Correlates of African American female adolescent offenders 3, 4-Methylenedioxymethamphetamine (MDMA or "Ecstasy") use and sexually transmitted infection morbidity.

The current study was designed to determine the extent to which self-reported ecstasy use in a population of juvenile adolescent detainees in a southern state is associated with high-risk health behaviors pertaining to sexually transmitted infection (STI) symptomology and past history of STI occurrence. Participants were 764 African American females extracted from an overall sample of 2,260 juvenile offenders housed at selected Youth Development Campuses in the state of Georgia. Significance tests were conducted using univariate logistic regressions to examine the independent associations of participant's self-reported ecstasy use and dichotomized HIV risk behavior correlates and history of having a prior STI before the most recent incarceration Participants who reported ecstasy use prior to incarceration were 1.7 (OR = 1.68, 95% CI = 0.78-3.64) and 1.8 times (OR = 1.87, 95% CI = 1.24-2.81) more likely respectively to indicate having had genital warts or chlamydia, and were more than 1.5 times (OR = 2.21, 95% CI = 0.83-5.44) and two times more likely to report having had gonorrhea or herpes, accordingly. Prevention programs for adolescent offender populations should develop interventions that target adolescents' substance use behavior as a function of STI risk taking as well as being culturally competent to deal specifically with these problem behaviors.

Correlates of Mandrax use and condom beliefs in preventing sexually transmitted infections among a cohort of South African prison inmates.

BACKGROUND: This study was designed to identify the extent to which self-reported Mandrax use impacts condom-use beliefs amongst South African prison inmates. METHODS: Participants were inmates from four prisons in the provinces of KwaZulu-Natal and Mpumalanga. In total, 357 inmates participated in the parent study of which 121 are included in this analysis based on their self-reported use of Mandrax. The questionnaire was developed in English, translated into Zulu, and back translated into English. Age significantly predicted the use of Mandrax: younger prison inmates reported higher use. Linear regression analysis was conducted to determine whether the use of Mandrax was associated with length of incarceration and other demographic variables, as well as participants' self-reported condom use beliefs behavior. RESULTS: Regression results indicated that two factors operationalizing condom-use beliefs were impacted by Mandrax use: 1) it is important to use condoms every time you have sex (p<0.01); 2) condoms work well to prevent the spread of HIV (p<0.02). Both factors were also inversely related to Mandrax use. CONCLUSION: STI prevention programs among prison inmates that seek to promote safer sex behaviors among men must address attitudes to condom use, specifically consistent and correct use of latex condoms and reducing substance misuse.

Self-reported ecstasy (MDMA) use and past occurrence of sexually transmitted infections (STIs) in a cohort juvenile detainees in the USA.

The current study was designed to determine the extent to which self-reported ecstasy use in a population of juvenile adolescent detainees in a southern state is associated with high-risk health behaviors pertaining to sexually transmitted infection (STI) symptomology and past history of STI occurrence. Participants were 2,260 juvenile offenders housed at selected Youth Development Campuses in the state of Georgia. Adjusted odds ratios (ORs) with 95 % confidence intervals (CIs) are presented. Juveniles who reported having used ecstasy previously were more likely to report that they had sore bumps of blisters near their sex organs before (OR 1.28, 95 % CI 0.74-2.21), with males who had used ecstasy prior incarceration being more than two times more likely to indicated that they had experienced having a drip or drainage from the penis (OR 1.76, 95 % CI 0.72-4.32), having vaginal discharge or odor from their vagina (OR 2.33, 95 % CI 1.16-4.65).

Predictors of suicide ideation and risk for HIV among juvenile offenders in Georgia.

The purpose of this study was to examine self-reported thoughts of suicide, HIV risk behaviors and history of sexually transmitted infections (STIs) in a sample of adolescent juvenile offenders in Georgia. Participants were 2260 juvenile offenders housed at selected youth development campuses (YDCs) in the state of Georgia. Self-reported measures of suicide ideation, HIV risk, and past occurrence of STIs were collected. Significance tests were conducted using univariate logistic regressions to examine the independent associations of lifetime self-reported thoughts of suicide and dichotomized HIV risk behaviour correlates prior to incarceration. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were presented. Significant differences were observed between juveniles in several factors for increased risk, including having been previously incarcerated (p<0.04), having had more than five alcoholic drinks in the same day (p<0.007), and having performed oral sex (p<0.028). We suggest that interventions for juvenile offenders that report thoughts of suicide, and that focus on HIV risk reduction should be developed based on the consideration of targeting factors that increase risk to specific STIs.

Psychosocial determinants of risky sexual behaviour amongst South African male prison inmates in KwaZulu-Natal and Mpumalanga Provinces.

PURPOSE: To inform future intervention programmes, the purpose of this paper is to explore the psychosocial and contextual determinants of intention to reduce risky sexual behaviour amongst inmates in South African prisons. DESIGN/METHODOLOGY/APPROACH: A cross sectional study using interviewer administered questionnaires was conducted with 357 inmates across four prison facilities in South Africa that were involved in a pre-release health education intervention for parolees in two provinces. FINDINGS: About 65 per cent of participants were first time offenders. Almost 50 per cent were unemployed prior to arrest and 66 per cent were married at time of incarceration. Self-efficacy, general life skills efficacy and sexual communication were the strongest predictors of intention to reduce risky behaviour upon release. High intenders were significantly different from low intenders in their self-efficacy, sexual communication, attitudes towards condom use and the perceived norm of sex being a non-utilitarian transaction. RESEARCH LIMITATIONS/IMPLICATIONS: One of the key limitations is the low literacy levels amongst prison inmates. Data also relied heavily on self reports of behaviours that may have occurred prior to the participants being incarcerated. ORIGINALITY/VALUE: It is concluded that the exploration of subpopulation specific behavioural determinants is a critical step in the development of effective, contextually-relevant, health education interventions.

Transient populations: linking HIV, migrant workers, and South African male inmates.

Risk factors associated with the spread of HIV are common among South Africa's transient populations-migrant workers and prisoners. Social ills in South Africa have yielded a growing transient population. Importantly, the migrant workers and prisoners in this population are likely to subscribe to masculine beliefs. Migrants have proven to be an effective bridge in the spread of HIV from high-risk to low-risk populations. Although a relationship between the populations has yet to be established, the circumstances of migrant camps are similar to those of prison camps. Given the high levels of HIV in South Africa and the parallels between migrants (a population whose great HIV threat to the general community has already been established) and prisoners, the integration of former male inmates into the community may pose serious public health concerns.

Age-based correlates of substance misuse among convicted felons in Georgia.

OBJECTIVE: This study sought to identify variables that independently correlate with age and substance use among a sample of 187 convicted felons in Georgia. RESULTS: Results of regression analysis indicated that younger inmates were 2 times more likely than older inmates to report the occurrence of alcohol use (RR 2.07; 95% CI .37, 11.6) and three times more likely than older inmates to report some history of marijuana use (RR 3.07; 95% CI 1.52, 6.11). In addition, younger inmates were half as likely or less to report using sedatives (RR .53, 95% CI .22, 1.29), tranquilizers (RR .49, 95% CI .22, 1.29), crack or cocaine (RR .33, 95% CI .18, .62), heroin (RR .48, 95% CI .16, 1.25), and to having ever received treatment for a drug problem (RR .46, 95% CI .23, .90). CONCLUSION: In conclusion, age-based factors correlate with participant's history of substance use. Ascertainment of these variables among inmate populations has the potential to improve treatment decisions both during and after incarceration.

Correlates of HIV/AIDS problem behaviors and incarceration status among inmates in Georgia.

This study examines the relationship between health self-efficacy, measures of sexual risk taking, health communication and negotiation skills, condom use, and substance use behaviors with history of prior incarceration among a sample of inmates in Georgia. The analysis herein is based on the completed survey responses from 188 inmates. The t test or simple chi-square tests were employed to examine differences in participant response means based on prior incarceration status and responses regarding HIV/AIDS problem behaviors for the entire population. The only statistically significant difference between first-time versus repeat offenders was the demographic variable age-meaning that repeat offenders were significantly older than were first-time incarcerated offenders (p < .001). In summary, the authors acknowledge the significance in identifying how a multitude of factors can be explored regarding incarcerated populations to enhance infectious disease interventions for this population.

Access point analysis on the state of health care services in South African prisons: a qualitative exploration of correctional health care workers' and inmates' perspectives in Kwazulu-Natal and Mpumalanga.

This paper explores inmates and prison health care workers perceptions of the state of health care services in four correctional facilities in South Africa. Structural and organisational issues are explored in terms of how they impact the delivery and provision of health care to inmates within correctional facilities. Additionally, the study forms an access point analysis of prisons as a health care setting as part of the development and testing of a STI/HIV health education intervention for soon to be released inmates. Focus group discussions (6-8 participants per group) were conducted with male inmates in four facilities in KwaZulu-Natal and Mpumalanga provinces. Individual face-to-face interviews were conducted with eight health personnel to get a view from both providers and end users of health care in correctional settings. Data were analysed thematically. We found strong evidence of prison being a strategic point to increase access to health services for offenders. Curative services within prisons were well established and running despite the presence of certain challenges varying across institutions. Prevention programmes emerged as an area that requires stronger emphasis to facilitate imparting skills and promoting safer practices for inmates upon release. Peer-led education programmes emerged as a key aspect of preparation for release and community reintegration amongst inmates.

Self-reported anal sex practice and sexual risk-taking after marijuana use among a sample of Georgia inmates.

The primary aim of this study was to examine factors related to anal sex practices and sexual risk-taking among a sample of soon-to-be-released adult male inmates with respect to self-reported HIV/AIDS risk behaviours. This study focused on collecting data from adult male inmates during the period from 2000 to 2003. Baseline level data were collected by project staff after a pool of eligible participants was selected by Department of Corrections personnel. Inmates had to be 18 years of age or older, male, and sexually active. Findings suggest that inmates did not vary much with respect to feeling that they would be less likely to take precautions before having sex after using marijuana. Inmates who reported having anal sex were more likely to indicate that they felt they were better lovers while under the influences of marijuana. Those with a history of anal sex also reported being more likely to do things sexually under the influence of marijuana than they would if they were sober (P < 0.03).

Predictors of condom use among a sample of male inmates: a social cognitive perspective.

The primary purpose of this study was to determine factors that predict condom self-efficacy among a sample of soon-to-be-released adult male inmates with respect to self-reported HIV/AIDS risk behaviors. Approximately 230 inmates had agreed to enroll in the study. This analysis is based on completed baseline surveys from 187 inmates. Data were collected at baseline (prior to implementing the intervention) on self-reported condom self-efficacy HIV/AIDS risk behaviors. Findings support that, requesting that your partner uses condoms every time they had sex was the strongest indicator of self-reported condom self-efficacy by inmates in the sample (p<0.01). Findings also suggest that engaging in sexual activity after smoking marijuana, limiting the number of sex partners and asking partners' HIV status were significant predictors for the dependent variable of condom self-efficacy (p<.05); engaging in sexual activity after drinking was not (p<0.11). Findings suggest that it may be wise to take a best-practice approach using former inmates as peer educators if health-based interventions are to be delivered to soon-to-be-released adult male inmates.

Lifetime occurrence of sexually transmitted infection (STI) and substance use risk among prerelease South African prison inmates.

The current study examined self-reported history of STI and substance use risk behaviors in a sample of South African prison inmates. Participants were 344 inmates from four prisons in the provinces of KwaZulu-Natal and Mpumalanga. Significance tests were conducted using univariate logistic regressions to examine the independent associations of Lifetime occurrence of a Sexual Transmitted Infection and dichotomized correlates of substance use risk behavior. Findings showed that inmates in Mpumalanga (OR 1.43; 95% CI 0.90, 2.23) had a greater risk for STIs than inmates in KwaZulu-Natal (KZN) (OR 1.11; 95% CI 0.88, 1.37). Moreover, past experience using injection drugs (OR 2.34; 95% CI 0.62, 8.88), experience of needle sharing (OR 2.13; 95% CI 0.55, 8.27), and drug/alcohol use leading to problems at school or work were the strongest indicators for inmates having a lifetime STI.

Short-term impact of an HIV risk reduction intervention for soon-to-be released inmates in Georgia.

The purpose of this study was to determine the impact of an intervention seeking to reduce risk for HIV/AIDS infection among a sample of soon-to-be-released adult male inmates. This analysis is based on a random sample of 116 adult male prisoners recruited and interviewed prior to their participation in an HIV/AIDS and recidivism risk reduction intervention and again three months after they were reintegrated into the community. The intervention program was designed to reduce risky sexual behaviors and alcohol, tobacco, and other drug-related behaviors. It had a randomized, Latin-square design to evaluate adult male offenders across four conditions. Findings indicate that the intervention for the inmate population was effective in reducing sexual self-expectation and substance use and increasing condom use self-efficacy over a three-month period.

Use of protective barriers and unprotected sex among adult male prison inmates prior to incarceration.

Research documents the challenges associated with preventing HIV/AIDS among prison inmate populations. This paper describes the predictors of protective barrier use and unprotected sexual intercourse among a sample of adult male inmates. Descriptive and scale information was collected on several variables using standard response formats. All major substance use constructs (marijuana, cocaine, and alcohol use) were assessed in terms of consumption prior to incarceration. T-tests were employed to evaluate the level of marijuana, cocaine, and alcohol use in general, as well as with particular respect to sexual situations. Linear regression analysis was conducted to determine whether the use of the substances, length of incarceration, and other demographic variables were associated with the frequency of reporting use of a protective barrier. The findings note that total years in prison, and marijuana and cocaine use were associated with inmates' risk behaviours. Marijuana and cocaine use were statistically significant predictors of risky sex behaviours.

Correlates of inmates' self-reported HIV/AIDS risk behaviors, prior incarceration, and marijuana use.

The primary purpose of this study was to determine associations between measures of prior incarceration and marijuana use with self-reported HIV/AIDS risk behaviors among a sample of soon-to-be-released adult male inmates. Analyses presented exclusively involve calculating two multiple logistic regression models to test the study hypothesis. The general model specified self-reported marijuana use as an outcome with selected demographic variables including ethnicity, age, education, and income prior to incarceration as predictor variables. Significant bivariate associations were recorded for age, education, and sexual self-expectation with respect to reincarceration. Specifically, the least amount of education reported, the more likely study participants were to have been incarcerated more than once.

The relationship among marijuana use, prior incarceration, and inmates' self-reported HIV/AIDS risk behaviors.

Inmates report use of a wide range of drugs including heroin, methadone, and cocaine at some point in their lives without a doctor's prescription. The most commonly used drugs include marijuana and cocaine; tobacco and alcohol are also widely used [Am. J. Public Health 90 (2000) 1939; Am. J. Drug Alcohol Abuse 26 (2000) 229]. The present study explores the relationship between marijuana use and prior incarceration on 208 inmates' self-reported HIV/AIDS risk behaviors. Analysis involved descriptive and chi-square tests of association. Findings indicate that inmates with higher self-reported levels of education were significantly less likely than others to be repeat offenders. Data also support the argument that income prior to the most recent arrest and frequency of marijuana use was related to the outcome of being a repeat offender.

History of prior TB infection and HIV/AIDS risk behaviours among a sample of male inmates in the USA.

This study looked at inmates' self-reported data on prior treatment for tuberculosis (TB) and HIV/AIDS risk among a sample of inmates in a medium security prison. Contingency tables were used and risk ratios were computed to provide an estimate of relative risk for inmates with a history of being treated for TB in opposition to inmates without a history of being treated for TB. Findings suggest that inmates who reported being treated for TB were more likely to have had sex with a man while in prison and to report that, while in prison, they had a main sex partner. They were also 1.15 times more likely to have had sex with a person from the transgender community while in prison and 2.53 times more likely to report having been forced to have sex while in prison than those without a past history of being treated for TB. Future studies should attempt to determine the extent to which having an infectious disease such as TB impacts behavioural change with respect to behaviours practised by inmates.