Convicted drug offenders who are denied government food benefits upon release from prison are at greater risk of engaging in dangerous, sexual risk behaviors in order to obtain food, Yale researchers have found. Their pilot study appears in the journal AIDS Education and Prevention.

Each year, nearly three-quarters of a million people are released from U.S. prisons. Many are already highly vulnerable to homelessness, HIV infection, and hunger due to uncertainty about how to find and pay for food (known as “food insecurity”).

Making matters worse, many individuals convicted of drug felonies are banned for life by a 1996 federal law from obtaining food assistance via the Supplemental Nutrition Assistance Program (SNAP), formally known as food stamps, and Temporary Assistance for Needy Families (TANF), formerly known as Aid to Families with Dependent Children. States were allowed to opt out of the federal law. Only 16 states and the District of Columbia did; 24 others implemented a modified version of the ban; 10 kept it fully in place for life, even for mothers and women who are pregnant.

A possible result of this policy is that many released drug offenders, particularly women and mothers, are turning to prostitution and other behaviors that put them at risk for HIV and other negative outcomes in order to obtain food.

The Yale researchers worked in collaboration with All of Us or None, a California organization that fights discrimination against current and former inmates and their families, to study the link between food insecurity and sexual risk behaviors among returning prisoners. They surveyed 110 individuals recently released from prisons in Connecticut and California, which have partial bans, and Texas, which has an outright, mandatory lifetime ban on food assistance for drug convicts.

Some of their findings were:

91 percent reported themselves as “food insecure.”

37 percent did not eat for an entire day in the past month, which is food insecurity in its most severe form; they were more likely to use heroin, cocaine, or alcohol before sex, and were more likely to exchange sex for money than those who had at least one meal each day.

61 percent did not receive food assistance benefits, and those who did reported receiving insufficient benefits.

38 percent of women living with children did not eat for a day in the past month.

25 percent of women living with children reported their children not eating for a day in the past month.

This is the first study to examine the association between food insecurity and sexual risk behaviors specifically among former inmates. “These individuals are incredibly vulnerable when they are released from prison. If they cannot get government food assistance, they are much more likely to be hungry and thus engage in dangerous sexual behavior in exchange for money or food for themselves and their children,” said first author Dr. Emily Wang, assistant professor of internal medicine at Yale School of Medicine.

The New York Times recently published an editorial suggesting that the federal food stamp ban be eliminated. It reads, in part, “… it is already clear that the bans are counterproductive and that it is time for states that have not completely lifted them to do so.”

Other authors are Gefei Zhu of Yale and Stanford, Amy Carroll-Scott and Lynn Fiellin of Yale; Linda Evans of All of Us or None; and Rani Desai of the West Haven Veterans Administration Medical Center.

The study was supported by Yale’s Center for Interdisciplinary Research on AIDS, through a grant from the National Institute of Mental Health (Grant # P30 MH 62294).

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