HIV Prevention: Behavioral Interventions in Correctional Settings

  • Barry Zack

To date, preventive care and prevention services have not been included in our conceptualization or operationalization of prisoners’ “right to health care.” Given the potential public health impact of focusing on prevention for prisoners, however, the time has come to examine this issue. Although not specifically a right under the Constitution, correctional systems should be obligated to offer comprehensive HIV prevention services to those in custody. The justification for this obligation, at a minimum, has to do with some of the basic tenants of public health disease control: target your prevention dollars on illnesses with high morbidity and mortality rates among populations with the highest rates and whom you can access. With the prevalence of HIV at least five times higher among the incarcerated compared to those who are not incarcerated, providing effective prevention programs would have a powerful impact on incidence rates in this population. Furthermore, in one well-referenced study, in 1997, 25% of all HIV-positive people in the United States reportedly serve some time in a correctional facility (Hammett et al., 2002) and 90% of prisoners, representing an estimated 7.5 million prisoners annually, return to the free community at some point (Bureau of Justice Statistics Correctional Surveys, 1996). As approximately 51.8% of those individuals are reincarcerated within 3 years (Bureau of Justice Statistics Correctional Surveys, 1996), it is clear that providing effective disease prevention programs to those who are incarcerated would not only help protect them, but would also likely have a synergistic impact on HIV rates in our communities. If departments of corrections were to adopt evidence-based prevention measures, prisoners would simultaneously be returning from incarceration less likely to be infected with HIV and armed with the knowledge and skills to play an important role in reversing the current epidemic trends. This role includes protecting themselves and their loved ones by reducing their own risk behaviors and protecting their communities by educating others and changing norms.


Risk Behavior Correctional Facility Justice Statistics Correctional Setting Syringe Exchange 
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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Barry Zack
    • 1
  1. 1.Community Health Systems at the University of CaliforniaSan FranciscoUSA

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