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.
Mass Incarceration in the U.S.
As of 2017, there are more than 2.3 million people confined by the American criminal justice system, spread out among state prisons, federal prisons, juvenile correctional facilities, and local jails. Of this number, almost half a million are locked up because of a drug offense. Nonviolent drug convictions play a significant role at the federal level, and are less prevalent at the state and local level. However, most states continue to arrest people for drug possession, which destabilizes individual lives, families and communities subject to over-policing, and results in criminal records, reduced employment opportunities, stigmatization, and the possibility of longer sentences for future offenses.
Women in the Criminal Justice System
There are more than one million women behind bars in the United States. Since 1985, the number of women in the criminal justice system has increased at nearly double the rate of men, making women the fasting growing segment of the incarcerated population. Like the incarcerated population at large, women of color are overrepresented in the criminal justice system, with black women representing 13% of the general female population in the United States, and 30% of all incarcerated women. Additionally, Hispanic women represent only 11% of the general female population but make up around 16% of incarcerated women.
Among those in jail, African American women are more than twice as likely to be diagnosed with HIV than are white or Hispanic/Latino women. Drug use and HIV infection are more prevalent among women in prison than among men in prison, due mainly to the circumstances and behaviors that affect women in particular. For example, injection drug users and sex workers are overrepresented in the correctional system. Because women constitute a relatively small fraction of the prison population, they are often surrounded by facilities, programs, and services that have been tailored for men, even though their needs are often very different. Responding to the particular needs of incarcerated women involves developing alternatives to imprisonment to reduce overcrowding, the prevention of sexual violence, and expanding health services to match those of the community.
The Prison Process
#1.
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
exponentially.
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.
#2.
Conditions Within Prisons
#3.
Post-Release Planning
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.
