HIV Epidemiology in CorrectionsHIV Epidemiology in Corrections

Albany Medical CollegeAlbany Medical College

Division of HIV MedicineDivision of HIV Medicine

HIV Regional Resource CenterHIV Regional Resource Center

Updated January 2011

HIV Correctional Regional Resource Center

Data Source for this ModuleData Source for this Module

• Unless otherwise noted, data in this slide set is taken Unless otherwise noted, data in this slide set is taken directly from an HIV report from the U.S. Department of directly from an HIV report from the U.S. Department of Justice’s statistical agency, The Bureau of Justice Justice’s statistical agency, The Bureau of Justice Statistics (BJS).Statistics (BJS).

• Report name: Report name: HIV in PrisonsHIV in Prisons, 2007-2008, NCJ 228307, 2007-2008, NCJ 228307 (Statistician: Laura M. Maruschak)(Statistician: Laura M. Maruschak)   

• These slides include highlights taken directly from the These slides include highlights taken directly from the most recent HIV report available from the BJS most recent HIV report available from the BJS (December 2009). The full report may be obtained from (December 2009). The full report may be obtained from www.ojp.usdoj.gov/bjs www.ojp.usdoj.gov/bjs

General Corrections OverviewGeneral Corrections Overview

• On December 31, 2009, state and federal On December 31, 2009, state and federal correctional authorities had jurisdiction* over correctional authorities had jurisdiction* over 1,613,740 inmates (1,500,278 males and 1,613,740 inmates (1,500,278 males and 113,462 females)113,462 females)

• This was an increase of 3,981 inmates from This was an increase of 3,981 inmates from year end 2008.year end 2008.

Prisoners in 2009, BJS*Jurisdiction refers to the legal authority over aprisoner, regardless of where the prisoner is held.

General Corrections Overview General Corrections Overview (con’t)(con’t)

• This 0.2% increase marked the third consecutive This 0.2% increase marked the third consecutive year of slower growth in the U.S. prison population year of slower growth in the U.S. prison population and the smallest increase during the decade. and the smallest increase during the decade.

• From 2000 to 2008, the state prison population From 2000 to 2008, the state prison population increased by 159,200 prisoners, and violent offenders increased by 159,200 prisoners, and violent offenders accounted for 60% of this increase.accounted for 60% of this increase.

• The number of drug offenders in state prisons The number of drug offenders in state prisons declined by 12,400 over this period.declined by 12,400 over this period.

Prisoners in 2009, BJS

HIV-infected InmatesHIV-infected Inmates in U.S. Prisons in U.S. Prisons

• At year end 2008, a reported 21,987 inmates held in At year end 2008, a reported 21,987 inmates held in state or federal prisons were HIV positive or had state or federal prisons were HIV positive or had confirmed AIDS.confirmed AIDS.

• This accounts for 1.5% of the total custody This accounts for 1.5% of the total custody population.population.

• Among states that reported data in 2006 through Among states that reported data in 2006 through 2008, the number of inmates with HIV/AIDS was 2008, the number of inmates with HIV/AIDS was stable between 2007 and 2008.stable between 2007 and 2008.

Women versus Men Women versus Men with HIV Infectionwith HIV Infection

• There are a greater percent of females than There are a greater percent of females than males with HIV infection in the incarcerated males with HIV infection in the incarcerated population.population.

• At year end 2008, 1.5% (20,075) of male At year end 2008, 1.5% (20,075) of male inmates and 1.9% (1,912) of female inmates inmates and 1.9% (1,912) of female inmates held in state or federal prisons were HIV held in state or federal prisons were HIV positive or had confirmed AIDS.positive or had confirmed AIDS.

Women versus Men Women versus Men with HIV Infectionwith HIV Infection

• Among states reporting data in both 2007 and Among states reporting data in both 2007 and 2008, the number of males with HIV/AIDS 2008, the number of males with HIV/AIDS increased by 186 and the number of females increased by 186 and the number of females decreased 214.decreased 214.

• Florida (334) reported the largest number of Florida (334) reported the largest number of female inmates with HIV/AIDS, followed by New female inmates with HIV/AIDS, followed by New York (300),and Texas (249). Six states reported York (300),and Texas (249). Six states reported having zero female inmates with HIV/AIDS. having zero female inmates with HIV/AIDS.

  Confirmed AIDS Cases inConfirmed AIDS Cases in U.S. Prisons U.S. Prisons

• At year end of 2008, an estimated 5,733 state and federal inmates had confirmed AIDS.

• Confirmed AIDS cases made up 0.5% of inmates in Confirmed AIDS cases made up 0.5% of inmates in

state prison and 0.3% of inmates in federal prison.state prison and 0.3% of inmates in federal prison.

• Confirmed AIDS cases accounted for nearly a quarter Confirmed AIDS cases accounted for nearly a quarter (24%) of all HIV/AIDS cases in state and federal (24%) of all HIV/AIDS cases in state and federal prison.prison.

AIDS-Related MortalityAIDS-Related Mortality

• During 2007, the most recent year for which data on During 2007, the most recent year for which data on inmates deaths are available for state prisons,120 inmates deaths are available for state prisons,120 state inmates died from AIDS-related causes, down state inmates died from AIDS-related causes, down from an estimated 155 in 2006.from an estimated 155 in 2006.

• Of the 120 AIDS-related deaths among state inmate Of the 120 AIDS-related deaths among state inmate in 2007, 112 were males and 8 were femalesin 2007, 112 were males and 8 were females

• Florida (14) reported the largest number of AIDS-Florida (14) reported the largest number of AIDS-related deaths, followed by New York (11) and Texas related deaths, followed by New York (11) and Texas (10).(10).

AIDS-Related Mortality (con’t)AIDS-Related Mortality (con’t)

NP

S-1 = N

ational Prisoners S

tatistics - 1

DC

RP =

Deaths in C

ustody Reporting Program

Inmate Deaths in Federal Prisons by Cause (2007 & 2008)

HIV Testing in PrisonsHIV Testing in Prisons

• Appendix Table 5 in the BJS 2007-08 report provides Appendix Table 5 in the BJS 2007-08 report provides a breakdown of individual state’s testing policies. Go a breakdown of individual state’s testing policies. Go to www.ojp.usdoj.gov/bjsto www.ojp.usdoj.gov/bjs

• During 2008, a total of 24 states reported testing all During 2008, a total of 24 states reported testing all inmates for HIV at admission or sometime during inmates for HIV at admission or sometime during custody.custody.

• Among these 24 states, 23 tested prisoners at Among these 24 states, 23 tested prisoners at admission, 5 tested while in custody, and 6 tested admission, 5 tested while in custody, and 6 tested upon release. upon release.

HIV Testing in Prisons (con’t)HIV Testing in Prisons (con’t)

• All fifty states and the federal system tested inmates if All fifty states and the federal system tested inmates if they had clinical indication of HIV infection or if they they had clinical indication of HIV infection or if they requested an HIV test. requested an HIV test. 

• Forty-two states and the federal system tested inmates Forty-two states and the federal system tested inmates after they were involved in an incident in which an after they were involved in an incident in which an inmate was exposed to a possible HIV transmission. inmate was exposed to a possible HIV transmission.

• 18 states and the federal system tested inmates who 18 states and the federal system tested inmates who belonged to specific “high-risk” groups.belonged to specific “high-risk” groups.

Concentration of HIV-infected Concentration of HIV-infected Inmates GeographicallyInmates Geographically

• Florida (3,626), New York (3,500), and Texas (2,450) reported Florida (3,626), New York (3,500), and Texas (2,450) reported the largest number of inmates who were HIV positive or had the largest number of inmates who were HIV positive or had confirmed AIDS. confirmed AIDS.

• These three states account for 24% of the total state custody These three states account for 24% of the total state custody population, but 46% of the state custody population who were population, but 46% of the state custody population who were HIV positive or had confirmed AIDS.HIV positive or had confirmed AIDS.

• Appendix table 1 gives state-specific data. Go to Appendix table 1 gives state-specific data. Go to www.ojp.usdoj.gov/bjswww.ojp.usdoj.gov/bjs

ResourcesResources

• AIDS Education & Training Centers National Resource Centerwww.aids-ed.org

• AIDS Education Global Information System www.aegis.com

• Albany Medical College Division of HIV Medicinewww.amc.edu/hiv

• Bureau of Justice Statistics www.ojp.usdoj.gov/bjs

• CDC National Prevention Information Network www.cdcnpin.org

• HIV Clinical Resource, New York State Department of Health AIDS Institute www.hivguidelines.org

• Johns Hopkins AIDS Service

www.hopkins-aids.edu

AcknowledgmentsAcknowledgments

• Douglas G. Fish, MDMedical Director Division of HIV Medicine Albany Medical College

• Sarah J. Walker, M.S. Associate Director of Correctional EducationDivision of HIV MedicineAlbany Medical College

• Abigail V. GallucciDirector of AIDS EducationDivision of HIV MedicineAlbany Medical College

• Jim YbarraProject AssistantDivision of HIV MedicineAlbany Medical College