Carroll County Health Department has initiated an AIDS education and prevention program aimed at two groups of underserved county jail inmates: those who are at-risk for contracting the virus that causes AIDS and HIV-positive inmates who are in danger of spreading the disease to others.
A part-time community health nurse based at the Carroll County Detention Center will work with members of both groups on an individual basis to provide health assessments, prevention counseling and case-management services, said Debbie Middleton, the county's supervisor of communicable diseases.
The program, funded with a $22,000 grant from the Maryland AIDS Administration, began last month at the detention center. The initiative is an example of the redirection of state money from AIDS treatment to disease prevention, Middleton said.
"The focus now is on prevention," she said. "Not that we're neglecting those that are already positive, but if we do good prevention, the problem will decrease."
Middleton said 85 percent to 90 percent of the county's jail JTC population -- now about 140 -- has engaged in behavior that increases their chances of contracting the human immunodeficiency virus, such as substance abuse and having multiple sex partners. The homeless; sexual partners of substance abusers; and inmates who previously have had a sexually transmitted disease also are considered to be at risk for becoming infected with the virus that causes acquired immune deficiency syndrome.
Although the county jail has offered AIDS testing and education for several years, Middleton said this is the first time at-risk and infected inmates have been offered one-on-one prevention counseling and case management.
"A lot of people are incarcerated repeatedly because of their high-risk behavior," she said. "It's a population that needed to have some care."
Under the new program, a community health nurse will present an education program to all high-risk inmates at the jail. Then, inmates who choose to may participate in the program's assessment and case management component.
A detailed confidential assessment, performed by the community health nurse, addresses such topics as the inmate's employment history, involvement with the criminal justice system, drug and alcohol use and sexual behavior.
Based on the results of the assessment, the nurse will conduct individual counseling sessions with the inmate to focus on his or her particular needs. Discussions might focus on boosting self-esteem, solving problems and dealing with anger, as well as techniques for avoiding high-risk behavior.
"When people have good self-esteem, they make better decisions, and that's what a lot of this program is all about," Middleton said.
As part of case management, the nurse will try to connect the inmate to follow-up services upon release from the detention center. This may involve giving the inmate information about Alcoholics Anonymous meetings, or setting up an appointment with an appropriate social service agency.