Journal of Correctional Health Care

Men’s risk behavior during a 3-month period prior to parole revocation was assessed. Frequent alcohol use was higher among men who had more children, were homeless, or had a history of alcohol and other drug abuse treatment. The use of drugs was greater among men who were younger or had a history of sexually transmitted infection (STI). The use of hard drugs was higher among men who had history of injection drug use. Unprotected vaginal or anal sex was increased among men who were younger, single, or had a history of STIs. Sex with a high-risk partner was greater among men who were older, used hard drugs, or had a history of STIs. Findings highlight the importance of developing risk-reduction programs for men on parole.

The prevalence of food allergies in the inmate population is a relatively unknown and perhaps underreported health issue. An inmate with an undetected food allergy is at risk for anaphylaxis or less serious complications and is becoming an increasing concern to correctional facilities. Allergic responses to foods cause many symptoms, including cutaneous, gastrointestinal, respiratory, cardiovascular, and anaphylactic. These nonspecific symptoms are often first thought to be related to other conditions. Cell-mediated disorders, food intolerances, and pharmacologic conditions should be considered in the differential diagnosis and appropriately ruled out. The symptoms may mimic other problems, and allergic reactions would not be among the first conditions considered in the differential diagnosis. Consideration of food allergies and recognition of the symptoms should prompt a diagnostic evaluation. Not all correctional institutions have access to a dietitian or conduct allergy testing and the need to prepare special meals may create challenges.

Incarcerated women report high rates of prior unintended pregnancies as well as low contraceptive use. Because jail could be a site of contraception care, this study aimed to assess women’s access to contraception prior to their arrest. A cross-sectional survey was administered to 228 reproductive-aged, nonpregnant women arrested in San Francisco. Twenty-one percent were currently using contraception. More than half (61%) had not used contraception in the last year, yet 11% wanted to have used it. Women in this latter subset reported greater difficulty with payment, finding a clinic, and transportation compared to women who had used contraception. In addition, 60% of all women in the sample would accept contraception if offered to them in jail. Thus, jail is a potentially important and acceptable point of access to contraception, which can circumvent some preincarceration logistical barriers.

This article describes a pilot screening program to detect Chlamydia trachomatis (Ct) and Neisseria gonorrhoeae (Ng) sexually transmitted infections (STIs) in adolescent and adult males newly incarcerated in New York City jails using urine-based nucleic acid amplification technology (NAAT). Between December 8 and 22, 2003, 2,417 males were tested; 162 (6.7%) were found positive for Ct and/or Ng STIs, with 138 (86.8%) exhibiting no STI signs or symptoms and 102 (63%) treated prior to jail release. Younger age, positive urine leukocyte esterase test, and ≥11 recent sex partners were predictors of STI. Urine-based screening and treatment was feasible in this setting and identified STI that would otherwise have been undetected. Jails may thus be important venues for targeted male STI screening.

This open-label randomized trial compared isoniazid (9 months) to rifampin (4 months) on toxicity and completion in a jailed population with latent tuberculosis infection. Rifampin resulted in fewer elevated liver function tests (risk ratio [RR] 0.39, 95% confidence interval [CI] [0.18, 0.86]) and less toxicity requiring medication withdrawal (RR 0.51, 95% CI [0.13, 2.01]), although one participant receiving rifampin experienced an allergic reaction. Completion was achieved for 33% receiving rifampin compared to 26% receiving isoniazid (p = .10). With careful monitoring rifampin is a safe and less toxic regimen and appears to be a reasonable alternative because of its shorter duration, allowing more people to complete treatment behind bars. Therapy completion in released inmates is unacceptably low and ensuring follow-up after discharge must be part of a decision to treat.

Most studies assessing the burden of psychiatric disorders in juvenile correctional facilities have been based on small or male-only samples or have focused on a single disorder. Using electronic data routinely collected by the Texas juvenile correctional system and its contracted medical provider organization, we estimated the prevalence of selected psychiatric disorders among youths committed to Texas juvenile correctional facilities between January 1, 2004, and December 31, 2008 (N = 11,603). Ninety-eight percent were diagnosed with at least one of the disorders. Highest estimated prevalence was for conduct disorder (83.2%), followed by any substance use disorder (75.6%), any bipolar disorder (19.4%), attention-deficit/hyperactivity disorder (18.3%), and any depressive disorder (12.6%). The estimated prevalence of psychiatric disorders among these youths was exceptionally high and showed patterns by sex, race/ethnicity, and age that were both consistent and inconsistent with other juvenile justice samples.