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HIV Still a Major Health Threat in Prisons and Jails

Between 1995 and 1999, the death rate from AIDS in prisons and jails plummeted, and the rate of increase of HIV in prisons grew at about one third the rate of increase of the general prison population. That bit of good news, part of a July 2001 report by Laura M. Maruschak of the Bureau of Justice Statistics, is overshadowed by the generally grim news about HIV and AIDS among prisoners.

The report, HIV in Prisons and Jails, 1999 , surveys prisons and jails nationwide on the extent of the HIV/AIDS epidemic within prisons. The survey found that 3.4% of all female state prisoners were HIV positive, compared to 2.1% of all male prisoners. Also, the overall rate of confirmed AIDS cases among prisoners is five times greater than the rate among the nonincarcerated general population in the United States. And while the number of AIDS deaths in state prisons has fallen from 1,010 in 1995 (a rate of 100 deaths per 100,000 prisoners) to 242 in 1999 (20 deaths per 100,000), AIDS remains the second-leading cause of death for state prisoners, behind "Natural causes other than AIDS," and far ahead of suicide, accident, execution, and "by another person." AIDS is estimated to have caused nearly 11% of state prisoner deaths, 6% of federal prisoner deaths, and about 8% (1 in 12) of all jail deaths.

HIV/AIDS cases are clustered in a few states, but every state prison system reported at least 1 AIDS case. New York, Florida, and Texas were the three most-infected states, collectively accounting for one-half the HIV cases nationwide. Florida, California, New York, New Jersey, and Georgia led all states in reported AIDS deaths. The two regions of the country with the most HIV/AIDS cases are the Northeast and the South. The percentage of AIDS related deaths in state prisons is about twice the rate of AIDS-related deaths in the U.S. general population.

The dramatic decline in AIDS deaths from 1995 to 1999 is attributed to improved health care. The report fails to document the specific treatments HIV-infected prisoners receive or the general level of health care service in prisons.

State prison systems and the federal prison system vary widely in testing for HIV infection. Texas and Georgia have quite limited testing. In Georgia, for example, a prisoner is tested only upon his or her request.

Other states test frequently. Many states test all prisoners upon admittance to the system. Only three states _ Arkansas, Nevada, and South Carolina _ and the federal Bureau of Prisons test all prisoners in custody at least annually.

One copy of the report is free upon request. Write Bureau of Justice Statistics, Office of Justice Programs, U.S. Dept. of Justice, Washington, D.C. 20531. Ask for HIV in Prisons and Jails, 1999 , NCJ 187456, July 2001. The report may also be downloaded from the BJS web site at

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