Ms. Nicole Pelligrino, research associate at LSU Health School of Public Health-New Orleans (SPH) is lead author of “Incarcerated Black Women in the Southern USA: a Narrative Review of STI and HIV Risk and Implications for Future Public Health Research, Practice, and Policy,” published in the January issue of the Journal of Racial and Ethnic Health Disparities. Co-authors of the article are: Dr. Barbara Zaitzow of the Appalachian State University, and Drs. Melinda Sothern, Richard Scribner and Stephen Phillippi, professors with LSU SPH.
The article discusses how historical inequality and a persisting lack of preventive care, behavioral, and environmental interventions contribute to disproportionately high incarceration and HIV rates amongst Black women in the Southern United States. The article reviews various programs that are currently attempting to address this issue, their relative successes, and the need to expand these types of interventions.
Although Black Americans represent only 12 percent of the U.S. population, they make up 44 percent of new HIV infections per year. Further, HIV prevalence is higher in women, and those who have served time in jail or prison. Black females in the south are seven times more likely to serve time in jail than White women – most frequently for non-violent offenses often associated with drug violations.
Among both correctional agencies and community programs, only half provide HIV testing, and even fewer offer “education, rapid testing, prevention and treatment interventions, or referrals to medical services upon release”. A lack of knowledge as well as stigma regarding HIV status follow women throughout their sentence and upon release into the community – increasing transmission risk.
In many cases, the role of negative environmental factors in risky health behaviors remains underaddressed. For example, common HIV risk behaviors, including concurrent sexual relationships, sex work, drug use, and/or inconsistent use of protection were linked to histories of childhood abuse, and perceived lack of parental support.
The article provides a narrative review of literature (published from 1995 to 2015), discussing the benefits and limitations of five intervention programs, while incarcerated and/or post release. After reviewing the efficacy of these interventions, the article concludes by endorsing those “which promote healthier relationships, cultural competence, and gender specificity, as well as those that enhance prevention skills”.
Finally, the article offers policy recommendations to improve “cultural sensitivity, competence and humility training for clinicians,” and “substantially increasing funding for prevention, treatment and rehabilitative services”. It concludes that the timeliness of these recommendations is most critical “given the recent national attention to incarceration, STI, and HIV disparities, particularly in the southern USA”.