Infectious diseases within American prisons
The corrections population is susceptible to infectious diseases through exposure to blood and other bodily fluids, drug injection, poor health care, prison overcrowding, demographics, security issues, lack of community support for rehabilitation programs, and high-risk behaviors.
Research suggests that elevated rates of infection are a result of increased prison sentencing for drug-related offences and the War on Drugs.
[8][9] Since prisons generally divide the individuals by gender, the populations experience different environments; incarcerated females in the United States tend to have higher rates of infection.
[10] Research suggests young men of color disproportionately represent U.S. inmates and these individuals may be at such a risk of contracting HIV due to high-risk behavior prior to entering the penitentiary system.
Furthermore, research also shows that AIDS is the single largest cause of death among African American men between ages 25 through 44 years, mainly due to drug-related transmission of the virus.
[14] The Western Journal of Medicine estimates the prevalence and predictors of HCV infection among inmates of California by conducting a system wide survey.
However, some hematologists believe a screening test should be done regardless of ability to pay for follow-up care as a means of changing behavior (for example, refraining from alcohol or not sharing needles).
[21] On any given day, 2.3 million people are incarcerated in 6,000 facilities in the United States, presenting officials with the difficult task of preventing coronavirus outbreaks among prisoners and staff.
In October 1995, the County of Los Angeles Department of Health Services faced a budget deficit that led to the decision of restructuring their outpatient care system.
Two scenarios were compared, assuming a national program offering the Hepatitis B vaccine to two million clients in order to create a decision model.
In order to qualify, county detention centers must complete an application for funds that includes the jail health budget to show need.
[32] Additionally, Duke University and UNC-Memorial Hospitals have collaborated with one jail's HCV positive inmates for further follow-up testing and care.
[35] Serious public health outbreaks such as the spread of methicillin-resistant Staphylococcus aureus have prompted drastic measures leading to medical isolation.
[36] Approaches to preventing the spread of infections such as HIV and HCV in prisons include not only internal changes within correctional facilities, but also increased external community support.
[39][40] Such access barriers are compounded by the fact that HCV is particularly prevalent in populations struggling with substance abuse problems, poverty, homelessness, mental illness, low literacy, and language issues, thereby subjecting them to mass incarceration.
While the World Health Organization has endorsed certain preventive practices, only Vermont and Mississippi State Prisons and Los Angeles, San Francisco, New York, Philadelphia, and Washington County Jails have provided condoms to inmates.
High-risk behavior that persists within prisons poses harm to inmates and the greater community alike, but US courts have chosen to remain silent.
The new CDC guidelines state "in all health-care settings, screening for HIV infection should be performed routinely for all patients aged 13–64 years.
"[47] Additional recommendations for juveniles that are incarcerated in adult jails include the following: Procedures for offering support to the inmate who receives a diagnosis of HIV should be in place to assure they can manage the infection.
But upon giving an inmate a diagnosis of HIV, steps should be taken immediately to ensure that an appointment has been made with a provider, that contact information for a health department or community-based organization case manager is available to help them navigate the healthcare system.
[48][49][50] Correctional facilities should have the following CDC recommended procedures and resources in place for inmates being discharged from custody: The high rate of turnover in local jails as opposed to prisons may make it difficult to implement a routine testing program at intake or on a scheduled basis.
When using this approach, providers in correctional settings should with their state or local health department to determine the demographics of HIV for their population.
Correctional facilities should assure that all cases of newly diagnosed infectious diseases are reported to the state or local health department for assistance with notification of results, counseling, partner services and linkage to care.
This approach calls for a collaborative effort between agencies to address high incarceration rates and other social justice issues such as poverty.
[1] Because of the ineffectiveness of some preventive techniques, advocates push for alternative forms of rehabilitation for drug offenders to keep these potentially infected people outside of the prison system.
Since prevention of any infectious diseases presents a major unsolved problem, public healthcare professionals advocate for a more inclusive and all-encompassing approach.
[1] Due to the high rate of HIV that exists within prisons and the carceral system, these sites are crucial in educating individuals for further infection.
The National Commission on Correctional Health Care conducted a study evaluating current modes of handling HIV through prevention programs across the US.
In particular, one of the researchers explored peer education in the forms of curriculum modeled after the American Red Cross and California's "Reach One, Teach One" program.
[56] Although there is near consensus in the literature about what needs to be done to reduce the incidence of sexual violence in prisons, to date, little if any research has been undertaken to assess which strategies are most effective.
