Inmate Health - Hiv/aids

An HIV-positive person is infected with the Human Immunodeficiency Virus. HIV interferes with and eventually destroys the body's immune system. Once the late stage of the disease is reached, the person has Acquired Immune Deficiency Syndrome. AIDS is incurable and leads to death. HIV/AIDS is transmitted in sexual contact, through breast-feeding of babies by an infected mother, and by blood. A common pathway is the use of unclean needles when injecting drugs. HIV can be treated but not cured. A very small percentage of those infected turn out to be so-called "nonprogressors," indicating that their bodies are able to overcome the virus; they do not "progress" and acquire AIDS.

According to Maruschak in HIV in Prisons and Jails, 2002 (Bureau of Justice Statistics, December 2004), the number of HIV-positive inmates hit its highest level in 1999 (25,801). Since then, the numbers have been declining. In 2002, 23,864 prisoners were HIV-positive.

TABLE 6.6
Prevalence of major disease categories in the Texas prison system, 1997–98*
SOURCE: "Table 2. Prevalence of Major Disease Categories in the TDCJ Prison System," in The Disease Profile of Texas Prison Inmates, Department of Pediatrics, University of Texas Health Science Center at San Antonio, April 2002, http://www.ncjrs.org/pdffiles1/nij/grants/194052.pdf (accessed April 1, 2005)

	Overall (n = 170,215)		Males (n = 155,947)		Females (n = 14,268)
Disease	Frequency	Prevalence	Frequency	Prevalence	Frequency	Prevalence
Infective and parasitic disease	50,366	29.6	45,144	28.9	5,288	37.0
Neoplasms	1,239	0.7	1,116	0.7	123	0.9
Endocrine, metabolic, nutritional and allergic diseases	5,569	3.3	4,996	3.2	573	4.0
Diseases of the blood and blood-forming organs	838	0.5	731	0.5	107	0.8
Mental disorders	18,368	10.8	15,539	10.0	2,828	19.8
Diseases of the nervous system and sense organs	7,132	4.2	6,409	4.1	723	5.1
Diseases of the circulatory system	23,828	14.0	22,066	14.2	1,762	12.4
Diseases of the respiratory system	10,808	6.3	9,665	6.2	1,143	8.0
Diseases of the digestive system	10,034	5.9	9,045	5.8	989	6.9
Diseases of the genitourinary system	1,267	0.7	952	0.6	315	2.2
Diseases of the skin and subcutaenous tissue	4,114	2.4	3,745	2.4	369	2.6
Diseases of the musculoskeletal system and connective tissue	6,093	15.3	23,917	15.3	2,174	15.2
Congenital anomalies	689	0.4	652	0.4	37	0.3
*Prevalence estimates represent the percentage of inmates with a given disease during the study period

(See Table 6.7.) Nearly half of the HIV-positive prisoners were found in three states: New York (5,000), Florida (2,848), and Texas (2,528). Female prisoners had a higher HIV-positive rate (3%) than did male prisoners (1.9%).

Table 6.7 further shows that the prevalence of HIV infection was 1.9% among state and federal prisoners in 2002—2% among state prison inmates and 1.1% among federal prisoners. Among state prisoners, the percentage of those with HIV has dropped from a high of 2.3% in 1999. Among federal prisoners, the rate has varied from 0.9% to 1.1%. (See Table 6.8.) Confirmed AIDS cases were nearly 3.5 times higher in the prison population in 2002 than in the general public, 0.48% of prisoners and 0.14% of the general public. The differences between these two populations are narrowing. While the HIV rate among the general public has been slowly rising, from a low of 0.8% in 1995, the rate for prisoners has been dropping since 1999. (See Table 6.9.)

Higher Prevalence in Women

In 2002 women prisoners were more likely to be HIV-positive than male prisoners—2.9% of female inmates in state prisons, or 2,164 women, were found to be HIV-positive compared to 1.9% of male prisoners, or 20,273 men. (Table 6.10.) Between 1998 and 2002, the rate of infection for both male and female prisoners declined. For men, it fell from 2.2%, while for women, it fell from 3.8%. The New York prison system had the largest number of female HIV-positive inmates (410). Florida had 340, followed by Texas, with 267. Among federal prisoners in 2002, 1.2% of females (116 inmates) were HIV-positive. (See Table 6.11.)

Race and Ethnicity

While there are no recent figures for the race and ethnicity of those inmates who are HIV-positive in prison, the BJS has published data on the race and ethnicity of HIV-positive prisoners in the nation's jails. Table 6.12, from HIV in Prisons and Jails, 2002, shows that in 2002, 2.9% of Hispanic jail inmates, 0.8% of white inmates, and 1.2% of African-American inmates were HIV-positive. African-American females (3%) had the highest rate of infection, while white males (0.6%) had the lowest. The forty-five-and-older age group had the highest rate of HIV infection (2.7%), with the twenty-four-or-younger age group having the least (0.2%).