A new study published in the International Journal of Drug Policy has found that without careful and deliberate mitigation efforts, criminal justice reforms that result in large, rapid decreases in incarceration rates can lead to an increased risk of HIV spread through communities, reports the Brookings Institution.
Simulations conducted in five different metropolitan areas indicate that criminal justice reform policies that result in extensive reductions in incarceration rates increase relationships involving people who inject drugs (PWID) that have the potential for HIV transmission.
On average, there is an approximately 10 percent increase in incidences of such relationships compared to simulation runs in which incarceration rates remained at current levels.
However, the study also points out that the simulated effects are restricted to a short time horizon of only three years, and that the potential positive effects of incarceration reform including decreases in HIV risk behaviors, stabilization of sexual networks, increased access to drug treatment, and HIV care and treatment might eventually offset any initial uptick in community-level HIV prevalence that follows criminal justice reforms.
In addition, these simulated effects are absent any concerted efforts to mitigate them. Prior research suggests that ensuring HIV prevention and treatment among justice-involved populations and the persons with whom they interact in the community requires a multipronged approach that bridges gaps between HIV and behavioral health services in correctional settings and those in the community.
It should also engage formerly incarcerated men and women with HIV testing and treatment, and behavioral health programs in the community, the study says.
Other key recommendations include:
build trust in the medical system and autonomy among formerly incarcerated men and women
facilitate community reintegration by reducing barriers to employment, housing, and social benefits, leveraging social capital; and
integrate case management and patient navigation in post-release and reentry programs.