HIV-Related Research in Correctional Populations: Now is the Time
- 291 Downloads
The incarcerated population has increased to unprecedented levels following the 1970 US declaration of war on illicit drug use. A substantial proportion of people with or at risk for HIV infection, including those with substance use and mental health disorders, have become incarcerated. The overlapping epidemics of incarceration and HIV present a need for academic medical centers to collaborate with the criminal justice system to improve the health of incarcerated populations. With coordinated collaboration and new programmatic initiatives it is possible to reduce HIV-associated risk behaviors and the likelihood of acquisition and transmission of HIV. Centers for AIDS Research (CFAR), funded by the National Institutes of Health, have proactively responded to this need through Collaboration on HIV in Corrections (CHIC) to improve the diagnosis, treatment, linkage to care, and prevention of HIV. This collaboration serves as a model for aligning academic expertise with criminal justice to confront this challenge to individual and public health. This is especially relevant given recent evidence of the effectiveness of antiretroviral therapy in reducing HIV transmission (Cohen et al. N Engl J Med 365(6):493–505, 2011).
KeywordsHIV/AIDS Corrections Prison Jail Collaboration Academic
This manuscript was supported by the Centers for AIDS Research (grants P30AI027757, P30AI027763, P30AI036211, P30AI028697, P30AI060354, P30AI050409, P30AI036219, P30AI027742, P30AI027767, P30AI064518, P30AI051519, P30AI045008, P30AI087714, P30AI082151, P30AI042853, P30AI054999, P30AI078498, P30AI050410, P30AI073961, P30AI036214, P30AI042845), as well as grants K24DA022112, K23DA029381, K24DA017072, R01DA025943, R01DA25932, R01DA017059, R01DA029910, R01DA030762, R01DA030768, R01DA030762, R01DA18641, R01DA030778, R01DA027211, and R01DA027211 from the National Institute on Drug Abuse, National Institutes of Health, and R01AA018944 from the National Institute on Alcohol Abuse and Alcoholism at the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health.
J. D. Rich: none; D. A. Wohl: none; C. G. Beckwith: none; A. Spaulding: none; N. E. Lepp: none; J. Baillargeon: expert testimony for UTMB/CMC; A. Gardner: none; A. Avery: none; F. L. Altice: speakers’ bureau for BMS, Genentech, Tibotec, Simply Speaking, and ViralEd; S. Springer: none.
Papers of particular interest, published recently, have been highlighted as: •• Of major importance
- 1.Cohen MS, Chen YQ, McCauley M et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505.Google Scholar
- 2.Pew Center on the States, One in 31: The Long Reach of American Corrections 2009: Washington, DC.Google Scholar
- 6.Springer SA, Azar MM, Altice FL. HIV, alcohol dependence, and the criminal justice system: a review and callfor evidence-based treatment for released prisoners. Am J Drug Alcohol Abuse. 2011;37(1):12–21.Google Scholar
- 10.•• Rich JD, Wakeman SE, Dickman SL. Medicine and the epidemic of incarceration in the United States. N Engl J Med. 2011;364(22):2081-3. A disproportionate amount of incarceration in the US has been caused by the failed war on drugs and a failure to provide treatment to those with mental illnesses and addictions. While the medical and public health communities should capitalize on the opportunity to provide treatment to the largely uninsured, low-income, and minority population cycling through the criminal justice system, they also have the responsibility of advocating for alternatives to incarceration that address the health needs of underserved communities. PubMedCrossRefGoogle Scholar
- 17.Sabol WJ, Minton TD, Harrison PM. Prison and jail inmates at midyear, 2006. U.S. Department of Justice, 2007. Document NCJ 217675.Google Scholar
- 18.••Altice FL, et al. Treatment of medical, psychiatric, and substance-use comorbidities in people infected with HIV who use drugs. Lancet 2010;376(9738):367-87. This study provides an overview of comorbidities among HIV-positive people who use drugs and reviews treatment complications for those multiple conditions, particularly pharmacokinetic drug interactions and adherence problems.PubMedCrossRefGoogle Scholar
- 20.Mumola CJ, Karberg JC. Drug use and dependence, state and federal prisons, 2004. U.S. Department of Justice, 2006. Document NCJ 213530.Google Scholar
- 21.Mattick RP, et al. Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence. Cochrane Database Syst Rev. 2008(2):CD002207.Google Scholar
- 25.Karberg J, James D. Substance dependence, abuse, and treatment of jail inmates, 2002. 2005: Washington, D.C.Google Scholar
- 26.Mumola C. Substance abuse and treatment, state and federal prisoners, 1997. Justice UDo, 1999:1-16.Google Scholar
- 29.James DJ, Glaze LE. Mental health problems of prison and jail inmates. 2006. Bureau of Justice Statistics.Google Scholar
- 37.Dolan K, Larney S. A review of HIV in prisons in Nepal. Kathmandu Univ Med J (KUMJ). 2009;7(28):351–4.Google Scholar
- 42.••Baillargeon J, et al. Accessing antiretroviral therapy followiong release from prison. JAMA 2009;301(8):848-57. This study of 2115 HIV-positive inmates in Texas found significant interruptions in ART following release from prison, with only 5% of subjects filling a subsidized prescription within 10 days of release and 30% filling it within 60 days of release. This interruption in treatment creates heightened risks for adverse clinical outcomes, reservoirs of drug-resistant HIV, and greater infectiousness. PubMedCrossRefGoogle Scholar
- 44.Khan MR, et al. Dissolution of primary intimate relationships during incarceration and associations with post-release STI/HIV risk behavior in a Southeastern City. Sex Transm Dis, 2010.Google Scholar
- 45.Maruschak L. HIV in prisons, 2006, B.o.J.S. US Department of Justice, Editor. 2007.Google Scholar