Prior Incarceration Research Articles

Supermax and Recidivism

This study examines the recidivism covariates of 610 released inmates who were confined in a supermax unit in 2004. Follow-up data (an average of 66 months from prison release in 2004) were collected for each inmate to assess the recidivism covariates of those who re-engaged in crime after prison release. The findings show that when compared with ex-supermax inmates who did not recidivate, those who did were younger, more likely to be serving time for a drug offense, and had a history of prior incarcerations and disciplinary infractions while incarcerated. Time to recidivate, however, was significantly predicted by gang membership, length of sentence, and prior substance abuse history. The implications of this research are discussed.

Health Care Practices and Associated Service Needs in a Sample of HIV-Positive Incarcerated Men in Puerto Rico

This report describes the HIV-related health care practices and associated support service needs of a sample of HIV-positive incarcerated men in Puerto Rico. Data are derived from a random sample of HIV-positive incarcerated men (n = 37) in Puerto Rico who completed a brief survey. Analysis included descriptive statistics to examine lifetime prevalence of substance use, selected health care practices, receipt of services, and hepatitis C virus (HCV) infection. Most men (97.3%) reported history of alcohol or drug use, prior incarceration, and drug use as the main risk factors for HIV infection (73.0%). In all, 83.8% of the men reported having had their first HIV screening test in a correctional facility, 55.6% reported intermittent HIV therapy, and most (83.8%) had also been diagnosed with HCV. Correctional facilities can be important settings for engaging high-risk populations in health care, capturing and enrolling unidentified HIV/HCV infections for clinical care, and engaging in substance abuse treatment. In order for these public health outcomes to be achieved, it is important to consider strategies to optimize care inside prison and in the community.

The Relationship Between Multiple Forms of Discrimination, Neighborhood Characteristics, and Depression Among Illicit Drug Users in New York City.

It is plausible that features of the social environment combined with experiences of discrimination may help further explain experiences of depression among illicit drug users. We examined the influence of census tract-level characteristics and multiple forms of individual-level discrimination on lifetime depression among illicit drug users in New York City enrolled in the "Social Ties Associated With Risk of Transition" study. Population average models accounted for clustering of individuals within census tracts. Discrimination based on prior incarceration explained Hispanic/White differences in depression and was independently associated with depression after accounting for neighborhood characteristics. Neighborhood poverty was only marginally related to lifetime depression. These data provide evidence supporting the influence of discrimination on depression among drug users. Research is needed to confirm these findings and highlight specific mechanisms through which discrimination and neighborhood socioeconomic status may operate to influence mental health.

How to improve testing when trying to predict inmate suicidal behavior

ObjectiveTo measure the predictive power of the Suicide Probability Scale (SPS) in a male inmate population (federal penitentiary) with the added contribution of actuarial data. MethodSPS scores and data from the files of 518 inmates were analyzed in relation to their suicidal behaviors over the following 10years. ResultsDuring this period, 12 inmates committed suicide (2.32%), 43 engaged in non-lethal self-harm (8.3%) and 15 expressed serious suicidal intention (2.9%), for a total of 70 (13.51%) who manifested at least one form of suicidal behavior. The records of the 518 inmates allowed identifying seven actuarial variables (out of 24 documented) that distinguished the group that acted out. These variables were tested in combination with the SPS score to determine the best predictive models of suicidal behavior. Depending on type of suicidal behavior and on observation period, the following seven variables could prove useful in improving the predictive capacity of the SPS: age, prior suicidal behavior, borderline personality disorder, length of sentence, number of sentences, prior incarceration in a provincial prison, and juvenile priors. However, analyses did not allow developing a better predictive model for the specific subgroup of suicide completers. ConclusionsSPS is improved when adding actuarial data.

Prevalence and risk factors forStaphylococcus aureuscolonization in individuals entering maximum-security prisons

To assess the prevalence and risk factors for colonization with Staphylococcus aureus in inmates entering two maximum-security prisons in New York State, USA, inmates (N=830) were interviewed and anterior nares and oropharyngeal samples collected. Isolates were characterized using spa typing. Overall, 50·5% of women and 58·3% of men were colonized with S. aureus and 10·6% of women and 5·9% of men were colonized with MRSA at either or both body sites. Of MSSA isolates, the major subtypes were spa type 008 and 002. Overall, risk factors for S. aureus colonization varied by gender and were only found in women and included younger age, fair/poor self-reported general health, and longer length of prior incarceration. Prevalence of MRSA colonization was 8·2%, nearly 10 times greater than in the general population. Control of epidemic S. aureus in prisons should consider the constant introduction of strains by new inmates.

Demographic, socio-environmental, and substance-related predictors of duration of untreated psychosis (DUP)

ObjectiveLonger duration of untreated psychosis (DUP) is associated with poorer early-course and long-term outcomes, and is a target of early detection and intervention efforts. Given the paucity of research on childhood and adolescent stressors (e.g., maltreatment and neighborhood disorder) as potential predictors of DUP, limited research on premorbid substance use as a determinant of DUP, and inconclusive findings on the association between DUP and neurocognition, we conducted three sets of analyses to address these issues. Mode of onset of psychosis was also considered, given its established role as an illness-level correlate of DUP. MethodsWe rigorously assessed DUP and other pertinent variables in 180 predominantly African American, low-income, and socially disadvantaged first-episode psychosis patients hospitalized in five psychiatric units. ResultsMode of onset of psychosis, prior incarceration, and the level of childhood/adolescent maltreatment were all significant independent predictors of DUP. Regarding premorbid substance use, having ever used cannabis and the amount of premorbid alcohol use were significantly associated with DUP. None of the seven neurocognitive domains assessed were even modestly, or clinically meaningfully, associated with DUP. ConclusionsThese and other findings on DUP may be informative for early detection and intervention services. For example, such services might benefit from special outreach to criminal justice settings and disadvantaged neighborhoods, and to young people likely to have a history of childhood/adolescent maltreatment and gradually developing psychotic symptoms.

Hepatitis C genotype distribution and homology among geographically disparate injecting drug users in Afghanistan

Hepatitis C virus (HCV) prevalence is high among injecting drug users in Afghanistan, but transmission dynamics are poorly understood. Samples from HCV-infected injecting drug users were sequenced to determine circulating genotypes and potential transmission linkages. Serum samples were obtained from injecting drug user participants in Hirat, Jalalabad, and Mazar-i-Sharif between 2006 and 2008 with reactive anti-HCV rapid tests. Specimens with detected HCV viremia were amplified and underwent sequence analysis. Of 113 samples evaluated, 25 samples (35.2%) were only typeable in NS5B, nine samples (12.7%) were only typeable in CE1, and 37 samples (52.1%) were genotyped in both regions. Of those with typeable HCV, all were Afghan males with a mean age of 31.1 (standard deviation [SD] ± 8.0) years and mean duration of injecting of 3.9 (SD ± 4.3) years. Most reported residence outside Afghanistan in the last decade (90.1%) and prior incarceration (76.8%). HCV genotypes detected were: 1a, (35.2%, n = 25), 3a (62.0%, n = 44), and 1b (2.8%, n = 2). Cluster formation was detected in NS5B and CE1 and were generally from within the same city. All participants within clusters reported being a refugee in Iran compared to 93.5% of those outside clusters. Only 22.2% (4/11) of those within clusters had been refugees in Pakistan and these four individuals had also been refugees in Iran. Predominance of genotype 3a and the association between HCV viremia and having been a refugee in Iran potentially reflects migration between Afghanistan and Iran among IDUs from Mazar-i-Sharif and Hirat and carry implications for harm reduction programs for this migratory population.

Female sex workers incarcerated in New York City jails: prevalence of sexually transmitted infections and associated risk behaviors

ObjectivesSexually transmitted infections (STIs) are an important cause of morbidity among incarcerated women and female sex workers (FSW). Little is known about FSW incarcerated in New York City (NYC) jails....

Penile Implants among Prisoners—A Cause for Concern?

BackgroundWe report the prevalence of penile implants among prisoners and determine the independent predictors for having penile implants. Questions on penile implants were included in the Sexual Health and Attitudes of Australian Prisoners (SHAAP) survey following concerns raised by prison health staff that increasing numbers of prisoners reported having penile implants while in prison.MethodsComputer-Assisted Telephone Interviewing (CATI) of a random sample of prisoners was carried out in 41 prisons in New South Wales and Queensland (Australia). Men were asked, “Have you ever inserted or implanted an object under the skin of your penis?” If they responded Yes: “Have you ever done so while you were in prison?” Univariate logistic regression and logistic regression were used to determine the factors associated with penile implants.ResultsA total of 2,018 male prisoners were surveyed, aged between 18 and 65 years, and 118 (5.8%) reported that they had inserted or implanted an object under the skin of their penis. Of these men, 87 (73%) had this done while they were in prison. In the multivariate analysis, a younger age, birth in an Asian country, and prior incarceration were all significantly associated with penile implants (p<0.001). Men with penile implants were also more likely to report being paid for sex (p<0.001), to have had body piercings (p<0.001) or tattoos in prison (p<0.001), and to have taken non-prescription drugs while in prison (p<0.05).ConclusionsPenile implants appear to be fairly common among prisoners and are associated with risky sexual and drug use practices. As most of these penile implants are inserted in prison, these men are at risk of blood borne viruses and wound infection. Harm reduction and infection control strategies need to be developed to address this potential risk.

Homelessness and Incarceration: An Examination of Barriers to Misdemeanor Resolution for the Homeless

The relationship between homelessness and crime has been investigated in few studies despite the implications of prior offenses and incarceration on job seekers. This study examined the relationship among homelessness, misdemeanors, incarceration, and misdemeanor resolution. Factors hindering misdemeanor resolution were explored by surveying participants at two Veterans Administration (VA) Stand Downs (n=186). The sample includes the primary service population of homeless veterans and other homeless persons. Respondents reported on factors perceived as limiting them from resolving misdemeanors, along with socio-demographic, homeless status, misdemeanor, and incarceration data. Factor Analysis yielded three factors as barriers that have implications for social work practice.

Risk Factor Detection as a Metric of STARHS Performance for HIV Incidence Surveillance Among Female Sex Workers in Kigali, Rwanda

Background:The epidemiologic utility of STARHS hinges not only on producing accurate estimates of HIV incidence, but also on identifying risk factors for recent HIV infection.Methods:As part of an HIV seroincidence study, 800 Rwandan female sex workers (FSW) were HIV tested, with those testing positive further tested by BED-CEIA (BED) and AxSYM Avidity Index (Ax-AI) assays. A sample of HIV-negative (N=397) FSW were followed prospectively for HIV seroconversion. We compared estimates of risk factors for: 1) prevalent HIV infection; 2) recently acquired HIV infection (RI) based on three different STARHS classifications (BED alone, Ax-AI alone, BED/Ax-AI combined); and 3) prospectively observed seroconversion.Results:There was mixed agreement in risk factors between methods. HSV-2 coinfection and recent STI treatment were associated with both prevalent HIV infection and all three measures of recent infection. A number of risk factors were associated only with prevalent infection, including widowhood, history of forced sex, regular alcohol consumption, prior imprisonment, and current breastfeeding. Number of sex partners in the last 3 months was associated with recent infection based on BED/Ax-AI combined, but not other STARHS-based recent infection outcomes or prevalent infection. Risk factor estimates for prospectively observed seroconversion differed in magnitude and direction from those for recent infection via STARHS.Conclusions:Differences in risk factor estimates by each method could reflect true differences in risk factors between the prevalent, recently, or newly infected populations, the effect of study interventions (among those followed prospectively), or assay misclassification. Similar investigations in other populations/settings are needed to further establish the epidemiologic utility of STARHS for identifying risk factors, in addition to incidence rate estimation.

25 Core decompression by laser osteoperforation: a new and minimal invassive modality for treatment of avascular necrosis (AVN) of femoral head. A preliminary report

Coverage with opioid agonist treatments (OAT) that include methadone and buprenorphine is low (N = 8400, 2.7%) for the 310,000 people who inject drugs (PWID) in Ukraine. In the context of widespread negative attitudes toward OAT in the region, patient-level interventions targeting the barriers and willingness to initiate OAT are urgently needed.A sample of 1179 PWID with opioid use disorder not currently on OAT from five regions in Ukraine was assessed using multivariable logistic regression for independent factors related to willingness to initiate OAT, stratified by their past OAT experience.Overall, 421 (36%) PWID were willing to initiate OAT. Significant adjusted odds ratios (aOR) for covariates associated with the willingness to initiate OAT common for both groups included: higher injection frequency (previously on OAT: aOR = 2.7; never on OAT: aOR = 1.8), social and family support (previously on OAT: aOR = 2.0; never on OAT: aOR = 2.0), and positive attitude towards OAT (previously on OAT: aOR = 1.3; never on OAT: aOR = 1.4). Among participants previously on OAT, significant correlates also included: HIV-negative status (aOR = 2.6) and depression (aOR = 2.7). Among participants never on OAT, however, living in Kyiv (aOR = 4.8) or Lviv (aOR = 2.7), previous imprisonment (aOR = 1.5), registration at a Narcology service (aOR = 1.5) and recent overdose (aOR = 2.6) were significantly correlated with willingness to initiate OAT.These findings emphasize the need for developing interventions aimed to eliminate existing negative preconceptions regarding OAT among PWID with opioid use disorder in Ukraine, which should be tailored to meet the needs of specific characteristics of PWID in geographically distinct setting based upon injection frequency, prior incarceration, and psychiatric and HIV status.

Crime Pays

This study draws on theories of stigma, social and human capital, and opportunity structure to assess the role of prior incarceration on illegal earnings. Tobit regression models are estimated for young adult ex-offenders and nonoffenders using the National Longitudinal Survey of Youth for 1997 to 2005. The findings reveal that individuals with an incarceration history earn significantly higher annual illegal earnings than those who do not have such a history. This is true net a variety of predictors of illegal income, including race and ethnicity. The current research indicates that spending significant time in jail or prison may force the ex-incarcerated into illegal opportunity structures to obtain income.

The Relationship Between Perceived Discrimination and High-Risk Social Ties Among Illicit Drug Users in New York City, 2006–2009

Discrimination can influence risk of disease by promoting unhealthy behaviors (e.g., smoking, alcohol use). Whether it influences the formation of high-risk social ties that facilitate HIV transmission is unclear. Using cross-sectional data from a cohort of illicit drug users, this study examined the association between discrimination based on race, drug use and prior incarceration and risky sex and drug ties. Negative binomial regression models were performed. Participants who reported discrimination based on race and drug use had significantly more sex and drug-using ties. But, after accounting for both racial and drug use discrimination, only racial discrimination was associated with increased sex, drug-using, and injecting ties. Drug users who experience discrimination and subsequently develop more sex and drug-using ties, increase their risk of contracting HIV. Future longitudinal studies illuminating the pathways linking discrimination and social network development may guide intervention development and identify drug-using subpopulations at high risk for disease transmission.

Prior Incarceration and Barriers to Receipt of Services among Entrants to Alternative to Incarceration Programs: A Gender-Based Disparity

The high levels of health and psychosocial needs among correctional populations strongly shape the well-being of the urban communities from which a large number of criminal justice-involved individuals come or to which they return. The benefits of providing services to correction-involved individuals and linking them to providers such as with alternative to incarceration (ATI) programs may be limited if they encounter difficulties accessing such services. This study identified the types of barriers that have prevented entrants into ATI programs from receiving health and psychosocial services. We then tested the association between number of prior incarcerations and number of barriers by gender. From a random sample of adults (N = 322; 83 women and 239 men) entering ATI programs in New York City, data were collected via structured interviews that elicited self-reported sociodemographics, substance use, prior incarcerations, and barriers that had actually prevented a participant from visiting or returning to a service provider. Participants reported an average of 3.0 barriers that have prevented them from receiving health and psychosocial services. The most prevalent barriers predominantly concerned service providers' inability to accommodate constraints on participants' time availability or flexibility, transportation, and money. Compared to women, men had a significantly different association that was in the adverse direction--i.e., more prior incarcerations was associated with more barriers--between prior incarcerations and encountering service barriers. Findings indicate that ATI program entrants experience many barriers that have prevented them from receiving health and/or psychosocial services. Furthermore, men with more extensive incarceration histories particularly are disadvantaged. ATI programs can improve the public health of urban communities if such programs are prepared and resourced to facilitate the receipt of services among program participants, especially men who have more extensive incarceration histories.

Incarceration Among Adults Who Are in the Public Mental Health System: Rates, Risk Factors, and Short-Term Outcomes

Incarceration of people with mental illness has become a major social, clinical, and economic concern, with an estimated 2.1 million incarcerations in 2007. Prior studies have primarily focused on mental illness rates among incarcerated persons. This study examined rates of and risk factors for incarceration and reincarceration, as well as short-term outcomes after incarceration, among patients in a large public mental health system. The data set included 39,463 patient records combined with 4,544 matching incarceration records from the county jail system during fiscal year 2005-2006. Risk factors for incarceration and reincarceration were analyzed with logistic regression. Time after release from the index incarceration until receiving services was examined with survival analysis. During the year, 11.5% of patients (N=4,544) were incarcerated. Risk factors for incarceration included prior incarcerations; co-occurring substance-related diagnoses; homelessness; schizophrenia, bipolar, or other psychotic disorder diagnoses; male gender; no Medicaid insurance; and being African American. Patients older than 45, Medicaid beneficiaries, and those from Latino, Asian, and other non-Euro-American racial-ethnic groups were less likely to be incarcerated. Risk factors for reincarceration included co-occurring substance-related diagnoses; prior incarceration; diagnosed schizophrenia or bipolar disorder; homelessness; and incarceration for three or fewer days. Patients whose first service after release from incarceration was outpatient or case management were less likely to receive subsequent emergency services or to be reincarcerated within 90 days. Modifiable factors affecting incarceration risk include homelessness, substance abuse, lack of medical insurance, and timely receipt of outpatient or case management services after release from incarceration.

Feasibility and willingness-to-pay for integrated community-based tuberculosis testing

BackgroundCommunity-based screening for TB, combined with HIV and syphilis testing, faces a number of barriers. One significant barrier is the value that target communities place on such screening.MethodsIntegrated testing for TB, HIV, and syphilis was performed in neighborhoods identified using geographic information systems-based disease mapping. TB testing included skin testing and interferon gamma release assays. Subjects completed a survey describing disease risk factors, healthcare access, healthcare utilization, and willingness to pay for integrated testing.ResultsBehavioral and social risk factors among the 113 subjects were prevalent (71% prior incarceration, 27% prior or current crack cocaine use, 35% homelessness), and only 38% had a regular healthcare provider. The initial 24 subjects reported that they would be willing to pay a median $20 (IQR: 0-100) for HIV testing and $10 (IQR: 0-100) for TB testing when the question was asked in an open-ended fashion, but when the question was changed to a multiple-choice format, the next 89 subjects reported that they would pay a median $5 for testing, and 23% reported that they would either not pay anything to get tested or would need to be paid $5 to get tested for TB, HIV, or syphilis. Among persons who received tuberculin skin testing, only 14/78 (18%) participants returned to have their skin tests read. Only 14/109 (13%) persons who underwent HIV testing returned to receive their HIV results.ConclusionThe relatively high-risk persons screened in this community outreach study placed low value on testing. Reported willingness to pay for such testing, while low, likely overestimated the true willingness to pay. Successful TB, HIV, and syphilis integrated testing programs in high risk populations will likely require one-visit diagnostic testing and incentives.

Marked for Death: An Empirical Criminal Careers Analysis of Death Sentences in a Sample of Convicted Male Homicide Offenders

Background Although prior criminal record and concurrent criminal charges constitute the main eligibility and aggravating circumstances used in capital sentencing, relatively little research has examined the criminal careers of offenders who are ultimately sentenced to death. Materials and Methods Using official criminal history data for 618 incarcerated male homicide offenders selected from 8 states—191 of whom were sentenced to death—the current study explored the criminal careers of offenders that received the most severe legal punishment. Results Poisson regression incidence rate ratio models indicated that multiple measures of prior criminal activity including contemporaneous and prior history of violence, prior incarceration, early onset of arrest, juvenile homicide offending, and juvenile child molestation were associated with subsequently being sentenced to death. Separate models for white, African American, and Hispanic males showed contrasting effects in their criminal careers and varying relationships between prior criminal career and current capital offending. Conclusion The current study adds to the literature on lifespan criminality by applying Poisson regression analyses and a criminal careers approach to study the most extreme offenders including those sentenced to death.

Racial and Ethnic Perceptions of Injustice

The study tests the explicit and implicit racial/ethnic divide, gradient, and justice system contact propositions of comparative conflict theory and explores whether prior incarceration experience (personal and vicarious) alters the observed relationship between race/ethnicity and perceptions of injustice. The study uses data from the Henry J. Kaiser Family Foundation, the Washington Post, and Harvard University 2006 survey concerning issues relating to African American males. The study found support for the racial/ethnic divide, gradient, and justice system contact hypotheses. The study also found support for the notion that prior incarceration experience intensifies the relationship between race/ethnicity and perceptions of injustice. The gap between African Americans and Whites in perceptions of injustice is more pronounced among persons with prior incarceration experience. The gap in perception of injustice between Whites and Hispanics was also stronger among those with prior incarceration experiences. The gap between African Americans and Hispanics was not impacted by prior incarceration experience. Future research should continue to explore the potential for prior incarceration experience to impact the relationship between race/ethnicity and perceptions of injustice.

Prevalence and correlates of HIV, syphilis, and hepatitis B and C infection and harm reduction program use among male injecting drug users in Kabul, Afghanistan: A cross-sectional assessment

BackgroundA nascent HIV epidemic and high prevalence of risky drug practices were detected among injecting drug users (IDUs) in Kabul, Afghanistan from 2005-2006. We assessed prevalence of HIV, hepatitis C virus (HCV), hepatitis B surface antigen (HBsAg), syphilis, and needle and syringe program (NSP) use among this population.MethodsIDUs were recruited between June, 2007 and March, 2009 and completed questionnaires and rapid testing for HIV, HCV, HBsAg, and syphilis; positive samples received confirmatory testing. Logistic regression was used to identify correlates of HIV, HCV, and current NSP use.ResultsOf 483 participants, all were male and median age, age at first injection, and duration of injection were 28, 24, and 2.0 years, respectively. One-fifth (23.0%) had initiated injecting within the last year. Reported risky injecting practices included ever sharing needles/syringes (16.9%) or other injecting equipment (38.4%). Prevalence of HIV, HCV Ab, HBSAg, and syphilis was 2.1% (95% CI: 1.0-3.8), 36.1% (95% CI: 31.8-40.4), 4.6% (95% CI: 2.9-6.9), and 1.2% (95% CI: 0.5-2.7), respectively. HIV and HCV infection were both independently associated with sharing needles/syringes (AOR = 5.96, 95% CI: 1.58 - 22.38 and AOR = 2.33, 95% CI: 1.38 - 3.95, respectively). Approximately half (53.8%) of the participants were using NSP services at time of enrollment and 51.3% reported receiving syringes from NSPs in the last three months. Current NSP use was associated with initiating drug use with injecting (AOR = 2.58, 95% CI: 1.22 - 5.44), sharing injecting equipment in the last three months (AOR = 1.79, 95% CI: 1.16 - 2.77), prior incarceration (AOR = 1.57, 95% CI: 1.06 - 2.32), and greater daily frequency of injecting (AOR = 1.40 injections daily, 95% CI: 1.08 - 1.82).ConclusionsHIV and HCV prevalence appear stable among Kabul IDUs, though the substantial number having recently initiated injecting raises concern that transmission risk may increase over time. Harm reduction programming appears to be reaching high-risk drug user populations; however, monitoring is warranted to determine efficacy of prevention programming in this dynamic environment.