U.S. Department of Justice Office of Justice Programs Bureaus of Justice Statistics Bulletin HIV in Prisons, 2003 September 2005, NCJ 210344 -------------------------------------------------------------- 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/hivp03.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#hivpj -------------------------------------------------------------- By Laura M. Maruschak BJS Statistician ------------------------------------------------- Highlights Number of HIV-Infected inmates steadily decreasing since 1999 * Between 2002 and 2003 the number of HIV-positive prisoners decreased less than 1%, while the overall prison population grew 1.6% during the same period. * At yearend 2003, 2.8% of all female State prison inmates were HIV positive, compared to 1.9% of males. * During 2003, 29 States reported a decrease in the number of HIV-positive prisoners, and 14 States and the Federal system reported an increase. * New York held about a fifth of all inmates(5,000 inmates) known to be HIV positive at yearend 2003. * Florida, with an increase of 264 HIV-positive inmates, reported the largest increase, followed by the Federal system (up 84). New Jersey, with 99 fewer HIV-positive inmates, reported the largest drop. Rate of AIDS-related deaths in State prisons decreased in 2003 * The overall rate of confirmed AIDS among the prison population (0.51%) was more than 3 times the rate in the U.S. general population (0.15%). * In 2003, 282 prisoners died from AIDS-related causes -- 268 State inmates and 14 Federal inmates. * The number of AIDS-related deaths in State prisons decreased 73% from 1995 to 2003. * Through a combination of death data from both National Prisoner Statistics and the Deaths in Custody Reporting Program, 55 additional AIDS- related deaths were identified for 2003. ---------------------------------------------- On December 31, 2003, 2.0% of State prison inmates and 1.1% of Federal prison inmates were known to be infected with the human immunodeficiency virus (HIV). Correctional authorities reported that 22,028 State inmates and 1,631 Federal inmates were HIV positive. The number known to be HIV positive totaled 23,659, down from 23,864 at yearend 2002. Of those known to be HIV positive in all U.S. prisons at yearend 2003, an estimated 5,944 were confirmed AIDS cases, up from 5,643 in 2002. Among State inmates, 0.5% had AIDS; among Federal inmates, 0.4%. During 2003, 268 State prisoners died from AIDS- related causes, down from 283 in 2002. In 2003, 8% of State inmate deaths were attributed to AIDS, down from 32% in 1995. Among Federal prisoners 14 died from AIDS-related causes, down 3 deaths from the total in 2002. This report is based on the 2003 National Prisoners Statistics(NPS-1) and the Deaths in Custody Reporting Program (DCRP). Data from NPS-1 are reported on one form by the departments of corrections in 50 States and by the Federal Bureau of Prisons. DCRP data are from individual records for each death. A record includes information on the deceased's characteristics such as gender, age, and race/ Hispanic origin. ---------------------------------------- Number of HIV-infected prison inmates at yearend 2003, down from 2002 At yearend 2003, 23,659 inmates in State and Federal prisons were known to be infected with the human immunodeficiency virus (HIV), down from 23,864 in 2002. Among State prison inmates, 22,028 were known to be HIV positive; among Federal inmates, 1,631. HIV-infected inmates were concentrated in a small number of States. New York (5,000), Florida (3,112), and Texas (2,460) held the largest number of HIV-positive inmates. These three States housed nearly half (48.0%) of all HIV-infected inmates in State prisons in 2003. New York has estimated the number of HIV-infected inmates using data obtained through blinded sero- prevalence studies conducted biennially by the New York Department of Health.* ** Footnote: New York draws blood from all entering inmates. Every other year an extra sample from 1,000 sequential receptions in each of 4 reception centers is tested for various diseases including HIV. The percentage with HIV-infection is applied to the total inmate population and then adjusted for length of stay and findings from other studies. Projections are made for the interim years without the blinded studies. *** The trend in HIV-infection among prisoners is affected by these estimated numbers in New York. Excluding New York, the number of HIV-infected inmates has been stable among the other States. Between 1998 and 2003 the number has fluctuated between 18,180 and 19,333. -------------------------------------------- ---------------------------------------------- HIV-positive inmates comprised 2.0% of the State prison population in 2003, unchanged since 2001. In Federal prisons HIV-positive inmates comprised 1.1% in 2003. Overall, the percentage of the total prison population with HIV has remained constant at 1.9% since 2001. Inmates in the Northeast had the highest rate of HIV infection In the Northeast 4.5% of the prison population were known to be HIV positive in 2003, followed by 2.2% in the South, 1.0% in the Midwest, and 0.7% in the West. New York had the highest percentage of inmates known to be HIV positive (7.6%), followed by Maryland (4.2%)and Florida (3.9%) Vermont, North Dakota, Montana, and Wyoming reported fewer than 10 HIV-positive inmates in their prisons. In 2003 every reporting jurisdiction held at least one HIV-positive inmate. Seven States reported that fewer than 0.5% of their inmate population were HIV positive. Between 2002 and 2003, 29 States reported a decrease in the number of HIV-positive inmates. The largest decrease was reported in New Jersey (down 99), followed by Connecticut (94), and Texas (68). Fourteen States and the Federal system reported an increase. The largest increases were reported in Florida (up 264), the Federal system (84), North Carolina (38), and Rhode Island (34). A greater percentage of females than males with HIV infection On December 31, 2003, 19,777 male inmates and 2,115 female inmates in State prisons were known to be HIV positive. Overall, 1.9% of male inmates and 2.8% of all female inmates were known to be HIV positive. New York reported the largest numbers of male and female HIV-positive inmates (4,570 and 430, respectively). The second largest numbers of HIV-positive male and female inmates were in Florida (2,744 and 368, respectively), followed by Texas (2,205 and 255, respectively). Four States (Vermont, Minnesota, North Dakota, and Montana) reported having no HIV-positive female inmates. Every reporting State had at least one HIV-positive male inmate. Over 10% of all female inmates were known to be HIV positive in two States -- New York (14.6%), and Maryland (11.1%). New York (with 7.3%) was the only State with more than 5% of male inmates known to be HIV positive. ---------------------------------------------- ---------------------------------------------- Number of HIV-positive male and female inmates in State prisons declined during 2003 In States that did not provide a breakdown of the number of HIV cases by gender, estimates were made using the data reported from the most recent year. Based on these yearend estimates, the number of HIV-infected females in State prisons decreased from 2,164 to 2,131 in 2003. The number of infected male inmates decreased from 20,273 to 20,060 in 2003. The estimated number of both male and female HIV-positive inmates in State prisons declined after 1998. Between 1998 and 2003 the percentage of male HIV-positive inmates decreased from 2.2% to 1.8%, as the percentage of female inmates fell from 3.8% to 2.7%. Confirmed AIDS cases in U.S. prisons increased during 2003 At the end of 2003, a reported 5,227 inmates in U.S. prisons had confirmed AIDS, up from 4,898 in 2002. Among those with confirmed AIDS, 4,601 were in State prisons, and 626 were in Federal prisons. 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 increased from 5,643 in 2002 to 5,944 in 2003. Between 1998 and 2003, 33 States and the Federal system consistently reported the number of inmates with confirmed AIDS. As with the reported and estimated numbers, the comparable number of inmates with confirmed AIDS declined between 1998 and 2003, from 5,864 to 4,956. --------------------------------------------- --------------------------------------------- Confirmed AIDS cases made up 0.5% of inmates in State prisons and 0.4% of those in Federal prisons. Of those known to be HIV-positive inmates, more than a fifth had confirmed AIDS. The States with the largest number of confirmed AIDS cases were New York (800), Texas (778), and Florida (711). Combined, these States held nearly half of all confirmed AIDS cases in State prisons. The Federal system held 626 inmates with confirmed AIDS. Eleven States reported having fewer than 10 confirmed AIDS cases in their prisons; 5 reported having none. Rhode Island (1.5%) had the highest percentage of confirmed AIDS, followed by Connecticut and New York (both 1.2%). In 12 States confirmed AIDS cases comprised 0.1% or less of State inmates. During 2003, 16 States reported a decrease in the number of confirmed AIDS cases. Illinois, with a decrease of 73, had the largest drop in the number of confirmed AIDS cases, followed by New York and Connecticut (both down 60). Seventeen States and the Federal system reported an increase in the number of confirmed AIDS cases, led by Texas(up 219) and Florida (191). Rate of confirmed AIDS 3 times higher among prison inmates than in the 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 2003 the rate of con- firmed AIDS in State and Federal prisons was more than 3 times higher than in the total U.S. population. About 51 in every 10,000 prison inmates had confirmed AIDS, compared to 15 in 10,000 persons in the U.S. general population. AIDS-related deaths in State prisons dropped from 1995 to 2003 The number of State inmates who died of Pneumocystis carinii pneumonia, Kaposi's sarcoma, or other AIDS-related diseases peaked in 1995 and steadily decreased until 2001. According to data reported in the NPS-1, the number of AIDS-related deaths (213) was slightly less than that in 2002 (215). Overall, after 1995 the number of AIDS-related deaths was down 797 from 1,010 in 1995 to 213 in 2003. ---------------------------------------------- Among Federal inmates 14 died from AIDS-related causes, down from 17 in 2002. In 2003 for every 100,000 inmates, 8 died from AIDS-related causes. These AIDS-related deaths accounted for 4% of all deaths in Federal prison. The introduction of protease inhibitors and combination antiretroviral therapies produced a substantial improvement in the effectiveness of HIV/AIDS care. See Hammett and Harmon, "Medical Treatment and a Continuum of Care" in 1996-1997 Update: HIV/AIDS, STDs and TB in Correctional Facilities (July 1999, NCJ 176344). DCRP identifies more States with AIDS-related deaths in State prisons Pursuant to the Death in Custody Reporting Act of 2000, BJS began in 2001 to collect individual- level information about deaths in State prisons (DCRP). Overall, 12 States under-reported AIDS- related deaths in the NPS-1 collection, while 11 States under-reported AIDS-related deaths in DCRP. For a total of AIDS-related deaths in prisons, DCRP and NPS-1 data were combined. The most complete data for each State's number of deaths were used to calculate the totals for 2001, 2002, and 2003. An additional 55 AIDS-related deaths were identified in 2003,68 in 2002, and 55 in 2001. Adjusted for under-reporting, the number of AIDS-related deaths in 2003 was 21 per 100,000 State prison inmates, down from 22 in 2002. For the general population the percentage of deaths due to AIDS increased in 2001 but declined in 2002. In 2002 the percentage of deaths due to AIDS was more than 2 times higher in the prison population than in the U.S. general population ages 15-54. About 1 in every 11 prisoner deaths were attributable to AIDS- related causes compared to 1 in 23 deaths in the general population. About 1 in 12 deaths in State prisons due to AIDS-related illnesses In 2003 for every 100,000 State inmates, 21 died from AIDS-related causes. The most AIDS deaths were reported in the South (157), followed by the Northeast (63). Together, these two regions accounted for more than 8 out of 10 AIDS-related deaths in State prisons. Florida reported the largest number of AIDS- related deaths (42), followed by New York and Texas (27). Eighteen States reported having no AIDS-related deaths. Relative to the number of inmates, Delaware had the highest rate of AIDS-related deaths (87 per 100,000 inmates), followed by Maryland (54 per 100,000), Florida (52 per 100,000), and Vermont (50 per 100,000). AIDS-related deaths reported in DCRP show variations by gender, race/Hispanic origin, and age Of the 210 reported inmate deaths due to AIDS- related causes in 2003, 202 were deaths of males, and 8 were deaths of females. Inmates between ages 35 and 44 accounted for almost half of all AIDS-related deaths (97). AIDS-related deaths among black inmates (146) accounted for more than two-thirds of all AIDS-related deaths. Relative to the total number of inmates under State jurisdiction at midyear 2003, males (18 deaths per 100,000) were nearly twice as likely as females (10 per 100,000) to die from AIDS- related causes. Black inmates (27 per 100,000) were about 3½ times more likely than whites (8 per 100,000) and almost 2½ times more likely than Hispanics (12 per 100,000) to die from AIDS-related causes. Inmates age 45 or older had the highest rates of AIDS-related death (36 per 100,000), 4 times the rate among those age 25 to 34 (9 per 100,000). 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 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. 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 1995-2001. 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 or older at yearend from the cumulative number of total AIDS cases for people age 13 or 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 or older prior to 2000 and 15 or older for 2000 and beyond. 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; Vol. 49, No. 8; and Vol. 50, No. 15. 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. BJS Deaths in Custody Reporting Program To implement the Death in Custody Reporting Act of 2000 (PL 106-297), BJS developed four quarterly data collections of death records: local jails (begun in 2000), State prisons (2001), State juvenile correctional agencies (2002), and State and local law enforcement agencies (2003). Records include data on the deceased's characteristics (such as age, gender, and race/ Hispanic origin), criminal background (such as legal status, offenses, and time in custody), and the death itself (such as cause, time, location, and medical conditions and treatment). ----------------------------------------- The Bureau of Justice Statistics is the statistical agency of the U.S. Department of Justice. Lawrence A. Greenfeld is director. Laura M. Maruschak wrote this report, under the supervision of Allen J. Beck. Todd D. Minton provided statistical review. Tom Hester and Tina Dorsey edited the report. Jayne Robinson prepared the report for publication. September 2005, NCJ 210344 --------------------------------------- End of file 08/31/05 ih