Substance Abuse

, Volume 22, Issue 4, pp 209–216 | Cite as

Active and Former Injection Drug Users Report of HIV Risk Behaviors During Periods of Incarceration

  • Jennifer G. Clarke
  • Michael D. SteinEmail author
  • Lucy Hanna
  • Mindy Sobota
  • Josiah D. Rich


American prisons have increasing numbers of inmates incarcerated for drug offenses. This population is at high risk for HIV-infection and may continue HIV transmission risk behaviors while incarcerated. We find that 31% of injection drug users with a history of imprisonment had used illicit drugs in prison, and nearly half of these persons had injected drugs while incarcerated. Male gender and number of times incarcerated were associated with drug use in prison. Interventions for drug-using prisoners that are advocated in some European prisons, such as needle exchange programs and methadone maintenance, need attention in the United States.

prisons HIV risk behaviors injection drug use incarceration 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Schoenbaum EE, Hartel D, Selwyn PA, Klein RS, Davenny K, Rogers M, Feiner C, Friedland G: Risk factors for human immunodeficiency virus infection in intravenous drug users. N Eng J Med 1989; 321:874–879Google Scholar
  2. 2.
    Des Jarlais DC, Friedman SR, Choopanya K, Vanichseni S, Ward TP: Internal epidemiology of HIV and AIDS among injecting drug users. AIDS 1992; 6:1053–1058Google Scholar
  3. 3.
    Dufour A, Alary M, Poulin C, Allard F, Noel L, Trottier G, Lepine D, Hankins C: Prevalence and risk behaviors for HIV infection among inmates of a provincial prison in Quebec City. AIDS 1996; 10:1009–1015Google Scholar
  4. 4.
    Carvell ALM, Hart GJ: Risk behaviors for HIV infection among drug users in prison. BMJ 1990; 300:1383–1384Google Scholar
  5. 5.
    Stark K, Müller R, Wirth D, Bienzle U, Pauli G, Guggenmoos-Holzmann I: Determinants of HIV infection and recent risk behavior among injecting drug users in Berlin by site of recruitment. Addiction 1995; 90:1367–1375Google Scholar
  6. 6.
    Taylor A, Goldberg D, Emslie J, Wrench J, Gruer L, Cameron S, Black J, Davis B, McGregor J, Follett E: Outbreak of HIV in a Scottish prison. BMJ 1984; 310:289–292Google Scholar
  7. 7.
    Decker MD, Vaughn WK, Brodie JS, Hutcheson RH Jr, Schaffner W: Seroepidemiology of hepatitis B in Tennessee prisoners. J Inf Dis 1984; 150:450–459Google Scholar
  8. 8.
    Bird AG, Gore SM, Burns SM, Duggie JG: Study of infection with HIV and related risk factors in young offenders' institution. BMJ 1993; 307:228–231Google Scholar
  9. 9.
    Lamothe F, Bruneau J, Coates R, Rankin JG, Soto J, Arshinoff R, Brabant M, Vincelette J, Fauvel M: Seroprevalence of and risk factors forHIV-1 infection in injection drug users in Montreal andToronto: A collaborative study. Can Med Assoc J 1993; 149:945–951Google Scholar
  10. 10.
    Mutter RC, Grimes RM, Labarthe D: Evidence of intraprison spread of HIV infection. Arch Intern Med 1994; 154:793–795Google Scholar
  11. 11.
    Müller R, Stark K, Guggenmoos-Holzmann I, Wirth D, Bienzle U: Imprisonment: A risk factor for HIV infection counteracting education and prevention programmes for intravenous drug users. AIDS 1995; 9:183–190Google Scholar
  12. 12.
    Dye S, Isaacs C: Intravenous drug misuse among prison inmates: Implications for the spread of HIV. BMJ 1991; 302:1506Google Scholar
  13. 13.
    Polonsky S, Kerr S, Harris B, Gaiter J, Fichtner RR, Kennedy MG: HIV prevention in prisons and jails: Obstacles and opportunities. Public Health Rep 1994; 109:615–625Google Scholar
  14. 14.
    Vlahov D, Brewer F, Muñoz A, Hall D, Taylor E, Polk BF: Temporal trends of human immunodefi-ciency virus type 1 (HIV-1) infection among inmates entering a statewide prison system, 1985–1987. J Acquir Immune Defic Syndr 1989; 2:283–290Google Scholar
  15. 15.
    Vlahov D, Brewer TF, Castro KG, Narkunas JP, Salive ME, Ullrich J, Munoz A: Prevalence of antibody to HIV-1 among entrants to US correctional facilities. JAMA 1991; 265:1129–1132Google Scholar
  16. 16.
    CDC: HIV prevention in US correctional system, 1991. JAMA 1992; 268:23–24Google Scholar
  17. 17.
    Gilliard D, Beck A: Bureau of justice statistics. Prison and Jail Inmates at Midyear, 1997.Washington, DC: U.S. Department of Justice; 1998Google Scholar
  18. 18.
    Stein MD, Hanna L, Natarajan R, Clarke J, Marisi M, Sobota M, Rich J: Alcohol use patterns predict high risk HIV behaviors among active injection drug users. J Sub Abuse Treatment 2000; 18:359–363Google Scholar
  19. 19.
    Gallo D, George JR, Fitchen JH, Goldstein A, Hindahl MS: Evaluation of a system using oral mucosal transudate for HIV-1 antibody screening and confirmatory testing. JAMA 1997; 277:254–258Google Scholar
  20. 20.
    Davies AG, Dominy NJ, Peters A, Bath GE, Burns SM, Richardson AM: HIV in injecting drug users in Edinburgh: Prevalence and correlates. J AIDS 1995; 8:399–405Google Scholar
  21. 21.
    Brewer TF, Vlahov D, Taylor E, Hall D, Munoz A, Polk BF: Transmission of HIV-1 within a statewide prison system. AIDS 1988; 2:363–367Google Scholar
  22. 22.
    Horsburgh CR, Jarvis JQ, McArthur T, Ignacio T, Stock P: Seroconversion to human immunodefi-ciency virus in prison inmates. Am J Public Health 1990; 80:209–210Google Scholar
  23. 23.
    Kelley PW, Redfield RR, Ward DL, Burke DS, Miller RN: Prevalence and incidence of HTLV-III infection in a prison. JAMA 1986; 256:2198–2199Google Scholar
  24. 24.
    Power KG, Markova I, Rowlands A, McKee KJ, Anslow PJ, Kilfedder C: Intravenous drug use and HIV transmission amongst inmates in Scottish prisons. Br J Addiction 1992; 87:35–45Google Scholar
  25. 25.
    Bird AG, Gore SM, Cameron S, Ross AJ, Goldberg DJ: Anonymous HIV surveillance with risk factor elicitation at Scotland's largest prison, Barlinnie. AIDS 1995; 9:801–808Google Scholar
  26. 26.
    Booth RE, Watters JK: How effective are risk-reduction interventions targeting injection drug users? AIDS 1994; 8:1515–1524Google Scholar
  27. 27.
    Shewan D, Reid M, Macpherson A, Davies JB: HIV infection in prisons: Most drug injectors stop injecting on entry to prison. BMJ 1995; 310:1264–1265Google Scholar
  28. 28.
    Shewan D, Gemmell M, Davies JB: Behavioral change among drug injectors in Scottish prisons. Soc Sci Med 1994; 39:1585–1586Google Scholar
  29. 29.
    WHO: Global program on AIDS: WHO guidelines on HIV & AIDS in prisons. World Health Organization/Global Program on AIDS, Geneva; 1993Google Scholar
  30. 30.
    Dolan K, Wall W, Wodak A: Methadone maintenance reduce injecting in prison. BMJ 1996; 312:1163Google Scholar

Copyright information

© Association for Medical Education and Research in Substance Abuse 2001

Authors and Affiliations

  • Jennifer G. Clarke
    • 1
  • Michael D. Stein
    • 1
    Email author
  • Lucy Hanna
    • 1
  • Mindy Sobota
    • 1
  • Josiah D. Rich
    • 1
  1. 1.Departments of Medicine and Community HealthBrown University School of MedicineProvidence

Personalised recommendations