HIV and AIDS Risk Behaviors Among Female Jail Detainees in Chicago: Implications for Public Health Policy

Public health professionals increasingly focus on women in the battle against HIV/AIDS. Although the prevalence of HIV infection among men in the general population has stabilized or even begun to decline, rates among women continue to increase. HIV infection rates are higher in correctional populations than in the general population among both men and women. In correctional settings, women have even higher infection rates than do men. HIV/AIDS risk behaviors among female jail detainees are important because the number of women jailed is increasing, and most detainees return to the community in a few days. Jails serve a clientele at high risk for HIV/AIDS.

This article has two objectives: (1) to describe sex- and injection drug use-related HIV/AIDS risk taking among female jail detainees and (2) to identify key subgroups of female jail detainees who are at especially high risk for contracting HIV/AIDS. Participants were in a larger study of psychiatric disorder among female jail detainees. The sample included 1,272 female arrestees entering the Cook County Department of Corrections in Chicago directly from pretrial arraignment between 1991 and 1993. Subjects' ages ranged from 17 to 67 years (mean=28.75, median=28); 40.4 percent were African-American, 33.6 percent were non-Hispanic white, 24.7 percent were Hispanic, and 1.3 percent were of another race/ethnicity; nearly 80 percent were unemployed; and mean and median education was 11 years. Interviews were conducted in private, and data were protected by a Federal Certificate of Confidentiality. Participants were asked about their criminal history, drug use practices, and HIV/AIDS sexual risk behaviors. Participants charged with both misdemeanors and felonies were categorized as felons.

The data were analyzed in two ways. The authors examined specific sexual and injection drug use HIV/AIDS risk behaviors to describe sex- and injection drug use-related HIV/AIDS risk taking among female jail detainees. In addition, the authors generated summary scores of sexual and injection drug use HIV/AIDS risk to identify key subgroups of female jail detainees who were at especially high risk for contracting HIV/AIDS.

This study provides empirical evidence that HIV/AIDS risk behaviors are extremely prevalent among women in jail and that there are distinct markers for women at greatest risk: non-Hispanic Whites are at high risk for sexually and injection drug use-transmitted HIV/AIDS; older women in jail are at particular risk for injection drug use-transmitted HIV infection and AIDS; women arrested for misdemeanors and nonviolent crimes -- drug crimes, prostitution, and theft -- are at high risk for both sexually and drug use-transmitted HIV infection and AIDS; women with substance abuse disorders are at high risk for both sexually and injection drug use-transmitted HIV infection and AIDS; and women with severe mental illness have the most extreme sexual risk behaviors.

This study suggests that providing HIV/AIDS education to jail detainees could reduce the HIV/AIDS epidemic in the population as a whole. The authors' findings confirmed the view of public health professionals who have long emphasized the need to intervene with incarcerated populations. "Because most jail detainees return to their communities within days, providing HIV/AIDS education in the jail must become a public health priority. In short, good correctional health is good public health," the authors concluded.

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