Infectious diseases within American prisons

Infectious diseases within American correctional settings are a concern within the public health sector. 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. The spread of infectious diseases, such as HIV/AIDS and other sexually transmitted diseases, hepatitis C (HCV), hepatitis B (HBV), and tuberculosis result largely from needle-sharing, drug use, and consensual and nonconsensual sex among prisoners. HIV/AIDS and hepatitis C need specific attention because of the specific public health concerns and issues they raise.

The implementation of HIV and STD screening programs in the correctional setting is an important approach to reducing the annual number of new HIV infections in the United States. The correctional system in America is a patchwork of a wide variety of settings such as state and federal prisons, local jails, juvenile detention centers and they include the legal constraints of state laws. One process for HIV testing would be unlikely or even impossible in all correctional settings.

There is an inherent difference in the jail versus the prison setting that merits infectious disease testing at the jail level. Jails are largely used to hold offenders who have been charged but not convicted of a crime. Local jails admitted an estimated 11.7 million persons during the 12-month period ending June 30, 2013. The average weekly turnover rate was 60.2 percent. Implementing HIV, HCV and other STD screening programs at the jail level is an effective way to detect disease before an infected individual is released back to the community and is able to transmit disease.

At least 17% of people living with HIV/AIDS have been incarcerated at some point in their life. The rate of contracting HIV is ten to one hundred times higher inside the prison system than outside. The incarcerated population is more likely to contract the disease because they are exposed to more high-risk behaviors within the correctional system. In a Louisiana prison study, 242 inmates (72.8% of male inmates) had participated in sexual encounters with other men, and did not always have access to proper protection. Additionally, research has demonstrated that infection rates via injection are much higher among those who have previously served prison terms. Research suggests that elevated rates of infection are a result of increased prison sentencing for drug-related offences and the War on Drugs. 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.

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