Public Policy Solution #9
Healthcare Services Should be Provided for Reentering Individuals, Including the Prevention, Screening, and Treatment of HIV/AIDS, Hepatitis C and Sexually Transmitted Diseases

Many incarcerated individuals are at high risk of becoming infected with HIV, hepatitis, or sexually transmitted diseases (STDs), and many others are already infected; such high rates of illness among the incarcerated and reentering populations stem from inadequate access to healthcare and in some cases past and continuing risky drug use (sharing syringes and other injection drug and alcohol equipment) and sexual behaviors (multiple sex partners, unprotected sex, and untreated STDs).1

The rate of HIV and AIDS among incarcerated individuals is very high:



  • At least 2 percent of all state prison inmates in the United States are HIV infected, according to a September 2005 report issued by the Bureau of Justice Statistics of the National Institute of Justice. This prevalence rate is more than six times that of the general unincarcerated population (0.3%), and is likely an underestimate, since HIV testing of inmates is not mandatory in all states.2

  • At the end of 2004, 2.6 percent of all female state prison inmates were HIV positive, compared to 1.8 percent of males.3

The large numbers of drug users in the criminal justice system and their high risk of getting and transmitting HIV, STDs, and hepatitis, create an urgent need for:



  • Comprehensive drug and alcohol treatment services

  • Prevention education and risk reduction counseling

  • Expanded care for infected inmates

  • Improved links between services in prisons and jails and those in the community4

It is common for substance abusing and addicted offenders to have other health conditions as well, such as tuberculosis, mental illness, or other chronic health problems. Many incarcerated women have reproductive health needs and, as stated before, histories of physical, emotional, and sexual abuse. For many individuals, the criminal justice system provides a first chance for basic health care, addiction treatment, prevention education, and counseling and testing. These basic but critically important services can help them break the cycles of addiction, incarceration, and disease transmission and can benefit families and the larger community through reduced disease transmission, medical and social welfare costs, and drug-associated crime.5 Reentry programs that include prevention, screening and treatment are key because such interventions reduce the risk of HIV infection and are much less costly than treating HIV-related illnesses. 6

1 “Drug Use, HIV, and the Criminal Justice System,” Center for Disease Control, IDU/HIV Prevention Project, August 2001, http://www.cdc.gov/idu/facts/druguse.htm

2 David Alain Wohl, M.D., HIV JournalView, Top 10 Research Publications in HIV Care – 2005 Year-end issue, University of North Carolina, AIDS Research and Treatment Unit, http://www.thebodypro.com/journalview/top10/top10.html#37

3 http://www.ojp.usdoj.gov/bjs/pub/pdf/hivp04.pdf

4 Id at 95.

5 Id at 95.

6Principles of Drug Addiction Treatment: A Research Based Guide, National Institute on Drug Abuse, http://www.nida.nih.gov/PODAT/PODAT5.html

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