There has been much concern about the sexual behavior of HIV-infected prisoners upon release. However, most studies have shown that after prisoners are released, their rates of unprotected sex are no different from that of the nonincarcerated HIV-positive population.

My colleagues and I have described how most HIV- infected men and women desire to return to their main partners after prison release and how a significant proportion appear to avoid sex altogether.

Perhaps more importantly, our research shows that prison release is associated with a deleterious effect on the health of these patients. Understanding the barriers to HIV screening (in and out of prison) and increasing access to medical care, employment and housing after release are the best strategies to maintain the health of released prisoners and to protect the public.

As you noted, studies are under way to improve our understanding of these issues in North Carolina. It is in this manner that we can best reduce any contribution former inmates make to the HIV epidemic in our state.

Becky L. White, M.D.

Assistant professor of medicine

University of North Carolina at Chapel Hill

Chapel Hill