Understanding HIV risk behaviors in prison: a qualitative study among recently released inmates

Abstract

Purpose – The purpose of this paper is to explore HIV risk behaviors of inmates during incarceration and gain an in-depth understanding of the context within which these behaviors occur. Design/methodology/approach – In total, 47 recently released ex-offenders participated in focus group discussions that explored the contexts surrounding inmate engagement in HIV risk behaviors in prison. Data were analyzed using NVivo 7 and results were organized into themes. Findings – Inmates engaged behaviors that could predispose them to HIV infection. These behaviors include unprotected sexual intercourse, transactional sex, injection drug use, tattooing, and body piercing. The results of this study show that the contexts within which risk behaviors occur among inmates are complex, involving inmates, corrections staff, and visitors. The reasons why inmates engage in risk behaviors are also myriad: finance; addiction; boredom; deprivation; prison culture; slack security and monitoring; indifference by correctional officers; and violence. Practical implications – Prevention of risk behaviors and ultimately HIV transmission in prison requires a multi-dimensional ecological approach that focusses on the inmates, prison staff, prison system, policies, and policy makers. Originality/value – This paper attempts to explore HIV risk behaviors of prison inmates. It is of value to health professionals, security agents, administrators, and non-governmental organizations that work with the incarcerated population.