E. Sloan, EdD, FAAN , Office of the President, Chicago State University, Chicago, IL
Background: Following a survey of HIV risk behaviors of inmates, a qualitative study was conducted among recently released ex-offenders to further explore the findings. The objectives were to determine the perceptions and knowledge of participants regarding the occurrence of HIV risk behaviors in prison that were identified in the survey based on their experiences while incarcerated.

Methods: The study was conducted at a community-based organization that provides care for recently released ex-offenders. Four focus group discussions (FGDs) each were conducted with purposive samples of male and female ex-offenders who met the set eligibility criteria. FGDs were tape-recorded and transcribed. Data were analyzed using the NVivo 7 software.

Results: Participants agreed that all the HIV risk behaviors reported in the survey, i.e., injection drug use, sexual intercourse including tattooing and body piercing did occur. Reasons given to explain inmates' involvement in these behaviors supported the deprivation and importation models. However, a striking recurring response was the association of inmates on life sentences with injection drug use and sexual intercourse. The focus group participants described attitudes on the part of “lifers” that can be inferred as fatalistic, exemplified by statements such as “…they just don't care; they know they are not going anywhere”.

Conclusions: In addition to the other models used to describe HIV risk behaviors of inmates, a fatalistic model may apply, especially among inmates on life sentences. Further studies are required to examine this model. If proven, the fatalistic model has programmatic implications for HIV prevention among incarcerated populations.

Learning Objectives:
1. Describe ex-offenders perceptions on the occurrence of HIV risk behaviors in prison 2.Discuss the models used to explain inmate behavior 3.Provide evidence for a possible fatalistic model in explaining inmate HIV Risk Behaviors 4. Stimulate future research examining the fatalistic model

Keywords: HIV Risk Behavior, Incarceration

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator of the study
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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