nstructor-Led Education and Educational Materials

Seventy-one percent of State/Federal prison systems and 5 percent of
city/county jail systems reported that HIV/STD education was mandatory
for all incoming inmates; 20 percent of State/Federal but no city/county
systems reported mandatory HIV/STD education at release. Fifty-one
percent of State/Federal systems and 44 percent of city/county systems
reported voluntary HIV/STD education at release. The Illinois
Departments of Corrections and Public Health jointly planned a prerelease
HIV education and referral program being presented by existing prerelease
counselors and inmate peer educators who were specially trained to
provide these services in prerelease centers.

The smaller percentages of city/county systems with mandatory education
programs no doubt relate to the shorter lengths of stay and more rapid
turnover of inmates in jails as compared with those in prisons.

The validation study revealed some discrepancies regarding whether
educational sessions were mandatory. Substantial percentages of facilities
in systems with “mandatory” HIV/STD education at intake or release
reported that these sessions were not in fact mandatory for all inmates
(table16).

Table 17 shows the topics covered in HIV/STD education programs,
according to the 1997 NIJ/CDC survey results. Basic information on the
diseases and the meaning of test results tend to be covered in almost all
systems’ education programs. However, topics pertinent to behavioral-risk
reduction–including safer sex practices, negotiating safer sex, safer
injection practices, and triggers for behavioral relapse–are less commonly
included. These are the types of topics that are likely to be intensively
covered in multisession prevention programs.

Similarly, validation study results indicate that discrepancies between
central office and facility responses are most frequent on topics relating to
behavioral-risk reduction (see table 18). This may be because these topics
are more controversial. The left side of table 18 shows the extent of
agreement in systems reporting that the listed topic is covered in their
education programs. For example, in seven systems reporting that
negotiation skills for safer sex were included in their education, fewer than
half (45 percent) of facilities reported that this topic was in fact covered.
Conversely, in eight systems reporting that this topic was not covered in
HIV/STD education, half of the facilities reported that it was included.
Thus, some individual facilities are going beyond the educational topics
ostensibly prescribed by their central offices.

Table 19 shows the categories of providers of HIV/STD education and
prevention programs in correctional systems. Very few systems are using
security staff to conduct HIV/AIDS education, whereas the involvement of
public health departments, AIDS service organizations, and other
community-based organizations is widespread. This indicates an
increasing willingness on the part of correctional systems to permit outside
organizations to offer programs in their facilities.

Accessibility and understandability of educational programs and materials
are critical to their effectiveness with inmates. In this regard, issues of
language, literacy, and cultural competence are pertinent. Thirty-nine
percent of State/Federal prison systems and 49 percent of city/county jail
systems report offering HIV/STD educational sessions in Spanish. These
percentages remain virtually unchanged from the 1994 survey (39 percent
and 41 percent, respectively). Fifty-five percent of State/Federal systems
and 66 percent of city/county systems reported having HIV/STD
educational materials for Latinos. Forty-one percent of State/Federal
systems and 58 percent of city/county systems said they had materials
especially for African-Americans, and 84 percent and 70 percent,
respectively, reported having materials especially for women. Similar
percentages were reported in 1994. More attention should probably be
paid to the development and distribution of culturally appropriate
HIV/STD educational materials. The mean grade level of HIV/STD
materials used by reporting correctional systems was 6.4 (SD = 1.8),
which seems appropriate.

Three examples of instructor-led HIV/STD education and prevention
programs observed as part of site visits conducted for the NIJ/CDC survey
are presented in the following text boxes.