Noting that "former prison inmates are at risk of HIV and hepatitis C (HCV) infection," the researchers designed the current study to understand how such individuals perceived their risk for these diseases after prison, the behaviors and environmental factors that put patients at risk for new infection, and the barriers to accessing health care.

The qualitative study used individual, face-to-face, semi-structured interviews to explore participants' perceptions, risk behaviors and barriers to accessing regular medical care post-incarceration. A team-based general inductive approach was used to code and analyze transcripts of the interviews.

The racially and ethnically diverse participants -- 20 men and nine women, ages 22 to 57 -- were interviewed within two months of their release from prison to the Denver, Colo., community.

The four principal themes that emerged from these interviews were:

• Risk factors -- including unprotected sex, transactional sex and drug use -- were prevalent in the post-release period.
• There was disproportionate engagement in risky behavior in the first few days post-release.
• Former inmates needed to know more about HIV and HCV.
• Former inmates faced major challenges in accessing health care and medications.

"Risk factors for HIV and HCV infection were prevalent among former inmates immediately after release," the authors concluded. "Prevention efforts should focus on education, promotion of safe sex and needle practices, substance abuse treatment, and drug-free transitional housing. Improved coordination between correctional staff, parole officers and community health care providers may improve continuity of care."

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