HIV Epidemiology in Corrections Corrections Curriculum Development: Module 1 Albany Medical College Division of HIV Medicine

Data Source for this Module Unless otherwise noted, data in this module is from an HIV report from the U.S. Department of Justice, Bureau of Justice StatisticsUnless otherwise noted, data in this module is from an HIV report from the U.S. Department of Justice, Bureau of Justice Statistics The Bureau of Justice Statistics is the statistical agency of the U.S.Department of Justice.The Bureau of Justice Statistics is the statistical agency of the U.S.Department of Justice. Report name: HIV in Prisons, October 2002, NCJ (Statistician: Laura M. Maruschak)Report name: HIV in Prisons, October 2002, NCJ (Statistician: Laura M. Maruschak)

General Corrections Overview As of June 30, 2002: 2,019,234 inmates were held in Federal or State prisons or in local jails.2,019,234 inmates were held in Federal or State prisons or in local jails. There were an estimated 474 prison inmates per 100,000 U.S. residents. This is up from 292 at the end of 1990.There were an estimated 474 prison inmates per 100,000 U.S. residents. This is up from 292 at the end of The number of women under the jurisdiction of State or Federal prison authorities increased 1.9% from June 30, 2001 to June 30, 2002, reaching 96,099.The number of women under the jurisdiction of State or Federal prison authorities increased 1.9% from June 30, 2001 to June 30, 2002, reaching 96,099. The number of men rose 1.4%, totaling 1,330,019 at midyear 2002.The number of men rose 1.4%, totaling 1,330,019 at midyear Prison and Jail Inmates at Midyear 2002, BJS

General Corrections Overview (con’t) At the end of 2001 there were: 3,535 sentenced black male inmates per 100,000 black males in the United States3,535 sentenced black male inmates per 100,000 black males in the United States 1,177 sentenced Hispanic male inmates per 100,000 Hispanic males1,177 sentenced Hispanic male inmates per 100,000 Hispanic males 462 white male inmates per 100,000 white males.462 white male inmates per 100,000 white males. Prison and Jail Inmates at Midyear 2002, BJS

HIV-infected Inmates in U.S. Prisons & Jails On December 31, 2000, 2.2% of State prison inmates, and 0.8% of Federal prison inmates were known to be infected with HIV.On December 31, 2000, 2.2% of State prison inmates, and 0.8% of Federal prison inmates were known to be infected with HIV. At the end of 2000, 25,088 inmates in State and Federal prisons were known to be HIV-infected, down from 25,801 in 1999.At the end of 2000, 25,088 inmates in State and Federal prisons were known to be HIV-infected, down from 25,801 in State prison inmates = 24,074, Federal inmates = 1,014State prison inmates = 24,074, Federal inmates = 1,014 Between 1995 and 2000 the number of HIV-positive inmates grew at a slower rate (3%) than the overall prison population (16%).Between 1995 and 2000 the number of HIV-positive inmates grew at a slower rate (3%) than the overall prison population (16%).

Women versus Men with HIV Infection There are a greater percent of females than males with HIV infection in the incarcerated population.There are a greater percent of females than males with HIV infection in the incarcerated population. Overall, 2.2% of male inmates and 3.6% of all female inmates were known to be HIV-infected.Overall, 2.2% of male inmates and 3.6% of all female inmates were known to be HIV-infected. On December 31, 2000, there were 19,935 male inmates and 2,243 female inmates in State prisons known to be HIV-infected.On December 31, 2000, there were 19,935 male inmates and 2,243 female inmates in State prisons known to be HIV-infected. The rate of HIV infection is higher among females than among males in all regions and in most States.The rate of HIV infection is higher among females than among males in all regions and in most States.

Confirmed AIDS Cases in U.S. Prison & Jails Confirmed AIDS Cases in U.S. Prison & Jails In every year since 1991, the rate of confirmed AIDS has been higher among prison inmates than in the general population.In every year since 1991, the rate of confirmed AIDS has been higher among prison inmates than in the general population. At year end 2000 the rate of confirmed AIDS in State and Federal prisons was about 4 times higher than in the total U.S. population.At year end 2000 the rate of confirmed AIDS in State and Federal prisons was about 4 times higher than in the total U.S. population. About 52 in every 10,000 prison inmates had confirmed AIDS, compared to 13 in 10,000 persons in the U.S. general population.About 52 in every 10,000 prison inmates had confirmed AIDS, compared to 13 in 10,000 persons in the U.S. general population. The number of confirmed AIDS cases in U.S. prisons decreased during 2000The number of confirmed AIDS cases in U.S. prisons decreased during 2000

Confirmed AIDS Cases in U.S. Prisons & Jails (con’t) At the end of 2000, 5,528 inmates in U.S. prisons had confirmed AIDS, down from 6,642 in 1999.At the end of 2000, 5,528 inmates in U.S. prisons had confirmed AIDS, down from 6,642 in Among those with confirmed AIDS, 5,230 were in State prisons and 298 were in Federal prisons.Among those with confirmed AIDS, 5,230 were in State prisons and 298 were in Federal prisons.

AIDS-Related Mortality The number of State inmates who died of Pneumocystis carinii pneumonia, Kaposi’s sarcoma, or other AIDS-related diseases peaked in 1995 and has been steadily decreasing.The number of State inmates who died of Pneumocystis carinii pneumonia, Kaposi’s sarcoma, or other AIDS-related diseases peaked in 1995 and has been steadily decreasing. AIDS-related deaths in State prisons have dropped by more than 80% since 1995.AIDS-related deaths in State prisons have dropped by more than 80% since After being the second leading cause of death since 1991, AIDS-related illnesses are now the third leading cause of death in State prisons following deaths due to natural causes (2,139), and suicides (185).After being the second leading cause of death since 1991, AIDS-related illnesses are now the third leading cause of death in State prisons following deaths due to natural causes (2,139), and suicides (185). Dramatic decreases in AIDS-related mortality can be attributed to the advent of effective treatments for HIV disease.Dramatic decreases in AIDS-related mortality can be attributed to the advent of effective treatments for HIV disease.

AIDS-Related Mortality (con’t) Relative to the number of inmates, the District of Columbia had the highest rate of AIDS-related deaths (80 per 100,000), followed by New Jersey and Florida (67 per 100,000 inmates), New Hampshire and Connecticut (44 per 100,000), and Pennsylvania (35 per 100,000).Relative to the number of inmates, the District of Columbia had the highest rate of AIDS-related deaths (80 per 100,000), followed by New Jersey and Florida (67 per 100,000 inmates), New Hampshire and Connecticut (44 per 100,000), and Pennsylvania (35 per 100,000). In 1999 the AIDS-related death rate (20 per 100,000) was lower for State prisoners than for a comparable group in the general population (25 per 100,000).In 1999 the AIDS-related death rate (20 per 100,000) was lower for State prisoners than for a comparable group in the general population (25 per 100,000).

Concentration of HIV-infected Inmates Geographically HIV-infected inmates are concentrated in a small number of States. New York (6,000), Florida (2,640), and Texas (2,492) held the largest number of HIV-infected inmates.HIV-infected inmates are concentrated in a small number of States. New York (6,000), Florida (2,640), and Texas (2,492) held the largest number of HIV-infected inmates. New York held nearly a quarter of all inmates (6,000 inmates) known to be HIV-infected in the United States at the end of 2000.New York held nearly a quarter of all inmates (6,000 inmates) known to be HIV-infected in the United States at the end of The States with the largest number of confirmed AIDS cases were New York (1,100), Texas (922), Florida (768), and Maryland (325). Combined, these States held more than half of all confirmed AIDS cases in State prisons.The States with the largest number of confirmed AIDS cases were New York (1,100), Texas (922), Florida (768), and Maryland (325). Combined, these States held more than half of all confirmed AIDS cases in State prisons.

Concentration of HIV-infected Inmates Geographically (con’t) Within the Northeast, 5.2% of the prison population were known to be HIV-infected in 2000, followed by 2.3% in the South, 1.1% in the Midwest, and 0.9% in the West.Within the Northeast, 5.2% of the prison population were known to be HIV-infected in 2000, followed by 2.3% in the South, 1.1% in the Midwest, and 0.9% in the West. Three States (North Dakota, South Dakota, and Wyoming) reported 10 or fewer cases of HIV-positive inmates in their prisons.Three States (North Dakota, South Dakota, and Wyoming) reported 10 or fewer cases of HIV-positive inmates in their prisons. Virginia, with an increase of 220 HIV-positive inmates, reported the largest increase, followed by Maryland (up 178) and Alabama (up 136). New York, with 1,000 fewer HIV-infected inmates, reported the largest drop.Virginia, with an increase of 220 HIV-positive inmates, reported the largest increase, followed by Maryland (up 178) and Alabama (up 136). New York, with 1,000 fewer HIV-infected inmates, reported the largest drop.

Resources AIDS Education & Training Centers National Resource CenterAIDS Education & Training Centers National Resource Center AIDS Education Global Information System Education Global Information System Albany Medical College Division of HIV MedicineAlbany Medical College Division of HIV Medicine index.htm Bureau of Justice StatisticsBureau of Justice Statistics CDC National Prevention Information Network HIV Clinical Resource, New York State Department of Health AIDS Institute Johns Hopkins AIDS Service

Acknowledgments Douglas G. Fish, MD, Medical Director (Division of HIV Medicine, Albany Medical College)Douglas G. Fish, MD, Medical Director (Division of HIV Medicine, Albany Medical College) Minda J. Hubbard, MSN, ANP-C, Clinical Research Administrator (Division of HIV Medicine, Albany Medical College)Minda J. Hubbard, MSN, ANP-C, Clinical Research Administrator (Division of HIV Medicine, Albany Medical College) Peter J. Piliero, MD, Director of HIV Research (Division of HIV Medicine, Albany Medical College)Peter J. Piliero, MD, Director of HIV Research (Division of HIV Medicine, Albany Medical College) Sarah J. Walker, M.S. Correctional Education Coordinator (Division of HIV Medicine, Albany Medical College)Sarah J. Walker, M.S. Correctional Education Coordinator (Division of HIV Medicine, Albany Medical College) Abigail V. Gallucci, Director of AIDS Education (Division of HIV Medicine, Albany Medical College) Lester N. Wright, MD, MPH, Deputy Commissioner & Chief Medical Officer (New York State Department of Correctional Services) Charles J. Moehs, MD, MPH, Facility Medical Director (New York State Department of Correctional Services)