Incarceration and the acquired immunodeficiency syndrome: Autopsy results in Texas prison inmates

The Texas Department of Criminal Justice (TDCJ) houses many subjects with acquired immunodeficiency syndrome (AIDS) who receive medical care in a comprehensive AIDS treatment center. In this case-control autopsy survey, we compared pathological outcomes of TDCJ inmates treated at the center (n = 155) with nonincarcerated patients who died during the same period (n = 155). Using multiple regression analysis and a proportional hazards model, survival time in the prisoners was equivalent to that in the controls. With few exceptions, the prevalences of opportunistic viral, fungal, protozoal, and bacterial infections contributing to mortality were equivalent between groups. Mycobacterium tuberculosis was isolated more frequently in the inmates, and M avium intracellulare was isolated less frequently (P < .0001). The inmates had a higher prevalence of bacterial infection of the central nervous system (CNS) (9.1% v 1.4%; P < .006); half of all CNS bacterial infections were caused by M tuberculosis. Inmates had significantly lower prevalences of vacuolar myelopathy (P < .006) and severe wasting disease (P < .0009). We conclude that survival of prison inmates with AIDS treated in a comprehensive AIDS treatment center was equivalent to that of nonincarcerated subjects with AIDS. Prevalences of certain complications of AIDS differed in the inmates, showing that the prison environment influenced some of the underlying causes of AIDS morbidity and mortality.     

在监女犯MMPI测试对照分析

目的 研究在监女犯与正常女性心理状况的差异性及其与犯罪的关系。方法 应用MMPI测查144例在监女犯并以文化、年龄相当的社会女性159例为对照组,使用x^2、t检验对资料进行处理。结果 13个基本量表的平均量表分比较,研究组均明显大于对照组（P＜0．01）,在监女犯心理偏离占84．03％,明显高于对照组的8．18％（P＜0．01）。结论 女性犯罪可能与其有较多的心理偏离有关,为在监女犯的改造提供科学依据。     

不同时期在押罪犯司法精神病学鉴定案例的对比分析

目的 探讨近年来在押犯罪司法精神病学鉴定的特点和发展趋势。方法 对1994年后经该院鉴定的87例与1993年前鉴定的33例在押罪犯案例进行对比分析。结果 1994年后组在押罪犯鉴定的案例明显增加（P＜0．01）。服刑能力的鉴定,1994年后组较多（P＜0．01）,服教能力的鉴定,1993年前组较多（P＜0．05）。1994年后组经济类案件有上升趋势（P＜0．05）,诊断为精神分裂症的有明显下降（P＜0．01）,诊断为拘禁性精神障碍的有明显上升（P＜0．05）。结论 在押罪犯司法精神病学鉴定已成为司法精神病学鉴定的重要组成部分,对其法定能力的评定需进一步入研究。     

"Just using old works": injecting risk behaviour in prison

A minority of injecting drug users engage in high risk injecting behaviours when in prison. In the United Kingdom between a quarter and a third of injectors who enter prison inject when in prison, and of these about three-quarters share needles and syringes. In the present study, 44 drug injectors who had been released from prison for no longer than 6 months were recruited and interviewed in three geographical areas in England. Interviewees were asked to recount their experiences of drug use during their most recent period of imprisonment. The majority of interviewees were male (38/44), had a mean age of 28 years, with a mean age of 16 years at first drug use, were primarily opiate users (39) and had multiple imprisonments. All respondents reported drug use when imprisoned and drug injecting was reported by 16 interviewees. Most injected at irregular intervals and at a reduced level, compared with injecting when in the community. Nine reported using needles and syringes that others had previously used. When considering other injecting equipment, more sharing occurred than was actually reported. Much re-use of equipment was viewed simply as “using old works”. The sharing of “cookers” and “filters”, and drug sharing by “backloading” and “frontloading” were common. The concept of “sharing” tended to be understood by respondents as related to the use of tools of injection (needles and syringes rather than other equipment); the use of tools in the act of injection (rather than for mixing drugs); proximity (multiple use of needles and syringes in the presence of others); temporality (shorter time elapse between consecutive use of needles and syringes previously used by another) and source (hired rather than borrowed or bought). We conclude that syringe sharing is an integral part of drug use and drug injecting in prison. Many of those interviewed displayed a restricted understanding of what denotes syringe sharing. Our data reinforce the need for interventions and initiatives to be developed within prisons to deal with the considerable risk posed by continued injecting drug use.     

Scotland's national naloxone program: The prison experience

Launched in 2011, the Scottish national naloxone program marked an important development in public health policy. Central to its design were strategies to engage prisoners given their elevated risk of drug‐related death in the weeks following liberation. Implementation across Scottish prisons has posed particular challenges linked to both operational issues within prison establishments and individual factors affecting staff delivering, and prisoners engaging, with the program. Barriers have been overcome through innovation and partnership working. This commentary has described how the development of the program in prisons has adapted to these challenges to a point where a largely consistent model is in place and where prisoners‐on‐release are reaping the benefits in terms of reduced opioid‐related mortality.     

A robust estimate of the number and characteristics of persons released from prison in Australia

Objective: To estimate the number and characteristics of adults released from prison in Australia. Method: We calculated ratios, stratified by age, sex and Indigenous status, by comparing the number of persons released from prison in New South Wales (NSW), with the number in NSW prisons on 30 June of the corresponding year. These stratified ratios were applied to Australia‐wide prison data to estimate the number and characteristics of persons released annually. Results: We estimated that in 2013, 38,576 persons were released from prison in Australia ? 25.3% more than the daily prison population. Young people, Indigenous people and women were over‐represented among those released. We estimated that 3.69 Indigenous women aged 18–24 were released annually for each equivalent person in prison; and 2.75 non‐Indigenous women aged 18–24 were released annually for each equivalent person in prison. Conclusions: The annual ‘flow’ through Australia's prisons is well in excess of the daily number, but information on those moving through prison systems is not yet publicly available. The characteristics of those released from prison differ meaningfully from those of people in prison. Routine, national reporting of prison separations is critical to informing upscaling and targeting of Throughcare services for this profoundly vulnerable population.     

Unexpected High Rate of Wild-Type HIV-1 Genotype Among Inmates Failing Antiretroviral Therapy

Abstract

Purpose: Combination antiretroviral therapy (ART) has proven to be effective in treating human immunodeficiency virus (HIV) infection. Chronic administration of antiretrovirals presents significant challenges, including the risk of selecting treatment-resistant viral strains that can determine treatment failure and can be transmitted. In many countries, a large proportion of the HIV-infected population goes through the correctional system at least once. Scarce data are available on circulation of resistant HIV strains in correctional facilities. We evaluated the prevalence of antiretroviral resistance among both naïve and treatment-experienced HIV-infected inmates of a correctional institution in Genoa, Italy. Method: The prevalence of antiretroviral resistance among the HIV-infected inmates observed at our institution who underwent genotypic testing from January 2004 to June 2007 was retrospectively reviewed. Results: 45 genotypes from 43 inmates were available. Most of the naïve patients (14/16; 87.5%) showed a wild-type (WT) genotype, as well as most of the ART-experienced patients who had discontinued ART (10/13; 76.9%). A high proportion of WT genotype (6/16; 37.5%) was also observed among the subjects apparently failing HAART. Conclusions: The prevalence of mutated strains in treatment-naïve individuals of the studied cohort is comparable to what is reported in nonimprisoned naïve subjects of our region. The high prevalence of WT genotypes in ART-failing patients makes it likely that they were not taking their treatments, probably to gain legal benefits from their worsening health conditions. Thus, resistance testing can also be considered as an additional tool for assessing adherence to ART for forensic/medicolegal evaluation. However, further and larger studies are necessary to validate it.     

True and false alibis among prisoners and their detection by police detectives

The present study was designed to determine whether differences exist between true and false alibis and how accurate police detectives and lay people are in determining the veracity of alibis. This article provides a replication of the research by Culhane et al. (2013 Culhane, S. E., Kehn, A., Horgan, A. J., Meissner, C. A., Hosch, H. M., &; Wodahl, E. J. (2013). Generation and detection of true and false alibi statements. Psychiatry, Psychology and Law, 20, 619–638. doi:10.1080/13218719.2012.729018[Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]) with more representative participants. In the first experiment, real suspects in a remand prison generated true or false alibis. In the second experiment, a subset of those alibis were written out and were provided to experienced police officers and students for alibi evaluation and discrimination. Our results show that differentiating between true and false alibis is difficult, and even when more representative materials and participants are included, the accuracy did not exceed 60%. Interestingly we found that students and police officers focus on other aspects during the alibi discrimination. Thus, research using student participant cannot be, directly, used in alibi discrimination studies.