Incarcerated women and HIV/AIDS: The imperative for gender-responsive programming and policies for women

U.S. women prisoners have health care needs that are minimally met by correctional health care systems. Many incarcerated women face a high risk of being infected with HIV and other infectious diseases – either before entry or during incarceration. Female inmates have a higher HIV antibody seroprevalence than male prisoners and are roughly 15 times more likely to be living with HIV than their non-incarcerated female counterparts. Women prisoners also have a higher prevalence of drug use and trauma histories compared to male prisoners and are more vulnerable to gender-based sexual violence and self-harm. Unfortunately, health services designed for the unique needs of incarcerated women are grossly inadequate, both while imprisoned and upon reentry to the community. In order to amplify efforts to remedy gender inequities in prison health, it is imperative for public health professionals to gain a better understanding of the unique health issues facing women prisoners and an awareness of existing efforts to promote gender-responsive programming and policies for women and girls along the criminal justice continuum. Since states have the authority to regulate women's health care in prisons, this presentation will review relevant regulations that impact incarcerated women's health and health care, particularly HIV serotesting in prisons. Additionally, state laws that require serotesting before and during incarceration, or upon release will be covered. Finally, a summary of key public health literature focused on the imperative for gender-responsive HIV programming and policies for women and girls at all points of the criminal justice continuum will be discussed.