The prevalence rate of HIV infection in jails and prisons is approximately 5 times the rate in the U.S. general population. The authors surveyed state prison officials to assess HIV testing and HIV prevention policies--specifically voluntary testing, group HIV prevention counseling, and peer education--in the 50 states and to determine whether those policies are associated with the characteristics of the state and its prison population.

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If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractPurpose -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.

The deprivation, importation, situational, and administrative control models have been used to explain inmate violence. More recently, HIV risk behaviors of inmates have been explained with the deprivation and importation models. The goal of this study is to assess the utility of these models in describing inmate HIV risk behaviors and to identify additional models that may exist. Forty seven ex-offenders released from prison within three months of the study were recruited from a community based organization. They 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. Inmates engaged in sex in exchange for money and for affection. Inmates who were drug users before incarceration were more likely to abuse drugs in prison. Security measures, if effective, deterred the entrance of illegal substance into prison, but when security is lax, inmates take the opportunity to engage in sex, and illegal substances are brought into prison. Our results reveal that deprivation, importation, situational, and administrative control factors are associated with HIV risk behaviors among inmates and they can be used in explaining these behaviors. The association of risk behaviors with long or life sentences suggests that fatalism may play a role in risk behaviors among inmates. Fatalism is a factor which requires future examination.

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