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Biomedical subjects

Jennifer G Clarke

Publications and source records attributed to Jennifer G Clarke.

12 recordsLinked to original sources
PubMed2006

Reproductive health care and family planning needs among incarcerated women.

OBJECTIVES: Women in correctional institutions have substantial reproductive health problems, yet they are underserved in receipt of reproductive health care. We assessed the level of risk for sexually transmitted diseases (STDs) and the reproductive health needs of 484 incarcerated women in Rhode Island to plan an intervention for women returning to the community. METHODS: We used a 45-minute survey to assess medical histories, pregnancy and birth control use histories, current pregnancy intentions, substance use during the past 3 months, histories of childhood sexual abuse, and health attitudes and behaviors. RESULTS: Participants had extremely high risks for STDs and pregnancy, which was characterized by inconsistent birth control (66.5%) and condom use (80.4%), multiple partners (38%), and a high prevalence of unplanned pregnancies (83.6%) and STDs (49%). Only 15.4% said it was not likely that they would have sexual relations with a man within 6 months after release. CONCLUSION: Reproductive health services must be offered to incarcerated women. Such interventions will benefit the women, the criminal justice systems, and the communities to which the women will return.

Adult↗
PubMed2006

Improving birth control service utilization by offering services prerelease vs postincarceration.

OBJECTIVES: We examined whether incarcerated women would substantially increase birth control initiation if contraceptive services were available within the prison compared with after their release back into the community. METHODS: During phase 1 of the study, a nurse educator met with women at the Rhode Island Adult Correctional Institute and offered them referrals for contraceptive services at a community health clinic after their release. During phase 2, contraceptive services were offered to women during their incarceration. RESULTS: The majority of the participants (77.5%) reported a desire to initiate use of birth control methods. Within 4 weeks of their release, 4.4% of phase 1 participants initiated use of a contraceptive method, compared with 39.1% of phase 2 participants (odds ratio [OR]=14.6; 95% confidence interval [CI]=5.5, 38.8). CONCLUSIONS: Provision of contraceptive services to women during their incarceration is feasible and greatly increases birth control initiation compared to providing services only in the community.

Adult↗
PubMed2006

Violence against women associated with arrests for sex trade but not drug charges.

The current study was designed to examine associations between gender-based violence and arrests due to sex trade or drug-related charges among a statewide sample of incarcerated women in Rhode Island. Incarcerated women were asked to participate in brief pre- and posttest surveys of their experiences of violence, sexual risk and substance use behaviors, as part of a study on the effectiveness of a family planning program in a state correctional facility; data from pretest surveys (N=447) were used for current analyses. Logistic regression analyses adjusted for demographics were used to assess significant associations between gender-based violence variables (i.e., adolescent intimate partner violence (IPV), adult IPV, childhood sexual assault (SA), adolescent SA, and adult SA) and arrests due to sex trade or drug-related charges. Significant relationships were observed between arrests for sex trade and adult SA (OR=2.1, 95%CI=1.2-3.6), adolescent IPV (OR=2.5, 95%CI=1.5-4.1), and adult IPV (OR=1.7, 95%CI=1.1-2.6); no significant associations were observed for drug-related charges. Findings from the current study demonstrate that experiences of gender-based violence are associated with arrests for sex trade but not drug-related charges. Interventions for incarcerated women are needed to consider and address history of victimization from gender-based violence and its relation to women's historic and future sex trade involvement.

Adolescent↗
PubMed2006

Pregnancy attitudes and contraceptive plans among women entering jail.

Unplanned pregnancies are an important and costly public health problem. Women entering jail are at particularly high risk for unplanned pregnancies when they leave jail, given the high rates of poverty, substance abuse and sexually transmitted infections (STIs) in this population, all of which are associated with unplanned pregnancies. Attitudes toward pregnancy vary substantially, influencing openness of incarcerated women to starting a birth control method. This study was conducted as part of a Title X service evaluation and examined varying attitudes towards pregnancy and associated plans to use contraceptives. The current study included 223 women entering jail who were, under 36 years of age, fertile, sexually active with men, and not planning to become pregnant in the near future. Nearly half of the women had negative pregnancy attitudes (PAs), indicating that they did not want to become pregnant, while 41.3% endorsed ambivalent PAs. Compared to those with ambivalent PAs, those with Negative PAs were more likely to report a previous unplanned pregnancy (90.6% vs. 75.4%), a previous pregnancy termination (40.0% vs. 22.8%), and recent consistent use of contraceptives (37.0% vs. 21.7%). Women with negative PAs were significantly more likely to want to start or to continue a birth control method compared to those with ambivalent PAs (66% vs. 47%). Tailoring services to women's specific pregnancy attitudes during periods of incarceration may aid in preventing unplanned pregnancies in populations of high-risk women.

Abortion, Induced↗
PubMed2005

Attitudes and practices regarding the use of methadone in US state and federal prisons.

In the United States, vigorous enforcement of drug laws and stricter sentencing guidelines over the past 20 years have contributed to an expanded incarcerated population with a high rate of drug use. One in five state prisoners reports a history of injection drug use, and many are opiate dependent. For over 35 years, methadone maintenance therapy has been an effective treatment for opiate dependence; however, its use among opiate-dependent inmates in the United States is limited. In June 2003, we conducted a survey of the medical directors of all 50 US states and the federal prison system to describe their attitudes and practices regarding methadone. Of the 40 respondents, having jurisdiction over 88% (n =1,266,759) of US prisoners, 48% use methadone, predominately for pregnant inmates or for short-term detoxification. Only 8% of respondents refer opiate-dependent inmates to methadone programs upon release. The results highlight the need to destigmatize the use of methadone in the incarcerated setting, expand access to methadone during incarceration, and to improve linkage to methadone treatment for opiate-dependent offenders who return to the community.

Drug Utilization↗
PubMed2005

Educational attainment but not literacy is associated with HIV risk behavior among incarcerated women.

PURPOSE: To identify the educational factors associated with HIV risk behaviors among incarcerated women. METHODS: We evaluated a cohort of female detainees at The Rhode Island Adult Correctional Institute between July and September 2004. Among the 423 women who participated in the study, 55% did not have a high school diploma, 29% had < or = 8th grade reading capacity, 32% had a learning disability, 37% had problem drinking, and 61% (257/423) reported HIV risk behavior. RESULTS: In multiple logistic regression, participants who had completed high school had the lowest likelihood of HIV risk behavior (adjusted odds ratio [OR] 0.35, 95% confidence interval [CI] 0.12-1.00). There was no association between participants? literacy level and HIV risk behavior (adjusted OR 2.02, 95% CI 0.83-4.92). CONCLUSIONS: Correctional education programs to reduce HIV risk behavior should focus on those with low educational attainment irrespective of literacy skills.

Adult↗
PubMed2005

Correlates of partner-specific condom use intentions among incarcerated women in Rhode Island.

CONTEXT: Few studies of incarcerated women have examined potential associations between risky sexual behavior and relationship context factors; thus, little is known about the correlates of intentions to use condoms with main and casual partners in this underserved population. METHODS: A sample of 221 women incarcerated in a Rhode Island Department of Corrections facility in 2002-2003 were interviewed. Multiple linear regression analysis was performed to assess associations between selected demographic, psychosocial and behavioral variables and participants' reported intentions to use condoms with main and casual sexual partners in the first six months after their release. RESULTS: Condom use at last sex with a main partner, sexually transmitted disease (STD) history, no strong desire to currently be pregnant, belief that others influence one's health and perceived STD risk were positively associated with women's intention to use condoms with main partners. Pregnancy history was negatively associated with intention to use condoms with a main partner. Condom use at last sex with a casual partner was positively associated with intention to use condoms with casual partners, whereas binge drinking and believing in the role of chance in determining one's health were negatively associated with intention to use condoms with casual partners. CONCLUSIONS: Whether incarcerated women define a partner as main or casual may influence their decisions about the need to protect themselves by using condoms. Programs that focus on the importance of condom use with all partners could greatly benefit incarcerated women and the communities to which they return.

Adult↗
PubMed2002

Human immunodeficiency virus in correctional facilities: a review.

It is estimated that up to one-fourth of the people living with human immunodeficiency virus (HIV) infection in the United States pass through a correctional facility each year. The majority of persons who enter a correctional facility today will return home in the near future. Most inmates with HIV infection acquire it in the outside community; prison does not seem to be an amplifying reservoir. How correctional health services deal with the HIV-infected person has important implications to the overall care of HIV-infected people in the community. Routine HIV testing is well accepted. Combination antiretroviral therapy has been associated with a reduction in mortality in prisons. A link between area HIV specialists and correctional health care providers is an important partnership for ensuring that HIV-infected patients have optimal care both inside prison and after release.

Community Health Services↗
PubMed2002

Microflora changes with the use of a vaginal microbicide.

BACKGROUND: The rate of HIV transmission is increasing more in women than in any other group. There is an urgent need for the development of microbicides with activity against this virus that women can use during intercourse. These products must be convenient, effective, and safe, and ideally they will cause minimal disruption in the normal vaginal ecosystem. GOAL: The objective of this study was to evaluate changes in vaginal microflora, specifically Lactobacillus species, with the use of BufferGel. STUDY DESIGN: A prospective cohort study was performed to evaluate the change in vaginal flora before and after BufferGel use. BufferGel was applied vaginally once or twice daily for 14 days by low-risk abstinent and monogamous women. RESULTS: There was no change in frequency of Lactobacillus species after BufferGel use. However, there was a decrease in H2O2-producing lactobacilli (from 4.9 x 107 to 1.1 x 107 cfu; P = 0.001). The proportion of facultative gram-negative rods present increased from 27% to 65% after BufferGel use, whereas obligately anaerobic microbes decreased from 62% to 38%. CONCLUSION: Use of BufferGel once or twice daily for 14 days resulted in no clinically significant change in Lactobacillus colonization.

Acrylic Resins↗
PubMed2002

Evaluating a lesbian and gay health care curriculum.

BACKGROUND: Many physicians are not prepared to deal with the health care concerns of their lesbian and gay patients. PURPOSE: To examine the impact of a seminar on the self-reported level of preparedness and comfort in dealing with lesbian and gay patients among general internal medicine residents. METHODS: General internal medicine residents at Rhode Island Hospital, Brown University participated in the 3-hr seminar. Residents voluntarily filled out preseminar and postseminar surveys measuring their self-reported level of preparedness and comfort in dealing with the health care, psychosocial, and sexual issues of lesbians and gay men. RESULTS: There was improvement in residents' self-reported level of preparation and comfort after the seminar. CONCLUSIONS: The results of the seminar are promising. Future evaluations of educational programs are needed to address whether improvements in preparation and comfort result in lasting changes and whether an educational intervention can improve the patient-physician interaction.

Curriculum↗
PubMed2002

Utilization of preventive health services by HIV-seronegative injection drug users.

Little is known about the use of preventive health services by HIV-seronegative IDUs. This study examines screening and preventive health services use by two populations of HIV-seronegative IDUs recruited from a needle exchange program and methadone program. We found high rates of HIV and tuberculin skin testing in the past year as well as tetanus vaccination among both groups of IDUs. Hepatitis B and C testing was significantly higher in the methadone group than the needle exchange group. Syphilis testing and pneumovax administration was disappointingly low in both groups. Given the burden of disease among IDUs, our findings suggest the need for a distinct set of testing and vaccination guidelines for the HIV-seronegative IDU population.

AIDS Serodiagnosis↗