High-risk HIV transmission behavior in prison and the prison subculture

Abstract

Nearly two million people are currently housed in state and federal prisons. The rate of AIDS infection is 5 times higher in prisons than in the general population. High-risk HIV transmission behaviors take place inside prisons, and there is little doubt that intraprison HIV transmission occurs. What is not well understood is what determines whether high-risk HIV transmission behaviors occur and how they can be prevented inside prison. In this article, an integrated theoretical framework, which merges the importation and deprivation models of inmate behavior, is proposed to explain intraprison high-risk HIV transmission behavior. Data from an inmate survey suggest that sex and tattooing are the two most prevalent intraprison high-risk HIV transmission behaviors and that the majority of high-risk behavior in prison can be attributed to the deprivation model. These data, coupled with insightful inmate comments, carry important policy implications and should inform future HIV education and prevention efforts.