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PubMed1998

HIV seroprevalence among male prison inmates in the Wisconsin Correctional System.

OBJECTIVE: To estimate HIV seroprevalence and the acceptance of voluntary HIV testing among male inmates entering the Wisconsin Correctional System during July 1, 1994-June 30, 1995, and compare these estimates with similar data obtained in 1987-1988. METHODS: A blinded HIV seroprevalence survey concurrent with a review of voluntary HIV antibody testing records. RESULTS: HIV test results were obtained for 3,681 (89%) male prison entrants during the study period; 26 (0.7%) were HIV-1 seropositive. Based on this estimate and the total number of male prison entrants (4,134), an estimated 29 HIV-1 seropositive male inmates entered the Wisconsin Correctional System during the study period. Eighty-four percent of all inmates were tested voluntarily. Among inmates testing HIV-1 seropositive, 69% were tested voluntarily. CONCLUSIONS: These data suggest that HIV-1 seroprevalence among male prison inmates in Wisconsin is low, and is unchanged from the late 1980s; however, a large increase in the prison population has resulted in a substantial increase in the absolute number of HIV-1 seropositive inmates entering the correctional system. Although overall acceptance of voluntary HIV testing is high, nearly one third of HIV-1 seropositive inmates declined voluntary HIV testing.

AIDS Serodiagnosis↗
PubMed1998

Three strikes and you're out: demographic analysis of mandatory prison sentencing.

Much of the debate about the costs and benefits of "three-strikes" laws for repeat felony offenders is implicitly demographic, relying on unexamined assumptions about prison population dynamics. However, even state-of-the-art analysis has omitted important demographic details. We construct a multistate life-table model of population flows to and from prisons, incorporating age-specific transition rates estimated from administrative data from Florida. We use the multistate life-table model to investigate patterns of prison population growth and aging under many variants of three-strikes laws. Our analysis allows us to quantify these demographic changes and suggests that the aging of prison populations under three-strikes policies will significantly undermine their long-run effectiveness.

Adolescent↗
PubMed1999

The continuous Prisoner's dilemma: II. Linear reactive strategies with noise.

We present a general model for the Continuous Prisoner's Dilemma and study the effect of errors. We find that cooperative strategies that can resist invasion by defectors are optimistic (make high initial offers), generous (always offer more cooperation than the partner did in the previous round) and uncompromising (offer full cooperation only if the partner does). A necessary condition for the emergence of cooperation in the continuous Prisoner's Dilemma with noise is b (1-p)>c, where b and c denote, respectively, the benefit and cost of cooperation, while p is the error rate. This relation can be reformulated as an error threshold: cooperation can only emerge if the probability of making a mistake is below a critical value. We note, however, that cooperation in the continuous Prisoner's Dilemma with noise does not seem to be evolutionarily stable: while it is possible to find cooperative strategies that resist invasion by defectors, such cooperators are generally invaded by more cooperative strategies which eventually yield to defectors. Thus, the long-term evolution of the continuous Prisoner's Dilemma is either characterized by unending cycles or by stable polymorphisms of cooperators and defectors.

Biological Evolution↗
PubMed2003

Prison construction and guarding behaviour by European honeybees is dependent on inmate small hive beetle density.

Increasing small hive beetle (Aethina tumida Murray) density changes prison construction and guarding behaviour in European honeybees (Apis mellifera L.). These changes include more guard bees per imprisoned beetle and the construction of more beetle prisons at the higher beetle density. Despite this, the number of beetles per prison (inmate density) did not change. Beetles solicited food more actively at the higher density and at night. In response, guard bees increased their aggressive behaviour towards beetle prisoners but did not feed beetles more at the higher density. Only 5% of all beetles were found among the combs at the low density but this percentage increased five-fold at the higher one. Successful comb infiltration (and thus reproduction) by beetles is a possible explanation for the significant damage beetles cause to European honeybee colonies in the USA.

Aggression↗
PubMed1996

Adaptation in a stochastic Prisoner's Dilemma with delayed information.

Players in a Prisoner's Dilemma are modeled as learning automata that receive feedback from the environment and coadaptively adjust their strategies. Theory and simulations show the coevolutionary dynamics of the reward-inaction and reward-penalty schemes. The players are assumed to be physically distributed or, at least, in an environment where the effects of decisions are lagged. These systems include biological and social systems with constraints on instantaneous information or where environmental responses do not necessarily reflect the true state of the system. Linear stability analysis determines the conditions for persistent oscillations in the players' mixed strategies. Using a parameterized stochastic version of the dilemma, the results indicate that if the environment modifies the payoffs, and thus 'releases' the prisoners from their dilemma, the prisoners become prone to instabilities in their strategies given sufficient delays. Again, the prisoners fail to coordinate their actions.

Biological Evolution↗
PubMed2006

Evolutionary escape from the prisoner's dilemma.

The classic prisoner's dilemma model of game theory is modified by introducing occasional variations on the options available to players. Mutation and selection of game options reliably change the game matrix, gradually, from a prisoner's dilemma game into a byproduct mutualism one, in which cooperation is stable, and "temptation to defect" is replaced by temptation to cooperate. This result suggests that when there are many different potential ways of interacting, exploring those possibilities may make escape from prisoner's dilemmas a common outcome in the world. A consequence is that persistent prisoner's dilemma structures may be less common than one might otherwise expect.

Animals↗
PubMed2000

Antiretroviral prescribing patterns in the texas prison system.

PURPOSE: Although prison inmates are reported to exhibit substantially elevated rates of HIV infection, little is known about HIV treatment patterns, particularly pharmacotherapy, in correctional institutions. The purpose of the present study, therefore, was to describe antiretroviral prescribing patterns in one of the nation's largest prison populations.METHODS: The study population consisted of all known (n = 2,360) HIV-infected inmates incarcerated in the Texas prison system in 1998. Information on medical conditions, sociodemographic factors, and pharmacotherapy was obtained from an institution-wide medical information system. Inmates who received more than one type of pharmacotherapy in 1998 were included in the appropriate number of categories.RESULTS: In 1998, 66.8 percent (95% CI = 64.0-69.4) of all HIV-infected inmates with CD4 counts below 500 were treated with highly active antiretroviral therapy (HAART); and 31.1 percent (95% CI = 29.3-33.0) were given no antiretroviral therapy. Logistic regression results showed that HAART treatment decreased monotonically as a function of patient CD4 count category.CONCLUSIONS: A substantial proportion of HIV-infected TDCJ inmates were placed on therapies that were not consistent with the generally recommended DHHS guidelines for their disease stage. It will be important to for future investigations to assess whether such patterns continue to exist among prison populations, and to assess the determinants of these patterns.

Journal Article↗
PubMed1998

Working memory constrains human cooperation in the Prisoner's Dilemma.

Many problems in human society reflect the inability of selfish parties to cooperate. The "Iterated Prisoner's Dilemma" has been used widely as a model for the evolution of cooperation in societies. Axelrod's computer tournaments and the extensive simulations of evolution by Nowak and Sigmund and others have shown that natural selection can favor cooperative strategies in the Prisoner's Dilemma. Rigorous empirical tests, however, lag behind the progress made by theorists. Clear predictions differ depending on the players' capacity to remember previous rounds of the game. To test whether humans use the kind of cooperative strategies predicted, we asked students to play the iterated Prisoner's Dilemma game either continuously or interrupted after each round by a secondary memory task (i.e., playing the game "Memory") that constrained the students' working-memory capacity. When playing without interruption, most students used "Pavlovian" strategies, as predicted, for greater memory capacity, and the rest used "generous tit-for-tat" strategies. The proportion of generous tit-for-tat strategies increased when games of Memory interfered with the subjects' working memory, as predicted. Students who continued to use complex Pavlovian strategies were less successful in the Memory game, but more successful in the Prisoner's Dilemma, which indicates a trade-off in memory capacity for the two tasks. Our results suggest that the set of strategies predicted by game theorists approximates human reality.

Biological Evolution↗
PubMed2002

Individual variation evades the prisoner's dilemma.

BACKGROUND: The Prisoner's Dilemma (PD) is a widely used paradigm to study cooperation in evolutionary biology, as well as in fields as diverse as moral philosophy, sociology, economics and politics. Players are typically assumed to have fixed payoffs for adopting certain strategies, which depend only on the strategy played by the opponent. However, fixed payoffs are not realistic in nature. Utility functions and the associated payoffs from pursuing certain strategies vary among members of a population with numerous factors. In biology such factors include size, age, social status and expected life span; in economics they include socio-economic status, personal preference and past experience; and in politics they include ideology, political interests and public support. Thus, no outcome is identical for any two different players. RESULTS: We show that relaxing the assumption of fixed payoffs leads to frequent violations of the payoff structure required for a Prisoner's Dilemma. With variance twice the payoff interval in a linear PD matrix, for example, only 16% of matrices are valid. CONCLUSIONS: A single player lacking a valid PD matrix destroys the conditions for a Prisoner's Dilemma, so between any two players, PD games themselves are fewer still (3% in this case). This may explain why the Prisoner's Dilemma has hardly been found in nature, despite the fact that it has served as a ubiquitous (and still instructive) model in studies of the evolution of cooperation.

Analysis of Variance↗
PubMed2006

Initiation of opiate addiction in a Canadian prison: a case report.

BACKGROUND: In North America, the harms of illicit drug use have been responded to primarily through law enforcement interventions. This strategy has resulted in record populations of addicted individuals being incarcerated in both Canada and the United States. The incarceration of non-violent drug offenders has become increasingly controversial as studies demonstrate the harms, including elevated HIV risk behavior, of incarcerating injection drug users. Other harms, such as the initiation of illicit drug use by prison inmates who previously did not use drugs, have been less commonly described. CASE PRESENTATION: We report on the case of an individual who initiated non-injection opiate use in a Canadian prison and developed an addiction to the drug. Upon release into the community, the individual continued using opiates and sought treatment at a clinic. The patient feared that he might initiate injection use of opiates if his cravings could not be controlled. The patient was placed on methadone maintenance therapy. CONCLUSION: While anecdotal reports indicate that initiation in prison of the use of addictive illicit substances is frequent, documentation through clinical experience is rare, and the public health implications of this behavior have not been given sufficient attention in the literature. Strategies of incarcerating non-violent drug offenders and attempting to keep illicit drugs out of prisons have not reduced the harms and costs of illicit drug use. Effective, practical alternatives are urgently needed; expanded community diversion programs for non-violent drug offenders deserve particular attention.

Journal Article↗
PubMed1998

HIV Seroprevalence and Risk Factors in a Brazilian Prison.

The burden of the AIDS epidemic in Brazil is characterized by high prevalence rates in specific groups, including prison populations. Reports o HIV seroprevalence rates from several, prisons in different countries have varied widely. Those rates have usually reflected the HIV seroprevalence in the community served by the correctional facility studied and the risk factors of inmates for HIV infection. The present study was designed: 1) to determine the HIV seroprevalence among inmates of Casa de Detenção de São Paulo; 2) to identify independent risk factors for HIV acquisition; and 3) to determine the relevance of transmission of HIV infection within the prison. From December 20, 1993, through January 5, 1994, 780 inmates were interviewed using a standardized questionnaire and had their blood drawn for HIV testing by ELISA with confirmatory Western Blot. Out of 766 inmates tested, 637 (83.1%) were negative for HIV, 105 (13.7%) were positive, and 24 (3.1%) had indeterminate test results. Multivariate logistic regression analysis identified the following variables as independent risk factors for HIV seropositivity: 1) age less than 29 years-old; 2) previous incarceration in Casa de Detençã; 3) more than one sexual partner in the last year in Casa de Detençã; and 4) intravenous drug use before admission to Casa de Detençã. We conclude from this study that HIV infection among prisoners is high (13.7%) and that several risk factors are responsible. Of these, intravenous drug use before imprisonment is the most likely factor, but HIV transmission can also occur during incarceration.

Journal Article↗
PubMed2002

Psychiatric morbidity in children remanded to prison custody-a pilot study.

Of the 1680 boys aged 15 and 16 remanded into prison custody in England and Wales during 1999, approximately 40% had histories of being "looked after". It is known that "Looked after" children in the community have very high rates of psychiatric disorder. This pilot study aimed to establish the psychiatric morbidity in children remanded to prison custody using an age appropriate instrument, the K-SADS. The 19 boys interviewed showed high rates of affective disorders, substance misuse and conduct disorder. As hypothesized those who had been "looked after" had significantly higher rates. This study highlights the need to develop child and adolescent mental health services for children in prison.

Adolescent↗
PubMed2005

Estimating drug treatment needs among state prison inmates.

Growing prison populations in the U.S. are largely due to drug-related crime and drug abuse. Yet, relatively few inmates receive treatment, existing interventions tend to be short-term or non-clinical, and better methods are needed to match drug-involved inmates to level of care. Using data from the 1997 Survey of Inmates in State Correctional Facilities, a nationally representative sample of 14,285 inmates from 275 state prisons, we present a framework for estimating their levels of treatment need. The framework is drawn partly from the American Society of Addiction Medicine Patient Placement Criteria and other client matching protocols, incorporating drug use severity, drug-related behavioral consequences, and other social and health problems. The results indicate high levels of drug involvement, but considerable variation in severity/recency of use and health and social consequences. We estimate that one-third of male and half of female inmates need residential treatment, but that half of male and one-third of female inmates may need no treatment or short-term interventions. Treatment capacity in state prisons is quite inadequate relative to need, and improvements in assessment, treatment matching, and inmate incentives are needed to conserve scarce treatment resources and facilitate inmate access to different levels of care.

Adult↗
PubMed2006

Development and evaluation of tuberculosis screening scores in Brazilian prisons.

BACKGROUND: Tuberculosis (TB) is highly endemic in Rio de Janeiro State prisons. In addition to TB screening at entry and passive case detection, active case identification may be warranted. OBJECTIVES: To develop and evaluate performances of scores aimed at identifying "tuberculosis suspects" in order to target TB screening among inmates. METHODS: Systematic chest X-ray screening was carried out in two prisons (n=1910). TB was diagnosed among individuals with X-ray abnormalities by sputum microscopic examination and culture or, if bacteriological results were negative, by response to TB treatment. Using this strategy as a reference, the clinical score proposed in WHO guidelines "TB Control in Prisons" was evaluated. Using the same variables in a logistic regression comparing TB and non-TB cases, another score was developed and evaluated. Finally, a 'new score', based on socio-demographic and clinical variables was developed and evaluated. RESULTS: When applied to our study population (prevalence of active TB: 4.6%), these scores missed many TB cases (sensitivities: 56%, 72%, 74%, respectively). Among the "TB suspects", the probability of finding TB cases was low (positive predictive value: 10%). The scores had high negative predictive values (>97%); specificities (75%, 60%, 67%) were low. Performances were similarly poor for smear-negative and smear-positive cases. CONCLUSION: The scores investigated performed poorly and would be unhelpful to target TB screening. Therefore, systematic X-ray screening may be considered, at least during the initial stages of the reinforced TB programme, in order to reduce the impressive burden of TB.

Adult↗
PubMed2004

Cost effectiveness of hepatitis A/B versus hepatitis B vaccination for US prison inmates.

Hepatitis B immunization is provided in many US prison systems. We examined the cost effectiveness of substituting bivalent hepatitis A/B vaccine in this setting, considering regional variation in hepatitis A risks and the potential for disease transmission by former prisoners. Where hepatitis A rates are >200, 100-200, and <100% the national average, declines in hepatitis A treatment costs would offset 137, 88, and 40% of the bivalent vaccine's added cost. In the three regions considered, cost effectiveness would be US$ <0, 2131, and 22,819 per life-year saved, respectively. Prison-based hepatitis A/B immunization would meet accepted standards of cost effectiveness throughout the US.

Adult↗
PubMed2003

Young male prisoners in a Young Offenders' Institution: their contact with suicidal behaviour by others.

Prison suicide rates are increasing. The impact of witnessing a suicide or how many people do so is unknown. The aim of this study was to find how many young people detained in a Young Offenders' Institution (YOI) have had contact with another's suicide attempt and to test for association between this and own self-harming behaviour. A questionnaire, developed for the project, was distributed within a YOI. 74% (355/480) responded. One hundred and fifty-one (43%) of the young men reported that they knew someone who had attempted suicide, 48 of them knowing someone who had thereby died. The contact with a non-fatal suicide attempted by others was associated with own self-harm (OR 1.73, CI 1.39-21.4, p<0.01); contact with completed suicide had no such association. The most important factor that increased the chance of knowing a suicide attempter was actual length of time spent in prison up to the time of the study; 95 (63%) of the young men with such contact had it in prison. No other significant vulnerability factors were identified. It seems likely that imprisonment is a specific vulnerability factor for self-harm, one explanation being that it increases the risk of exposure to a contact with suicidal behaviour by others. Further work is called for to test relationships between such exposure and own behaviour over time, and to gather first hand accounts from the young men in such circumstances in order to understand the meaning for them of the contact with suicidal behaviour by others. This would inform appropriate intervention strategies, and could save much morbidity, and even mortality.

Adolescent↗
PubMed2003

The relevance of suicidal behaviour in jail and prison suicides.

PURPOSE: Suicide rates in correctional institutions have been increasing during the last decades. There has been little interest in whether suicidal ideation and intent has been documented by non-medical prison staff (reports of attempted suicide, suicide threats, self-harm), and whether these signs of suicidality had the consequence of adequate intervention efforts. METHODS: The personal files of inmates who committed suicide in the 29 Austrian jails and prisons during the last 25 years (1975-1999) were included. We analysed personal characteristics, criminological data, circumstances of custody and information about psychiatric disorders and treatment. RESULTS: Of a total of 250 suicides, 220 personal files were available and included. Suicide attempts were known in 50% of all suicides and 37% had expressed suicidality. In >20%, non-medical staff had documented signs of suicidality, but no further preventive action (e.g. referral to psychiatric care) had taken place. CONCLUSION: Signs of suicidality play an important role in vulnerability profiles for jail and prison suicides and should have the minimal consequence of further psychiatric care.

Adult↗
PubMed2000

Health, place and British prisons.

This short communication considers people's health care needs in prison. It shows that people have a wide range of health care needs that are not always met when they spend time in prison. To locate these issues the paper draws on the "patient or prisoner" debate to understand the challenges that face future policies.

England↗