Women & Health

doi: 10.1080/03630242.2014.983005pmid: N/A

LeBlanc, Tanya Telfair; Reid, Laurie; Dean, Hazel D.; Green, Yvonne

doi: 10.1080/03630242.2014.962859pmid: 25375857

Fogel, Catherine I.; Gelaude, Deborah J.; Carry, Monique; Herbst, Jeffrey H.; Parker, Sharon; Scheyette, Anna; Neevel, A.

doi: 10.1080/03630242.2014.932888pmid: 25204565

Incarcerated women are disproportionately affected by HIV and sexually transmitted infections (STIs) due to risk factors before, during, and after imprisonment. This study assessed the behavioral, social, and contextual conditions that contribute to continuing sexual risk behaviors among incarcerated women to inform the adaptation of an evidenced-based behavioral intervention for this population. Individual, in-depth interviews were conducted with 25 current and 28 former women prisoners to assess HIV/STI knowledge, perceptions of risk, intimate relationships, and life circumstances. Interviews were independently coded using an iterative process and analyzed using established qualitative analytic methods. Major themes identified in the interviews involved three focal points: individual risk (substance abuse, emotional need, self-worth, perceptions of risk, and safer sex practices); interpersonal risk (partner pressure, betrayal, and violence); and risk environment (economic self-sufficiency and preparation for reentry). These findings highlight the critical components of HIV/STI prevention interventions for incarcerated women.

Satterwhite, Catherine Lindsey; Newman, Daniel; Collins, Dayne; Torrone, Elizabeth

doi: 10.1080/03630242.2014.932890pmid: 25189136

An estimated 2.9 million new chlamydia infections occur in the United States each year. Among women, chlamydia can lead to serious adverse outcomes, including pelvic inflammatory disease and infertility. Chlamydia prevalence is highest among females aged 15–19 years. Despite long-standing recommendations directed at young, sexually active females, screening remains sub-optimal. Juvenile detention centers (JDCs) are uniquely situated to screen and treat high-risk adolescents. From 2009–2011, performance measure data on chlamydia screening coverage (proportion of eligible females screened) and positivity (proportion of females tested who were positive) were available from 126 geographically-dispersed JDCs in the United States. These facilities reported screening 55.2% of females entering the facilities (149,923), with a facility-specific median of 66.4% (range: 0–100%). Almost half (44.4%) of facilities had screening coverage levels of 75–100%. This screening resulted in the detection of 12,305 chlamydial infections, for an overall positivity of 14.7% (facility-specific median = 14.9%, range: 0–36.9%). In linear regression analysis, chlamydia positivity was inversely associated with screening coverage: as coverage increased, positivity decreased. The burden of chlamydia in JDCs is substantial; facilities should continue to deliver recommended chlamydia screening and treatment to females and identify mechanisms to increase coverage.

DiClemente, Ralph J.; Davis, Teaniese L.; Swartzendruber, Andrea; Fasula, Amy M.; Boyce, Lorin; Gelaude, Deborah; Gray, Simone C.; Hardin, James; Rose, Eve; Carry, Monique; Sales, Jessica M.; Brown, Jennifer L.; Staples-Horne, Michelle

Reisner, Sari L.; Bailey, Zinzi; Sevelius, Jae

doi: 10.1080/03630242.2014.932891pmid: 25190135

Limited national data document the prevalence of incarceration among transgender women, experiences of victimization while incarcerated, and associations of transgender status with health. Data were from the National Transgender Discrimination Survey (NTDS), a large convenience sample of transgender adults in the U.S., collected between September 2008 and March 2009. Respondents who indicated a transfeminine gender identity were included in the current study (n = 3,878). Multivariable logistic regression was used to model ever being incarcerated and experiencing victimization while incarcerated as a function of race/ethnicity and health-related indicators. Overall, 19.3% reported having ever been incarcerated. Black and Native American/Alaskan Native transgender women were more likely to report a history of incarceration than White (non-Hispanic) respondents, and those with a history of incarceration were more likely to report negative health-related indicators, including self-reporting as HIV-positive. Among previously incarcerated respondents, 47.0% reported victimization while incarcerated. Black, Latina, and mixed race transgender women were more likely to report experiences of victimization while incarcerated. Transgender women reported disproportionately high rates of incarceration and victimization while incarcerated, as well as associated negative health-related indicators. Interventions and policy changes are needed to support transgender women while incarcerated and upon release.

Visher, Christy A.; Bakken, Nicholas W.

doi: 10.1080/03630242.2014.932889pmid: 25190220

Women entering the correctional system represent a population at high risk for mental health and the body of research on the mental health needs of women offenders is growing. These mental health problems pose challenges for women at every stage of the criminal justice process, from arrest to incarceration to community reentry and reintegration. In this article, we examined mental health status among a sample of 142 women leaving confinement and the role that mental health problems played in shaping their reentry outcomes using data collected between 2002 and 2005 in Houston, Texas. In the year after leaving prison, women with mental health problems reported poorer health, more hospitalizations, more suicidal thoughts, greater difficulties securing housing and employment, more involvement in criminal behavior, and less financial support from family than women with no indication of mental health problems. However, mental health status did not increase the likelihood of substance use relapse or reincarceration. The article concludes with a discussion of recommendations for improved policy and practice.

Nowotny, Kathryn M.; Belknap, Joanne; Lynch, Shannon; DeHart, Dana

doi: 10.1080/03630242.2014.932892pmid: 25204664

Recent research has documented the unusually high rates of incarcerated women’s serious mental illness (SMI) and substance use disorders (SUD). Complicating these high rates is the high comorbidity of SMI with SUD and trauma histories. Yet, incarcerated women have significantly less access to treatment and health services while incarcerated than men. We used data from a multi-site, multi-method project funded by the Bureau of Justice Assistance (2011–2012) to determine the risk profile of women in jail (n = 491) with a current co-occurring SMI (i.e., major depressive disorder, bipolar disorder, schizophrenia spectrum disorder) and SUD (i.e., abuse, dependence). The study spanned multiple geographic regions, and structured diagnostic interviews were used to understand better the women that comprised this vulnerable population. One-in-five of the women had a current co-occurring disorder (CCOD). The findings revealed that significantly more women with a CCOD had been exposed to violence and were exposed to drugs at a younger age. Further, about one-third of women with a CCOD had received no treatment from a health care professional in the past year, demonstrating a substantial unmet need. We conclude that investing in mental and behavioral health care in jails is critical to the health and safety of women as well as the communities to which they return.

Kuo, Caroline; Johnson, Jennifer; Rosen, Rochelle K.; Wechsberg, Wendee; Gobin, Robyn L.; Reddy, Madhavi K.; Peabody, Marlanea; Zlotnick, Caron

doi: 10.1080/03630242.2013.850143pmid: 24965256

Incarcerated women, in comparison to nonincarcerated women, are at high risk for sexually transmitted infections (STIs) and many have experienced interpersonal violence. The psychological construct of emotional dysregulation—which includes heightened intensity of emotions, poor understanding of emotions, negative reactivity to emotion state, inability to control behaviors when experiencing emotional distress, and maladaptive emotion management responses—is a possible pathway to explain the link between interpersonal violence exposure and STI risk. The present study examined maladaptive emotion management responses for emotional dysregulation (i.e., avoidance and numbing, and dissociation) occurring in the context of risky sexual behavior. We collected qualitative data from 4 focus groups with a sample of n = 21 incarcerated women (aged 18+ years) from urban facilities in New England. Qualitative data were analyzed using a thematic analysis approach. Findings indicated that incarcerated women reported engaging in a variety of maladaptive responses for emotion management during sexual encounters. These maladaptive responses for emotion management appear to increase sexual risk behaviors and alter women’s ability to implement STI protective behaviors, such as sexual negotiation and condom use. Preventive interventions to reduce sexual risk behaviors should incorporate strategies to promote emotional regulation among incarcerated women with histories of interpersonal violence.

Mukherjee, Soumyadeep; Pierre-Victor, Dudith; Bahelah, Raed; Madhivanan, Purnima

doi: 10.1080/03630242.2014.932894pmid: 25190332

Incarceration-induced stress makes pregnant women in correctional facilities a high-risk group for mental health problems, resulting in adverse maternal and fetal outcomes. A systematic review was conducted to examine the prevalence and correlates of mental health issues among pregnant inmates. Databases searched included PubMed, Medline, CINAHL Plus, PsycINFO, National Criminal Justice Reference System, Social Work Abstracts, Cochrane and Campbell libraries, which were searched for studies published in English from 1950 till July 2013. Eleven studies were included of pregnant women in correctional facilities and addressed at least one mental illness. Quality score was assigned to these eligible articles. Due to heterogeneity, a narrative review was performed. All of the studies were conducted in the United States, with quality scores ranging from 7 to 10 out of 10. Only one of these studies used mixed methods, the rest were quantitative. Tobacco use among pregnant inmates exceeded 50%, with some studies reporting as high as 84%. Alcohol use was common; 36% of the inmates used illicit drugs in one study. Depression and anxiety levels were high—some studies reported depression among 80% of inmates. Findings suggest that mental health among pregnant prisoners is a huge concern that has not been adequately addressed.