Laura McTighe Co-Director Institute for Community Justice 21 S. 12 th Street, 7 th Floor Philadelphia, PA Confronting the Social Drivers of HIV Incidence in the US HIV and Incarceration: A Case Study

Laura McTighe | Institute for Community Justice | 21 S. 12 th Street, 7 th Floor, Philadelphia, PA | A Snapshot of HIV and Incarceration More than 1 in 100 people in the U.S. in prison are currently in prison. 1 1 in 31 people are currently in prison, on probation or on parole in prison, on probation or on parole. 2 people with HIV 1 in 7 people with HIV will pass through prison this year. 3 1 Pew Center on the States.(2008) “One in 100: Behind Bars in America 2008.”One in 100: Behind Bars in America Pew Center on the States. (2009)“One in 31: The Long Reach of American Corrections.”One in 31: The Long Reach of American Corrections 3 Spaulding AC, Seals RM, Page MJ, Brzozowski AK, Rhodes W, et al. (2009) “HIV/AIDS among Inmates of and Releases from US Correctional Facilities, 2006: Declining Share of Epidemic but Persistent Public Health Opportunity.” PLoS ONE 4(11): e7558. doi: /journal.pone

Laura McTighe | Institute for Community Justice | 21 S. 12 th Street, 7 th Floor, Philadelphia, PA | Two Crises, the Same Communities 1 in 9 Black men between the ages of 20 and 34 is in prison, but only 1 in 30 of the general population. Black men comprise only 13% of the population, but account for half of new HIV diagnoses. Since 1980, 8 times as many women are incarcerated. 75% of these women are mothers, two-thirds with children under the age of 18. More than 25% of people diagnosed with HIV are women. AIDS remains the leading cause of death among Black women ages 25 to The link among race, prison and HIV is so strong that it almost completely explains the disproportionate impact of HIV in the Black community. 4 4 Rucker C. Johnson & Steven Raphael. (2005) “The Effects of Male Incarceration Dynamics on AIDS Infection Rates Among Africa-American Women and Men.” S\ee Also: Robert Fullilove. (2006)“African Americans, Health Disparities and HIV/AIDS: Recommendations for Confronting the Epidemic in Black America.” National Minority AIDS Council.

Laura McTighe | Institute for Community Justice | 21 S. 12 th Street, 7 th Floor, Philadelphia, PA | Legislating HIV Vulnerability Just as the War on Drugs was gaining speed in the 1980s, the AIDS crisis broke. fueling the domestic AIDS epidemic The same policies that have built mass incarceration in the US have also become primary forces fueling the domestic AIDS epidemic. 4 4 Kevin Caplicki, Justseeds portfolio ‘Voices from Outside’

Laura McTighe | Institute for Community Justice | 21 S. 12 th Street, 7 th Floor, Philadelphia, PA | Community Health in a Time of Mass Incarceration 5 5 Relationship Instability Fractured Communities Loss of Caregivers Financial Instability Broken Family Ties Lack of Jobs Lack of Social Services Fractured Communities Arrest – Jail/Prison – Reentry Need for Services and Support

Laura McTighe | Institute for Community Justice | 21 S. 12 th Street, 7 th Floor, Philadelphia, PA | A Vision for Community Healing 6 6 Relationship Stability CommunityWholeness Family Support Financial Stability Family Reintegration Ready Employment Access to Social Services CommunityWholeness Arrest – Jail/Prison – Reentry Comprehensive Care and Support

Laura McTighe | Institute for Community Justice | 21 S. 12 th Street, 7 th Floor, Philadelphia, PA | Beyond Prison-Based Testing, Prevention and Care “We must remember… that incarceration itself —not just inadequate prevention and care behind bars— contributes substantially to the global burden of HIV, particularly among drug users and sex workers. In fact, we would argue that the single most important strategy stem the rate of incarceration itself single most important strategy in controlling HIV in prison is to stem the rate of incarceration itself.” 5 5 Duncan Smith-Rohrberg Maru, Sanjay Basu, & Frederick L Altice. (2007) "HIV control efforts should directly address incarceration.” The Lancet Infectious Diseases: Vol. 7 No Nicolas Lampert, Justseeds portfolio ‘Voices from Outside’

Laura McTighe | Institute for Community Justice | 21 S. 12 th Street, 7 th Floor, Philadelphia, PA | Structural Interventions for Preventing HIV and Incarceration In Communities:  Sentencing reform  Community policing  Prison budget reinvestment  Youth empowerment In Jail/Prison:  Harm reduction programs  Treatment education and advocacy  Good time earned time At Reentry:  Civic participation  Community-led mentoring  Job creation and retention  Housing expansion 8 8

Laura McTighe | Institute for Community Justice | 21 S. 12 th Street, 7 th Floor, Philadelphia, PA | ~thank you~ 9 9 Pete Yahnke, Justseeds portfolio ‘Voices from Outside’ contact: Laura McTighe Co-Director x402 (office) (cell)