The rate of HIV among prisoners is 5-7 times higher than among the general population.
It is estimated that approximately 150,000 HIV-infected persons (14% of all Americans with HIV) pass through correctional facilities each year.
Why this disparity?
For a large segment of the prison population, the conditions and behaviors that led to an HIV infection are exactly those that led to their incarceration (e.g. injection drug users, sex workers, victims of domestic abuse, those with mental illness, and those living in poverty). Another segment of inmates are infected with HIV during their sentence, via unprotected sex and needle sharing.
The Prison Process
Unjust and Discriminatory Incarceration
The United States contains five percent of
the world’s population, yet it holds twenty-
one percent of its inmates. The emphasis on
a “tough on crime” attitude that became
popular in political rhetoric throughout the
1980s and 1990s led to an unbelievable
increase in the number of people behind
bars. In 2010, America’s prisons housed more
than 2.2 million people, an increase of about
1.9 million when compared to the late 1970s.
However, since 1990, violent and property
crime rates have steadily decreased, yet the
prison population continues to increase
The “war on drugs” plays a significant role in
this phenomenon, and is not only largely
responsible for the increase in incarceration rates, but also for the racial disparities that are a product of the current criminal justice system. Men and women of color are disproportionately represented in the corrections system, as African Americans and Hispanics make up around 32% of the U.S. population and 56% of the prison population. African Americans, who are especially harmed by the current system, are imprisoned at more than 5 times the rate of whites.
Conditions Within Prisons
Upon release, prisoners face stigma and marginalization, which serves only to further deepen health disparities, as they are unable or become unwilling to access health and social support services. Many prisoners return home to sexual and needle-sharing partners, meaning that the risk of transmitting disease is high following release, making the issue of HIV within prisons a community problem.
Post-release planning should include support and education that encourages the reduction of risky sexual and injection drug-related behaviors, and ensures that HIV medication regimens are adhered to in the long-term.
Prisons and HIV
It is estimated that 3.8% of the global prison population is living with HIV. This rate of HIV among prisoners is 5 to 7 times that of the general population. HIV rates are highest among black prisoners.The correctional setting is often the first place incarcerated men and women are diagnosed with HIV and provided treatment. Inmates in jails and prisons across the United States, generally, do not receive health care that meets public health standards. In some facilities, prisoners with HIV have no confidentiality or privacy regarding their HIV status. They may be segregated and housed separately from other inmates, and may be blocked from some recreational activities and work assignments.
For many inmates, the behaviors and circumstances that contributed to their HIV infection are those that led to their incarceration (e.g., drug use, sex work, domestic abuse, mental illness, poverty). For others, infection with HIV occurred during incarceration via sex or sharing needles. Response to the critical need for health care interventions and prevention efforts in correctional facilities have a direct impact on the health of the communities to which prisoners return.
All graphics by Jaclyn Saik