HIV stigma and discrimination in prisons and jails: Results of a staff survey

Criminal justice system populations are at disproportionately high risk for HIV infection, compared to the general population. Inmate culture and correctional staff attitudes and behaviors are important in seeking HIV services, including prevention, testing, and treatment. Perceived stigma and discrimination can seriously undermine engagement in these services. Prior research has identified a high level of misperceptions and knowledge gaps about HIV among correctional staff, but there has been no research on their stigma and discrimination attitudes. Negative staff attitudes or perceptions may create an environment in which inmates are not comfortable engaging in prevention services, learning about or risking disclosure of their HIV status, seeking testing, or taking ART. We report findings from a stigma and discrimination attitude survey among correctional staff in 32 prison and jail facilities in 8 states and Puerto Rico, conducted as part of a NIDA-funded CJDATS2 project. Adapting items from previous research involving non-correctional samples, exploratory structural equation modeling found three main underlying factors: (1) HIV stereotypes and discriminatory attitudes toward individuals with HIV/AIDS, (2) support of discriminatory HIV/AIDS practices/policies, (3) overt support of discriminatory actions. Multi-group, factor score comparison across jail vs. prison/community program settings and staff type (e.g., correctional vs. non-correctional staff (HIV related staff, community medical staff)) identified several group differences: (1) substance abuse treatment staff held more negative attitudes towards persons with HIV/AIDS, than HIV related staff; (2) substance abuse treatment staff held significantly more negative attitudes, than community medical staff. We consider the research and service implications of our findings.