U.S. Department of Justice Office of Justice Programs Bureau of Justice Statistics Bulletin HIV in Prisons, 200 October 2002, NCJ 196023 revised 2/24/03 th ---------------------------------------------------------------- This file is text only without graphics and many of the tables. A Zip archive of the tables in this report in spreadsheet format (.wk1)and the full report including tables and graphics in .pdf format are available from: http://www.ojp.usdoj.gov/bjs/abstract/hivp00.htm This report is one in a series. More recent editions may be available. To view a list of all in the series go to http://www.ojp.usdoj.gov/bjs/pubalp2.htm# ----------------------------------------------------------------- ----------------------------------- Highlights HIV-positive and confirmed AIDS cases among inmates drop in 2000 * Between 1995 and 2000 the number of HIV-positive prisoners grew at a slower rate (3%) than the overall prison population (16%). * At yearend 2000, 3.6% of all female State prison inmates were HIV positive, compared to 2.2% of males. * During 2000, 18 States reported a decrease in the number of HIV-positive prisoners and 29 States reported an increase. * New York held nearly a quarter of all inmates (6,000 inmates) known to be HIV positive at yearend 2000. * Virginia with an increase of 220 HIV- positive inmates reported the largest increase, followed by Maryland (up 178) and Alabama (up 136). New York with 1,000 fewer HIV-positive inmates reported the largest drop. * The overall rate of confirmed AIDS among the Nation's prison population (0.52%) was about 4 times the rate in the U.S. general population (0.13%). * Among Federal inmates, 21 died from AIDS-related causes, up from 16 in 1999. * During 2000, Florida (48) and New Jersey (20) reported the most AIDS- related deaths. * In 1999 the AIDS-related death rate (20 per 100,000) was lower for State prisoners than for a comparable group in the general population (25 per 100, 000). ----------------------------------------- By Laura M. Maruschak BJS Statistician On December 31, 2000, 2.2% of State prison inmates, and 0.8% of Federal prison inmates were known to be infected with the human immunodeficiency virus (HIV). Correctional authorities reported that 24,074 State inmates and 1,014 Federal inmates were HIV positive. The number known to be HIV positive totaled 25,088 down from 25,801 at yearend 1999. Of those known to be HIV positive in all U.S. prisons at yearend 2000, 5,528 were confirmed AIDS cases, down from 6,642 in 1999. This was the first decrease in the number of confirmed AIDS cases since data collection started in 1991. Among State inmates, 0.6% had AIDS; among Federal inmates, 0.2%. During 2000, 174 State prisoners and 21 Federal prisoners died from AIDS-related causes. State prisons had the fewest AIDS- related deaths in 10 years -- less than a fifth of the number (1,010) recorded during the peak year in 1995. In 2000, 6% of State inmate deaths were attributed to AIDS, down from 32% in 1995. This report is based on the 2000 National Prisoners Statistics (NPS-1) and the 2000 Census of State and Federal Adult Correctional Facilities. Data from the NPS were provided by the departments of corrections in 50 States and the District of Columbia and by the Federal Bureau of Prisons. Data from the Census were provided by 1,504 facilities for June 30, 2000. Number of HIV-infected prison inmates at yearend 2000 down from 1999 At yearend 2000, 25,088 inmates in State and Federal prisons were known to be infected with the human immunodeficiency virus (HIV), down from 25,801 in 1999. Among State prison inmates, 24,074 were known to be HIV positive; among Federal inmates, 1,014. HIV-infected inmates were concentrated in a small number of States. New York (6,000), Florida (2,640), and Texas (2,492) held the largest number of HIV-positive inmates. These three States housed nearly half of all HIV-infected inmates in State prisons in 2000. HIV-positive inmates comprised 2.2% of the State prison population in 2000, down from 2.4% in 1995. In Federal prisons, HIV-positive inmates comprised 0.8% in 2000, the lowest rate since reporting began in 1991. Overall, the percent of the total prison population with HIV decreased from 2.1% in 1999 to 2.0% in 2000. Inmates in the Northeast had the highest rates of HIV infection Within the Northeast, 5.2% of the prison population were known to be HIV positive in 2000, followed by 2.3% in the South, 1.1% in the Midwest, and 0.9% in the West. New York had the highest percentage of inmates known to be HIV positive (8.5%), followed by Maryland (4.3%), and Florida (3.7%). Three States (North Dakota, South Dakota, and Wyoming) reported 10 or fewer cases of HIV-positive inmates in their prisons. In 2000 every reporting jurisdiction held at least one HIV-positive inmate. Six States reported that fewer than 0.5% of their inmate population were HIV positive. Between 1999 and 2000, 18 States reported a decrease in the number of HIV-positive inmates. The largest decrease was reported in New York -- 6,000 in 2000, down from 7,000 in 1999. Twenty-nine States reported an increase. The largest increases were reported in Virginia (up 220), Maryland (178), and Alabama (136). A greater percent of females than males with HIV infection On December 31, 2000, there were 19,935 male inmates and 2,243 female inmates in State prisons known to be HIV positive. Overall, 2.2% of male inmates and 3.6% of all female inmates were known to be HIV positive. The rate of HIV infection was higher among females than among males in all regions and in most States. New York reported the largest number of male and female HIV-positive inmates (5,400 and 600, respectively). The second largest number of HIV-positive male and female inmates were in Florida (2,269 and 371, respectively)followed by Texas (2,220 and 272, respectively). Four States (Maine, North Dakota, Hawaii, and Wyoming) reported having no HIV-positive female inmates. No State reported zero HIV-positive male inmates. In six States and the District of Columbia, more than 5% of all female inmates were known to be HIV positive. In two jurisdictions over 15% of all female inmates were known to be HIV positive the District of Columbia (41.0%) and New York (18.2%). New York (with 8.0%) was the only State with more than 5% of their male inmates known to be HIV positive. Number of HIV-positive female inmates rose during 2000 In States that did not provide a breakdown of the number of HIV cases by gender, estimates were made to provide comparable year-to-year data. Estimates were made using the distribution from the most recent year in which data were reported. Based on these yearend estimates, the number of HIV infected females increased from 2,402 to 2,472 during 2000. The number of infected male inmates decreased from 22,175 in 1999 to 21,894 in 2000. On average, from 1995 to 2000 the estimated number of male State prisoners infected with HIV increased annually by 0.7%; and the number of female prisoners by 2.1%. While the estimated number of both male and female HIV-positive inmates in State prisons has increased since 1995, the percentage of male HIV-positive inmates has remained nearly stable, fluctuating between 2.3% and 2.1%, and the percentage of female inmates has decreased from 4.0% in 1995 to 3.4% in 2000. The number of confirmed AIDS cases in U.S. prisons decreased during 2000 At the end of 2000, 5,528 inmates in U.S. prisons had confirmed AIDS, down from 6,642 in 1999. Among those with confirmed AIDS, 5,230 were in State prisons and 298 were in Federal prisons. Confirmed AIDS cases made up 0.6% of inmates in State prisons and 0.2% of those in Federal prisons. Of those known to be HIV-positive inmates, over a fifth had confirmed AIDS. The States with the largest number of confirmed AIDS cases were New York (1,100), Texas (922), Florida (768), and Maryland (325). Combined, these States held more than half of all confirmed AIDS cases in State prisons. Fifteen States reported having fewer than 10 confirmed AIDS cases in their prisons. New York (1.6%) reported the highest percentage of confirmed AIDS, followed by Connecticut (1.5%), Maryland (1.4%), and Massachusetts (1.3%). In 15 States, confirmed AIDS cases comprised 0.1% or less of State inmates. During 2000, 19 States and the District of Columbia reported a decrease in the number of confirmed AIDS cases. Excluding California which had 224 HIV/AIDS cases awaiting classification, Texas with a decrease of 72, had the largest drop in the number of confirmed AIDS cases, followed by New York (down 70). Sixteen States reported an increase in the number of confirmed AIDS cases, led by Washington up from 7 in 1999 to 74 in 2000. Because some States each year did not provide a breakdown of the number of HIV cases by type of HIV infection, estimates of the number of confirmed AIDS cases were made for those States to provide comparable year-to-year data. Based on yearly estimates, the number of confirmed AIDS cases decreased from 7,039 in 1999 to 6,520 in 2000. Overall, since 1995 the estimated number of confirmed AIDS cases has increased by 1,363. Rate of confirmed AIDS higher among prison inmates than U.S. general population In every year since 1991, the rate of confirmed AIDS has been higher among prison inmates than in the general population. At yearend 2000 the rate of confirmed AIDS in State and Federal prisons was about 4 times higher than in the total U.S. population. About 52 in every 10,000 prison inmates had confirmed AIDS, compared to 13 in 10,000 persons in the U.S. general population. About a third of prisoners with confirmed AIDS were held in 25 facilities Data on confirmed AIDS cases from the 2000 Census of State and Federal Adult Correctional Facilities was collected from 1,504 facilities. At midyear 2000, 25 facilities held nearly a third (1,995) of the 6,011 inmates with AIDS. The facility holding the largest number of inmates with confirmed AIDS was the Stiles Unit in Texas (452), followed by the Broad River Correctional Institution in South Carolina (217), the Central Florida Reception Center in Florida (140), and the Mohawk Correctional Facility in New York (111). These 4 facilities housed about 15% of all inmates with confirmed AIDS. Two facilities reported that more than 1 in 7 of their inmates had confirmed AIDS; Broad River Correctional Institution in South Carolina (21%) and Stiles Unit in Texas (16%). Nearly a quarter of HIV-positive prisoners were housed in medical treatment facilities The 2000 Census of State and Federal Adult Correctional Facilities identified 135 facilities that had medical treatment as either a primary or secondary function. These facilities held 4,662 inmates known to be HIV positive. Fifty-one percent of HIV-positive inmates in facilities that primarily function as a medical facility had confirmed AIDS; among those with HIV in facilities where medical treatment is a secondary function, 30% had confirmed AIDS. The majority of inmates known to be HIV positive were held in general population facilities. AIDS-related deaths in State prisons have dropped by more than 80% since 1995 The number of State inmates who died of Pneumocystis carinii pneumonia, Kaposis's sarcoma, or other AIDS-related diseases peaked in 1995 and has been steadily decreasing. Between 1995 and 2000 the number of AIDS-related deaths decreased from 1,010 to 174. AIDS-related deaths accounted for 6% of all deaths among State prisoners in 2000, down from 32% in 1995. With the introduction of protease inhibitors and combination antiretroviral therapies, there has been vast improvement in the quality and effectiveness in HIV/ AIDS care. After being the second leading cause of death since 1991, AIDS-related illnesses are now the third leading cause of death in State prisons following deaths due to natural causes (2,139), and suicides (185). Among Federal inmates, 21 died from AIDS- related causes up from 16 in 1999. In 2000 for every 100,000 inmates, 14 died from AIDS-related causes. These AIDS related deaths accounted for more than 7% of all deaths in Federal prison. Fewer deaths reported in all jurisdictions in 2000 compared to 1995 In 2000,for every 100,000 State inmates, 14 died from AIDS-related causes compared to 109 per 100,000 in 1995. The most AIDS deaths were reported in the South (91), followed by the Northeast (52). Together, these two regions accounted for more than three-quarters of AIDS-related deaths in State prisons. Florida reported the largest number of AIDS- related deaths (48), followed by New Jersey (20), and Pennsylvania (13). Twenty-four States reported having no AIDS-related deaths. Relative to the number of inmates, the District of Columbia had the highest rate of AIDS- related deaths (80 per 100,000), followed by New Jersey and Florida (67 per 100,000 inmates), New Hampshire and Connecticut (44 per 100,000), and Pennsylvania (35 per 100, 000). AIDS deaths as a percent of all deaths in State prison more than two and a half that in the general population The percentage of deaths because of AIDS is about 21/2 times higher in the prison population than in the U.S. general population age 15-54. In 1999 about 1 in every 9 prisoner deaths were attributable to AIDS-related causes compared to fewer than 1 in 20 deaths in the general population. AIDS death rate lower for State prisoners than for comparable general population Although AIDS deaths represent a higher percentage of all deaths among prisoners than in the general population, the rate of AIDS-related deaths (20 per 100,000) for State inmates in 1999 was significantly lower than the rate (25 per 100,000) for a comparable group in the general population. To compare death rates, a rate of death for a comparable population was estimated by weighting AIDS-related death rates in the general population by the percent of State prisoners in each gender and racial/ ethnic subgroup. A weighted average (24.6 per 100,000) was calculated by summing these weights. This average represents the rate of death due to AIDS for persons in the general population based on a similar composition of men and women, and whites, blacks, Hispanics, and persons of other races. 20 States and the Federal Bureau of Prisons test all inmates for HIV at admission or while in prison Data on HIV prevalence rates are reported in the National Prisoners Statistics series (NPS) by prison officials. The quality of the information reported may vary by the circumstances under which inmates were tested. Circumstances range from testing all inmates to testing only upon inmate request. Each State, the District of Columbia, and the Federal Bureau of Prisons test their inmates for HIV based on certain criteria. Most jurisdictions (51) test inmates if they have HIV-related symptoms or if the inmates request a test. Forty States and the Federal Bureau of Prisons test inmates after they are involved in an incident, and 15 States test inmates who belong to specific "high-risk groups." Missouri, Alabama, Nevada, and the Federal Bureau of Prisons test inmates upon their release. Arkansas, Georgia, Mississippi, South Carolina, and Nevada test all inmates currently in custody. Three States (New York, Virginia, and Oregon) and the Federal Bureau of Prisons test inmates selected at random. Since 1991 the number of jurisdictions reporting each testing policy has remained relatively stable with the exception on those testing based on involvement in an incident. In 2000 42 reported testing those involved in an incident, up from 20 in 1991. Methodology National Prisoner Statistics The National Prisoner Statistics series (NPS-1)includes yearend counts of prisoners by jurisdiction, gender, race, Hispanic origin, and admissions and releases during the year. The series consists of reports from the departments of corrections of the 50 States, the District of Columbia, and the Federal Bureau of Prisons. Since 1991 respondents have indicated the circumstances under which inmates are tested for HIV and have provided the number of HIV-infected inmates in their custody. Census of State and Federal Adult Correctional Facilities The 2000 Census of State and Federal Adult Correctional Facilities was the sixth enumeration of State institutions sponsored by the Bureau of Justice Statistics. Earlier censuses were completed in 1974, 1979, 1984, 1990, and 1995. The facility universe was developed from the 1995 census. Each department of corrections was contacted to identify new facilities and facilities that had been closed since June 30, 1995. Data were collected from all facilities, resulting in a final response rate of 100%. Facilities were included in the census if they had separate staffs; housed primarily State or Federal prisoners; were physically, functionally, and administratively separate; and operational on June 30, 2000. Overall, the census identified 84 Federal facilities, 1,295 State facilities, 22 facilities under State and local authority, 3 facilities operated by the District of Columbia, and 264 privately operated facilities. The census included the following types of adult correctional facilities: prisons and penitentiaries; boot camps; prison farms; reception, diagnostic, and classification centers; road camps, forestry and conservation camps; youthful offender facilities (except in California); vocational training facilities; prison hospitals; drug and alcohol treatment facilities; and State- operated local detention facilities (in Alaska, Connecticut, Delaware, Hawaii, Rhode Island, and Vermont). AIDS in the U.S. resident population The number of persons with confirmed AIDS in the U.S. general population (age 13 and over) was derived from the Centers for Disease Control and Prevention (CDC), HIV/AIDS Surveillance Report, yearend editions 1995-99. For each year the number of active AIDS cases in the United States was calculated by subtracting the number of cumulative AIDS deaths for people age 15 and older at yearend from the cumulative number of total AIDS cases for people age 13 and older at yearend as listed in the HIV/AIDS Surveillance Report. The rate of confirmed AIDS cases in the U.S. resident population was calculated by dividing the annual totals for individuals with AIDS by the population estimates for the U.S. resident population of individuals 13 and older. AIDS-related deaths in the United States The number of AIDS-related deaths for persons age 15-54 was derived from the CDC, HIV/AIDS Surveillance Report, yearend editions. Deaths in the U.S. population for persons age 15-54 were taken from the CDC, Monthly Vital Statistics Report, Vol. 42, No. 2(S); Vol. 43, No. 12; Vol. 43, No. 6(S); Vol. 45, No. 3(S); and Vol. 45, No. 11(S); and from CDC, National Vital Statistics Report, Vol. 47, No. 9; Vol. 47, No. 25; Vol. 48, No. 11; and Vol. 49, No. 8. AIDS-related deaths as a percentage of all deaths in the U.S. population were calculated by dividing the national estimate of AIDS deaths of persons age 15-54 by the national mortality estimates of persons age 15-54 in a given year. ---------------------------------------- The Bureau of Justice Statistics is the statistical agency of the U.S. Department of Justice. Lawrence A. Greenfeld is director. BJS Bulletins present the first release of findings from permanent data collection programs such as the National Prisoner Statistics. Laura M. Maruschak wrote this report, under the supervision of Allen J. Beck. Paige M. Harrison provided statistical review. Tom Hester and Tina Dorsey edited the report. Jayne Robinson prepared the report for publication. October 2002, NCJ 196023 ------------------------------------------- End of file 10/24/02 ih revised 2/24/03 th