Project period: 12/01/2009 - 06/30/2011
Grant Type: Pilot Project
HIV infection has become concentrated in prisons and jails with nearly 25% of all people with HIV spending time in a correctional facility. Because of the widespread incarceration of persons with or at risk for HIV infection, prevention efforts are increasingly focused on correctional facilities, including identification and treatment of inmates with HIV/AIDS. Less attention has been directed to what happens upon release and the socioeconomic determinants of their health. Seven million individuals are released from U.S. prisons and jails each year, many of whom are unemployed, homeless, and have difficulties securing their basic needs upon release. Many states prohibit individuals convicted of drug felonies from receiving government entitlements, including food stamps. Individuals released from prison who lack access to food stamps may be at greater risk of food insecurity, defined as the absence of "access at all times to enough food to meet their dietary needs for a productive and healthy life." Food insecurity and its association with HIV risk behaviors have been most extensively researched in Sub-Saharan Africa, but the data are lacking in the U.S. Using a community-based participatory research approach, I propose to study the association between food insecurity and HIV risk behaviors in a population of recently-released inmates differentially impacted by lack of access to food stamps in three U.S. states. We hypothesize that (1) individuals released from prison who are prohibited from obtaining food stamps will have higher rates of food insecurity compared to those with access to food stamps, and (2) that food insecurity is associated with increased HIV risk behaviors in this population. This cross sectional study will lay the groundwork for further research leading to new targets for HIV prevention, including the provision of food with drug treatment or sexual risk reduction training, and the basis for political advocacy for eliminating the ban on food stamps.
Outcome(s):Wang E.A., Zhu, G.A., Evans L., Carroll-Scott, A., Desai, R., and Fiellin L.E. (2012) 'A Pilot Study Examining Food Insecurity and HIV Risk Behaviors among Individuals Recently Released from Prison', AIDS Education and Prevention, [in press].