10th Conference on Retroviruses and Opportunistic Infections Boston, MA USA - February 10 -14, 2003

Conf Retroviruses Opportunistic Infect 2003 Feb 10-14;10th: abstract no. 36
D. A. Wohl, L. Shain, M. Adamian, B. L. Stephenson, R. Strauss, C. Golin, A. Kaplan
Univ of North Carolina, Chapel Hill

BACKGROUND: As many as 20% of HIV-infected persons in the U.S. enter and leave a correctional facility each year. To what extent HIV-infected prison releasees contribute to the spread of HIV in the communities to which they return is not well described.

METHODS: Prospective observational study. From May 01-Oct 02, 80 HIV-infected state prison inmates within 3 mos of release were enrolled. Subjects were interviewed prior to release about pre-incarceration and expected post-release sexual and drug-related HIV transmission risk behaviors. Follow-up phone interviews were conducted 30-60 days following release.

RESULTS: Of the 80 subjects enrolled (58% women, 87% non-white, 81% heterosexual, mean age = 36 yrs), 83% have been released. Pre-incarceration crack cocaine use was reported by 84% of subjects and 29% had injected drugs. Post-release interviews have been conducted in 85% of those eligible a mean of 36 days following release. Within 6 mos of release, 2 subjects died and 4 were re-incarcerated. Prior to incarceration, 74% of inmates had a main sex partner (MP) with whom 79% report unprotected sex during the year before incarceration (54% of MP were HIV-uninfected). Seventy-five percent (75%) of inmates had other sex partners (OP) in the year prior to incarceration (mean OP number = 12 [outlier excluded], range 1-1,460) and 74% had unprotected sex with their OP in the year before they came to prison (64% of OP were HIV-uninfected; 19% were of unknown HIV status). Over half (51%) of releasees stated they had sex since release (mean time to sex post-release = 6 days, range 1-744 hours). A MP without HIV or of unknown HIV status was reported by 64% of releasees with a MP; however, 24% had unprotected sex with their MP since release. Given their current sex behavior, 31% of releasees felt that it was very or somewhat likely that they would infect their HIV-negative MP. Since release, 16% reported using street drugs at least once a week, 18% have used crack cocaine, and 8% have injected drugs.

CONCLUSIONS: Immediately following prison release a significant proportion of HIV-infected former inmates engage in behaviors with high risk of transmitting HIV and may play a significant role in the transmission of the virus within the communities to which they return. There is an urgent need for the development of interventions to reduce HIV transmission risk behaviors of HIV-infected releasees.

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Copyright © 2003 - Foundation for Retrovirology and Human Health. Reproduction of this abstract (other than one copy for personal reference) must be cleared through the Foundation for Retrovirology and Human Health. Licensed (AIDSLINE) from National Library of Medicine.