Although investigators have studied HIV-related behavior and attitudes in prisons, little is known about HIV/AIDS phenomena in work release or other alternative forms of incarceration. This study examined the sexual- and drug-risk behavior of 270 male drug users in three work-release facilities located in New York City, comparing their self-reported risk profiles to findings from studies of related high-risk samples in other settings. The respondents reported lower rates of current drug use (heroin, crack cocaine, and alcohol), injection drug use, sexual risk taking, and sexually transmitted diseases than did these comparison groups, and the respondents reported comparable rates of condom use. The rates of most HIV-related risk behaviors in this sample were substantially lower than those reported in other studies of comparison populations. Explanations for these unexpectedly low rates of self-reported risk behavior are offered, and ways in which to overcome practical and methodological challenges that arise in conducting HIV/AIDS research in transitional correctional settings are suggested.
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References
1.
Blumberg, M. (1990). AIDS: The impact on the criminal justice system. Columbus, OH: Merrill.
2.
Boekeloo, B. O. , Schiavo, L., Rabin, D. L., Conlon, R. T., Jordan, C. S., & Mundt, D. J. (1994). Self-reports of HIV risk factors at a sexually transmitted disease clinic: Audio vs. written questionnaires. American Journal of Public Health, 84, 754-760.
3.
Brunswick, A. , Aidala, A., Dobkin, J., Howard, J., Titus, S., & Banazak-Holl, J. (1993). HIV-1 seroprevalence and risk behavior in an urban African-American cohort. American Journal of Public Health, 83, 1390-1394.
4.
Bureau of Justice Statistics . (1991a). Drugs and jail inmates, 1989. Washington, DC: U.S. Department of Justice.
5.
Bureau of Justice Statistics . (1991b). Profile of jail inmates, 1989. Washington, DC: U.S. Department of Justice.
6.
Bureau of Justice Statistics . (1993). Survey of state prison inmates, 1991. Washington, DC: U.S. Department of Justice.
7.
Bureau of Justice Statistics . (1995). HIV in prisons and jails, 1993. Washington, DC: U.S. Department of Justice.
8.
Carey, J. W. (1993). Linking qualitative and quantitative methods: Integrating cultural factors into public health. Qualitative Health Research, 3, 298-318.
9.
Catania, J. , Coates, T., Peterson, J., Dolcini, M., Kegeles, S., Siegel, D., Golden, E., & Fullilove, M. (1993). Changes in condom use among Black, Hispanic, and White heterosexuals in San Francisco: The AMEN cohort survey. Journal of Sex Research, 30, 212-218.
10.
Celentano, D. , Brewer, F., Sonnega, J., & Vlahov, D. (1990). Maryland inmates' knowledge of HIV-1 transmission and prevention: A comparison with the U.S. general population. Journal of Prison and Jail Health, 9, 45-54.
11.
Chaiken, M. (1989). In-prison programs for drug-involved offenders. Washington, DC: National Institute of Justice.
12.
Corby, N. H. , Jamner, M., & Wolitski, R. J. (1996). Using the theory of planned behavior to predict intention to use condoms among male and female injecting drug users. Journal of Applied Social Psychology, 26, 52-75.
13.
Dennis, M. L. , Fetterman, D. M., & Seachrest, L. (1994). Integrating qualitative and quantitative evaluation methods in substance abuse research. Evaluation and Program Planning, 17, 419-427.
14.
Edlin, B. , Irwin, K., Faruque, S., McCoy, C. B., Word, C., Serrano, Y., Inciardi, J., Bowser, B., Schilling, R. F., & Holmberg, S. (1994). Intersecting epidemics: Crack cocaine use and HIV infection among inner-city young adults. New England Journal of Medicine, 331, 1422-1427.
15.
Edlin, B. , Irwin, K., Ledwig, D., McCoy, H., Serrano, Y., Word, C., Bowser, B., Faruque, S., McCoy, C., Schilling, R. F., Holmberg, S., & the Multicenter Crack Cocaine and HIV Infection Study Team. (1992). High-risk sex behavior among young street recruited crack cocaine smokers in three American cities: An interim report. Journal of Psychoactive Drugs, 24, 363-371.
16.
El-Bassel, N. , & Schilling, R. F. (1991). Drug use and sexual behavior of indigent African-American men. Public Health Reports, 106, 586-590.
17.
Fernando, D. , Schilling, R. F., & El-Bassel, N. (1996). Epidemiologic issues and needle-related risk behaviors among injection drug users. Unpublished manuscript, School of Social Work, Columbia University.
18.
Garfein, R. S. , Vlahov, D., Galai, N., Doherty, M. C., & Nelson, K. E. (1996). Viral infections in short-term injection drug users: The prevalence of the hepatitis C, hepatitis B, human immunodeficiency, and human T-lymphotropic viruses. American Journal of Public Health, 86, 655-661.
19.
Geringer, W. , Marks, S., Allen, W., & Armstrong, K. (1993). Knowledge, attitudes, and behavior related to condom use and STDs in a high-risk population. Journal of Sex Research, 30, 75-83.
20.
Goldstein, M. , Friedman, S., Neaigus, A., Jose, B., Idelfonso, G., & Curtis, R. (1995). Self-reports of HIV risk behavior by injecting drug users: Are they reliable?Addiction, 90, 1097-1104.
21.
Hawks, R. L. , & Chiang, C. N. (Eds.). (1986). Urine testing for drugs of abuse (NIDA Monograph No. 73). Rockville, MD: National Institute on Drug Abuse.
22.
Hilts, P. (1991, March 29). Prisons faulted on combating AIDS. New York Times, p. A11.
23.
Holmberg, S. (1994). Emerging epidemiologic patterns of HIV in the United States. AIDS Research and Human Retroviruses, 18(Suppl. 2), 51.
24.
Holmberg, S. (1996). The estimated prevalence and incidence of HIV in 96 large U.S. metro-politan areas. American Journal of Public Health, 86, 642-654.
25.
Hser, Y. , Anglin, D., & Chou, C. (1992). Reliability of retrospective self-report by narcotics addicts. Psychological Assessment, 4, 207-213.
26.
Khalsa, M. E. , Kowalewski, M. R., Lunn, R., Anglin, M. D., & Miller, K. A. (1994). AIDS-related knowledge, beliefs, and risk behaviors in a sample of crack addicts. Journal of Drug Issues, 24, 537-553.
27.
Koehler, R. , & Lindner, C. (1992). Alternative incarceration: An inevitable response to institutional overcrowding. Federal Probation, 12-18.
28.
Lamothe, F. , Bruneau, J., Soto, N., Lachance, J., Vincelette, M., Brabant, M. (1993, June). Behaviours of male intravenous drug users (IVDUs) involved in prostitution in Montreal, Quebec, Canada. Paper presented at the Ninth International Conference on AIDS, Berlin.
29.
Laporte, C. , Jeffers, J., Marx, R., Perez, J., Watts, L., Fontana, M., & Joseph, H. (1988, June). KEEP: An effective AIDS prevention education and outreach program for heroin addicts in the New York City jails. Paper presented at the Fourth International Conference on AIDS, Stockholm, Sweden.
30.
Latkin, C. , Vlahov, D., & Anthony, J. C. (1993). Socially desirable responding and self-reported HIV infection risk behaviors among intravenous drug users. Addiction, 88, 517-526.
31.
Lewis, D. , Watters, J., & Case, P. (1990). The prevalence of high-risk sexual behavior in male intravenous drug users with steady female partners. American Journal of Public Health, 80, 465-466.
32.
Lockwood, D. (1980). Prison sexual violence. New York: Elsevier/Thormond.
33.
Lockwood, D. (1994). Issues in prison sexual violence. In M. C. Braswell, R. H. Montgomery, Jr., & L. X. Lombardo (Eds.), Prison violence in America (2nd ed., pp. 97-102). Cincinnati, OH: Henderson.
34.
Maguire, K. , Pastore, A., & Flanagan, T. (1993). Sourcebook of criminal justice statistics, 1992. Washington, DC: Government Printing Office.
35.
Magura, S. , Kang, S., & Shapiro, J. (1995). Measuring cocaine use by hair analysis among criminally-involved youth. Journal of Drug Issues, 25, 683-701.
36.
Magura, S. , Shapiro, J., Siddiqi, Q., & Lipton, D. (1990). Variables influencing condom use among intravenous drug users. American Journal of Public Health, 80, 82-84.
37.
Mayer, J. , Kane, D., Rodriguez, A., Rosado, Y., Schiller, J., & Dougherty, T. (1993, June). Drug relapse among recently paroled HIV+ individuals: Montreal, Quebec, Canada. Paper presented at the Ninth International Conference on AIDS, Berlin.
38.
McElrath, K. , Dunham, R., & Cromwell, P. (1995). Validity of self-reported cocaine and opiate use among arrestees in five cities. Journal of Criminal Justice, 23, 531-540.
39.
Melnick, S. , Burke, G., Perkins, L., McCreath, H., Gilbertson, D., Sidney, S., & Hulley, S. (1993). Sexually transmitted diseases among young heterosexual urban adults. Public Health Reports, 108, 673-679.
40.
Mieczkowski, T. , Barzelay, D., Gropper, B., & Wish, E. (1991). Concordance of three measures of cocaine use in an arrestee population: Hair, urine, and self-report. Journal of Psychoactive Drugs, 23, 241-249.
41.
Monroe, M. C. , Colley-Niemeyer, B. J., & Conway, G. A. (1988). Report of studies of HIV seroprevalence and AIDS knowledge, attitudes and risk behaviors in inmates in the South Carolina Department of Corrections. Columbia: South Carolina Department of Corrections.
42.
Morrison, C. S. , McCusker, J., Stoddard, A. M., & Bigelow, C. (1995). The validity of behavioral data reported by injection drug users on a clinical risk assessment. International Journal of the Addicitions, 30, 889-899.
43.
National Commission on AIDS . (1991). Report on HIV disease in correctional facilities. Washington, DC: Author.
44.
Nemoto, T. , Brown, L. S., Foster, K., & Chu, A. (1990). Behavioral risk factors of human immunodeficiency virus infection among intravenous drug users and implications for preventive interventions. AIDS Education and Prevention, 2, 116-126.
45.
New York State Department of Correctional Services . (1992). Characteristics of inmates under custody. Albany, NY: Author.
46.
New York State Department of Correctional Services . (1993a). Absconders and parolees from work release. Albany, NY: Author.
47.
New York State Department of Correctional Services . (1993b). The comprehensive alcohol and substance abuse treatment program. Albany, NY: Author.
48.
Ostrow, D. G. , & Kessler, R. C. (1993). Methodological issues in AIDS behavioral research. New York: Plenum.
49.
Polonsky, S. , Kerr, S., Harris, B., Gaiter, J., Fichtner, R. R., & Kennedy, M. G. (1994). HIV prevention in prisons and jails: Obstacles and opportunities. Public Health Reports, 109, 615-625.
50.
Saxon, A. , Calsyn, D., Whittaker, S., & Freeman, G. (1991). Sexual behaviors of intravenous drug users in treatment. Journal of Acquired Immune Deficiency Syndromes, 4, 938-944.
51.
Schilling, R. F. , El-Bassel, N., & Gilbert, L. (1992). Drug use and AIDS risks in a soup kitchen population. Social Work, 37, 353-358.
52.
Schilling, R. F. , El-Bassel, N., Ivanoff, A., Gilbert, L., Su, K.-H., & Safyer, S. (1994). Sexual risk behavior among incarcerated drug-using women. Public Health Reports, 109, 539-547.
53.
Schilling, R. F. , El-Bassel, N., Schinke, S. P., Nichols, S. E., Botvin, G. J., & Orlandi, M. A. (1991). Sexual behavior, attitudes towards safer sex, and gender among a cohort of 244 recovering IV drug users. International Journal of the Addictions, 26, 865-883.
54.
Schumacher, J. , Milby, J., Raczynski, J., Caldwell, E., Engle, M., Carr, J., & Michael, M. (1995). Validity of self-reported crack cocaine use among homeless persons in treatment. Journal of Substance Abuse Treatment, 12, 335-339.
55.
Shultz, J. , Weatherby, N., McCoy, C., Greer, P., Branca, P., O'Connor, D., Bock, A., Cabral, I., & Needle, R. (1991). Characteristics and risk behaviors of homeless Black men seeking services from the Community Homeless Assistance Plan, Dade County, Florida, August, 1991. Morbidity and Mortality Weekly, 40, 865-868.
56.
Simpson, T. L. , Westerberg, V. S., Little, L. M., & Trujillo, M. (1994). Screening for childhood physical and sexual abuse among outpatient substance abusers. Journal of Substance Abuse Treatment, 11, 347-358.
57.
Struckman-Johnson, C. , Struckman-Johnson, D., Rucker, L., Bumby, K., & Donaldson, S. (1996). Sexual coercion reported by men and women in prison. Journal of Sex Research, 33, 67-76.
58.
Temple, M. (1993). Patterns of sexuality in a high-risk sample: Results from a survey of new intakes at a county jail. Archives of Sexual Behavior, 22, 111-129.
59.
Tewksbury, M. (1989). Measures of sexual behavior in an Ohio prison. Sociology and Social Research, 74, 34-39.
60.
Watkins, K. , Metzger, D., Woody, G., & McLellan, A. (1993). Determinants of condom use among intravenous drug users. AIDS, 7, 719-723.
61.
Weinstock, H. S. , Lindan, C., Bolan, G., Kegeles, S. M., & Hearst, N. (1993). Factors associated with condom use in a high-risk heterosexual population. Journal of Sex Research, 20, 14-20.
62.
Weisfuse, J. , Greenberg, B., Back, S., Makki, H., Thomas, P., Rooney, W., & Rautenberg, E. (1991). HIV-1 infection among NYC inmates. AIDS, 5, 1133-1138.
63.
Wolber, G. , Carne, W., & Alexander, R. (1990). The validity of self-reported abstinence and quality sobriety following chemical dependency treatment. International Journal of the Addictions, 25, 495-513.
64.
Wooden, W. S. , & Parker, J. (1982). Men behind bars: Sexual exploitation in prison. New York: Plenum.
65.
Zimmerman, R. , & Langer, L. (1995). Improving estimates of prevalence rates of sensitive behaviors: The randomized list technique and consideration of self-reported honesty. Journal of Sex Research, 32, 107-117.
66.
Zimmerman, S. , Martin, R., & Vlahov, D. (1991). AIDS knowledge and risk perceptions among Pennsylvania prisoners. Journal of Criminal Justice, 19, 239-256.
