HIV Education and Prevention Services

Horizons, Inc. has offered an HIV Prevention Program since 1995. The curriculum focuses on HIV prevention education for women who are engaging in high-risk behaviors. More than 100 female offenders annually participate in 12-week programs on HIV prevention. In addition to education and prevention, this program focuses on the development of healthy relationships. Because many of the participants are ex-prostitutes, this is one of few programs in Milwaukee that combines substance abuse prevention, HIV prevention, and assessment of risk for women in the sex trading industry. The groups focus on protection, discussion of HIV prevention with primary partners, the risk of multiple partners, violence and sex, and healthy behaviors. Horizons is the only AODA program in Milwaukee that provides this type of HIV Prevention Services.

Women offenders remain among one of the highest risk populations for HIV disease:

AIDS has become the leading cause of death among female inmates (U.S. Department of Justice, 1997)

A 1996 survey of jail inmates indicated almost three percent of the women reported being HIV positive

Individuals in prison are seven times as likely to be infected with HIV than individuals living in the community (CDC, 1997)

Nationally, inmates of color and female inmates have higher rates of HIV and AIDS than their white, male counterparts. In Wisconsin, people of color are over-represented in correctional facilities in comparison to the percentage of minorities in the state’s total population. (Wisconsin Comprehensive HIV Prevention Plan, 2002)

Female offenders often have histories that place them at high risk for HIV infection, including trading sex for money/drugs, injection drug use, and/or partnering with injection drug users (Spector, 1999). In addition to having a higher incidence of HIV and AIDS than male offenders, women have a higher incidence of physical health problems including asthma, seizure disorders, hypertension, diabetes, hepatitis, heart disorders, and sexually-transmitted diseases (Miles, 1999).

Despite high rates of HIV, STD’s and substance abuse and a history of low utilization of prevention health services, a substantial proportion of women offenders do not have adequate access to essential reproductive health and STD/HIV prevention services such as STD/HIV screening and treatment, gynecological exams, HIV/AIDS prevention counseling and behavioral change counseling (de Ravello, 1999). Researchers attribute this to the fact that corrections, public health, and community-based providers have not developed relationships that effectively link and deliver surveillance, prevention, and treatment that includes substance abuse and social services within correctional settings (Miles, J. 1999).

Despite the statistics, many women offenders don’t consider themselves at risk for HIV transmission. In general, women offenders do not focus adequate attention on their health (both general and reproductive). Practical considerations such as day-to-day survival, employment, housing, transportation and childcare often take precedence over personal care. Experience has shown that a residential setting is, in many ways, an ideal setting for providing HIV education and prevention services. Here at Horizons, women have the opportunity to learn information in a safe environment, practice risk reduction negotiation strategies they can transfer into their relationships, and receive support from each other for engaging in better health practices that reduce HIV and STD’s.