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Review
. 2011 Jan;37(1):12-21.
doi: 10.3109/00952990.2010.540280. Epub 2010 Dec 21.

HIV, alcohol dependence, and the criminal justice system: a review and call for evidence-based treatment for released prisoners

Sandra A Springer  1 , Marwan M Azar, Frederick L Altice
Affiliations
Review

HIV, alcohol dependence, and the criminal justice system: a review and call for evidence-based treatment for released prisoners

Sandra A Springer et al. Am J Drug Alcohol Abuse. 2011 Jan.

Erratum in

  • Am J Drug Alcohol Abuse. 2011 May;37(3):203

Abstract

Background: People with both HIV and alcohol use disorders (AUDs) are disproportionately concentrated within the U.S. criminal justice system; approximately one-quarter of all people with HIV cycle through the system each year. HIV-infected prisoners with AUDs face many obstacles as they transition back to the community. Specifically, although they have impressive HIV treatment outcomes during the period of incarceration while they are free from alcohol; upon [corrected] release, however, they face inordinate challenges including relapse to alcohol use resulting in significant morbidity and mortality.

Objective: To review the existing literature regarding the relationship of HIV and treatment for AUDs within the criminal justice system in an effort to determine "best practices" that might effectively result in improved treatment of HIV and AUDs for released prisoners.

Methods: PubMed, PsychInfo and Medline were queried for articles published in English from 1990 to 2009. Selected references from primary articles were also examined.

Results: Randomized controlled trials affirm the role of pharmacotherapy using naltrexone (NTX) as the therapeutic option conferring the best treatment outcome for AUDs in community settings. Absent from these trials were inclusion of released prisoners or HIV-infected individuals. Relapse to alcohol abuse among HIV-infected prisoners is associated with reduced retention in care, poor adherence to antiretroviral therapy with consequential poor HIV treatment outcomes and higher levels of HIV risk behaviors.

Conclusions and scientific significance: Untreated alcohol dependence, particularly for released HIV-infected prisoners, has negative consequences both for the individual and society and requires a concentrated effort and rethinking of our existing approaches for this vulnerable population.

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References

    1. The Pew Center on the States. One in 100: Behind Bars in America. Washington, D.C: The Pew Charitable Trusts; Feb 28, 2008.
    1. Hammett TM, Harmon MP, Rhodes W. The burden of infectious disease among inmates of and releasees from US correctional facilities, 1997. Am J Public Health. 2002;92(11):1789–1794. - PMC - PubMed
    1. Maruschak L, Beavers R. HIV in Prisons, 2007–08. Washington, D.C: U.S. Department of Justice, Office of Justice Programs; 2009.
    1. Spaulding AC, Seals RM, Page MJ, Brzozowski AK, Rhodes W, Hammett TM. HIV/AIDS among inmates of and releasees from US correctional facilities, 2006: declining share of epidemic but persistent public health opportunity. PLoS ONE. 2009;4(11):e7558. - PMC - PubMed
    1. Springer SA, Pesanti E, Hodges J, Macura T, Doros G, Altice FL. Effectiveness of antiretroviral therapy among HIV-infected prisoners: reincarceration and the lack of sustained benefit after release to the community. Clin Infect Dis. 2004;38(12):1754–1760. - PubMed

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