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HIV and Incarcerated People: The Good, the Bad, and the Ugly

by Douglas Ankney

In June 2023, Prison Policy Initiative (PPI) reviewed data from the federal Bureau of Justice Statistics on HIV and people in America’s prisons, finding that infection rates for the virus—which has no cure—remain stubbornly higher behind bars, running three times the overall rate for all those living in the U.S.

There was some good news: The share of U.S. state and federal prisoners living with HIV continued a steady decline from its 1992 peak of 2.5% to 1.2% in 2016.

There was also bad news: Unfortunately, but not unsurprisingly, Black men are hit hardest by HIV and incarceration. Black people are overrepresented in prison, making up 14% of the total U.S. population but 33% of those imprisoned. Blacks are also much more likely to be infected with HIV, accounting for a whopping 40% of all those living with the virus. Prison mortality rates reflect these disparities: from 2016 through 2019, 114 prisoner deaths were recorded of people with HIV, and two-thirds of them—74, or 65%— were Black.

On top of that is an ugly trend: Thirty-five states now have laws criminalizing exposing someone to HIV. These laws are either “standalone” offenses or sentencing enhancements that increase a penalty simply because the person who committed the crime is HIV-positive. The result is that some states criminalize otherwise legal conduct “that cannot actually lead to transmission of the virus, resulting in charges and convictions based on HIV status alone.” In Florida, for example, it is generally not illegal to donate blood. But it’s a criminal offense if an HIV-positive person donates blood—even though extensive blood testing eliminates any likelihood that the blood would be used. From 1997 to 2020, at least 154 Floridians were incarcerated for HIV-related offenses. See: HIV in Prisons 2021, PPI (2023).  

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