# Presentation: 195621

## Prisons and Drug Abuse:Challenges to HIV Perinatal Prevention Efforts

**Lori de Ravello, MPH**
**Division of Reproductive Health**
**February 13, 2002**

## Slide 2

## Jail 101

**Short-term facility.**
**Usually operated by a city, county, or local government.**
**Typically holds arrestees awaiting trail or sentencing and inmates convicted and sentenced to less than one year.**
**50% of arrestees are released with 48 hours.**
**Public health interventions (e.g., screening, testing, counseling, making referrals) must happen *****QUICKLY *****or not at all.**
**Most jails do very little screening - usually only for TB, sometimes for STDs, sometimes for pregnancy, rarely for HIV.**

## Prison 101

**Longer-term facility.**
**Usually operated by the State or Federal government.**
**Greater opportunity to implement long-term public health interventions with follow-up.**
**Prisons have a very comprehensive medical intake process, but the level and quality of ongoing medical care varies.**

## COMMUNITY

**COMMUNITY**

**CORRECTIONS**

**Release, Parole,**
**Probation**

**Discharge**
**Planning**

**Referrals &**
**Linkages**

**Transitional**
**Housing**

**Social Services**

**Street Outreach**

**Drug & Alcohol**
**Treatment**

**Public Health**
**Settings**

**Title X/Family**
**Planning Settings**

## Profile of Incarcerated Women

**70% are women of color.**
**Median age of 31.**
**61% are high school graduates or have a GED.**
**53% were unemployed at the time of arrest.**
**60% have ever received welfare.**
**30% received welfare just before their arrest.**
**50% were using alcohol, drugs, or both at the time of their offense.**
**41% used drugs daily in the month prior to their offense.**
**>44% report previous sexual or physical abuse.**

## 58% have or have had an immediate family member incarcerated.
65% of female state inmates have prior convictions.
41% have never been married.
75% have children, 70% have children under 18.
62% are single parents.
70% had sole custody of their minor children prior to incarceration.
6-10% are pregnant at time of arrest; 15% delivered a child in the last year.

**65% of female state inmates have prior convictions.**
**41% have never been married.**
**75% have children, 70% have children under 18.**
**62% are single parents.**
**70% had sole custody of their minor children prior to incarceration.**
**6-10% are pregnant at time of arrest; 15% delivered a child in the last year.**

**Profile of Incarcerated Women**** ****(continued)**

## Offenses Committed by Female State Prisoners, 1999

**Drug Offenses**
**Violent Offenses**
**Property Offenses**
**Public-order Offenses**

**25,100**
**21,600**
**19,600**
**7,800**

## Female Inmates in State and Federal Correctional Facilities, 2000

**FBOP = 10245**

## Incarceration Rates for Female Inmates inFederal & State Correctional Facilities, 2000

***Rates are per 100,000 population.***

## The female prisoner population has more than doubled since 1990 and is growing at a faster rate than for men.

## Adult and Adolescent Women in Correctional Facilities

**State and Federal Prisons****	****  91,612 (annual count)**
**Adolescent Facilities ****	**** ****	****+14,319 (one-day count)**
**Local Jails ****	****	**** ****	**_**+ 67,487 (one-day count)**_
**	****	****	****	****	****	****173,418 a day**

## Slide 13

## Pregnancy Testing & Results

**Pregnancy Testing & Results**

**45% of state/ federal systems and 29% of city/county systems do routine pregnancy testing.**
**Approximately 6% (10,400) of incarcerated women are pregnant at entry.**

## ChlamydiaFemale State Inmates, 1999

**Percent**

**Notes:**
Source: CDC, STD Surveillance, 1999 - Special Focus Profiles: STDs in Persons Entering Correctional Facilities

## GonorrheaFemale State Inmates, 1999

**Percent**

**Notes:**
Source: CDC, STD Surveillance, 1999 - Special Focus Profiles: STDs in Persons Entering Correctional Facilities

## SyphilisFemale State Inmates, 1999

**Percent**

**Notes:**
Source: CDC, STD Surveillance, 1999 - Special Focus Profiles: STDs in Persons Entering Correctional Facilities

## Known HIV Positive Female StatePrison Inmates, 1999

## Drug Use by Female Arrestees, 2000(Selected cities from 30 ADAM sites)

## Drug Use by Female Juvenile Detainees, 2000

## What does this mean for HIV perinatal prevention efforts?

**Growing numbers**

**Women of color**
**Young**
**Single**
**Uneducated**

**Pregnant**
**Poor prenatal care**
**Uninsured**

**High rates of STDs**
**Unprotected sex**

**Drug users**
**Injection drug users**

**Inconsistent**
**services**
**while incarcerated**

## “Because That’s Where

***“******Because That’s Where***
***the Money Is”***

*Willy Sutton*