U.S. Department of Justice Office of Justice Programs Bureau of Justice Statistics Revised 1/28/2010 Bulletin HIV in Prisons, 2007-08 December 2009 NCJ 228307 ------------------------------------------------------------ This file is text only without graphics and many of the tables. A Zip archive of the tables in this report in spreadsheet format (.csv)and the full report including tables and graphics in .pdf format are available from: http://bjs.ojp.usdoj.gov/index.cfm?ty=pbdetail&iid=1747 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://bjs.ojp.usdoj.gov/index.cfm?ty=pbse&sid=7 ------------------------------------------------------------ Laura M. Maruschak BJS Statistician Randy Beavers, BJS Intern This report provides the number of state and federal prisoners who were infected with the human immunodeficiency virus (HIV) or had confirmed acquired immune deficiency syndrome (AIDS) at yearend 2007 and 2008. The number of HIV/AIDS cases is reported by gender and type of infection. Using data from the Deaths in Custody Reporting Program (DCRP), this report presents the number of AIDS-related deaths in state prisons and a profile of inmates who died in 2007. In addition, data on federal inmates who died from AIDS-related causes are included for both 2007 and 2008. The circumstances under which federal inmates were tested for HIV in 2008 are described in this report. General population comparisons are provided on confirmed AIDS cases and AIDS-related deaths. Highlights *At yearend 2008, a reported 21,987 inmates held in state or federal prisons were HIV positive or had confirmed AIDS, accounting for 1.5% of the total custody population. Among states that reported data in 2006 through 2008, the number of inmates with HIV/AIDS was stable between 2007 and 2008. *At yearend 2008, 1.5% (20,075) of male inmates and 1.9% (1,912) of female inmates held in state or federal prisons were HIV positive or had confirmed AIDS. *Florida (3,626), New York (3,500), and Texas (2,450) reported the largest number of prisoners who were HIV positive or had confirmed AIDS. These three states account for 24% of the total state custody population, but 46% of the state custody population who were HIV positive or had confirmed AIDS. *New York reported the large decreases (down 450 from 2007 to 2008) in the number of prisoners who were HIV positive or had confirmed AIDS. *Between 2007 and 2008, California (up 246)and Florida (up 166) reported the largest increases in the number of prisoners who were HIV positive or had confirmed AIDS. *At yearend 2008 an estimated 5,733 state and federal prisoners had confirmed AIDS. *During 2007, 130 state and federal prisoners died from AIDS-related causes. *Florida (14), New York (11), and Texas (10) reported 10 or more AIDS-related deaths during 2007. HIV infection by region and state A total of the 21,987 inmates held in state or federal prison on December 31, 2008, were HIV positive or had confirmed AIDS (table 1). Among states reporting data in 2006 through 2008, HIV or confirmed AIDS among state prisoners was stable between 2007 (19,936) and 2008 (19,924). Between 2007 and 2008, the percent of the state custody population with HIV or confirmed AIDS remained stable at 1.6%. States in the South held more than twice the number of prisoners who were HIV positive or had confirmed AIDS than those states in the Northeast (11,003 compared to 5,484). When comparing percentage distribution, 1.9% of the custody population in Southern states were HIV-positive or had confirmed AIDS versus 3.2% in Northeastern states (see appendix table 1). Nine states (Maine, New Hampshire, Vermont, Nebraska, North Dakota, South Dakota, Alaska, Montana, and Wyoming) held less than 20 prisoners who were HIV positive or had confirmed AIDS. New York reported the largest percent of custody population (5.8%) who were HIV positive or had confirmed AIDS, followed by Florida (3.6%), Maryland (2.5%), Massachusetts (2.4%), North Carolina (2.1%), and New Jersey (2.1%). At yearend 2008, 1,538 federal prisoners were HIV positive or had confirmed AIDS. While there appears to be a decrease from the 1,679 reported HIV/AIDS cases in 2007, a comparison between years should not be made due to the implementation of a new record-keeping system. HIV infection by gender At yearend 2008, 20,075 men and 1,913 women held in state or federal prisons were HIV positive or had confirmed AIDS (table 2). Among states reporting data in both 2007 and 2008, the number of males with HIV/AIDS increased by 186, and the number of females decreased 214. Between 2007 and 2008, percent of male inmates with HIV/AIDS remained stable at 1,5%, while the percent of females who were HIV positive of had confirmed AIDS decreased from 2.1% to 1.9%. Florida (3,292), New York (3,200), and Texas (2,201) reported more than 2,000 male inmates with HIV/AIDS (see appendix table 2). Florida (334) reported the largest number of female inmates with HIV/AIDS, followed by New York (300), and Texas (249). Six states reported having zero female inmates with HIV/AIDS. New York was the only state to report more than 5% of its male custody population and more than 10% of its female custody population with HIV or confirmed AIDS. Among persons being held in federal prison, 1,460 male and 78 female inmates were HIV positive or had confirmed AIDS cases. Confirmed AIDS cases At yearend 2008, a reported 5,174 inmates in state (4,561) and federal (613) prisons had confirmed AIDS (table 3). Confirmed AIDS cases made up 0.5% of inmates in state prison and 0.3% of inmates in federal prison. Confirmed AIDS cases accounted for nearly a quarter (24%) of all HIV/AIDS cases in state and federal prison. For states that did not provide a breakdown of the number of HIV cases by type of infection, estimates of the number of confirmed AIDS cases were made to provide comparable year-to-year data. Based on yearly estimates, the number of confirmed AIDS cases in state prisons decreased from 4,836 in 2007 to 4,561 in 2008. Louisiana (2.2%) and New York (1.2%) reported the highest percentage of confirmed AIDS cases in 2008 (see appendix table 3). Five states Maine, Iowa, North Dakota, South Dakota, and Idaho reported zero cases of confirmed AIDS. At yearend 2008, a total of 613 federal inmates had confirmed AIDS. While there appears to be a decrease from the 682 reported confirmed AIDS cases in 2007, a comparison between years should not be made due to the implementation of a new record-keeping system. In 2007, the most recent year for which general population data are available, the overall rate of estimated confirmed AIDS among the state and federal prison population (0.41%) was more than 2 times the rate in the general population (0.17%)(table 4).***Footnote 1 Data to adjust for composition differences in the populations are not available***. AIDS-related deaths During 2007, the most recent year for which data on inmates deaths are available for state prisons, 120 state inmates died from AIDS-related causes, down from an estimated 155 in 2006 (see appendix table 4). In 2006, counts of inmate deaths were based on a combination of data from the National Prisoners Statistics (NPS-1) collection and the Deaths in Custody Reporting Program (DCRP). Because BJS no longer collects data on deaths in the NPS-1, deaths in 2007 were based solely on individual reports submitted to the DCRP. When comparing 2006 and 2007 AIDS-related deaths reported in the DCRP (131), a decline- while smaller-was still observed during the period. Whether using reported or estimated data from multiple data collections, there has been a downward trend in the number of AIDS-related deaths over the past 12 years (figure 1). The rate of AIDS deaths per 100,000 prisoners decreased from 11 deaths in 2006 to 9 in 2007. Florida (14) reported the largest number of AIDS-related deaths, followed by New York (11) and Texas (10). Of the 120 AIDS-related deaths among state inmate in 2007, 112 were males and 8 were females (table 5). Nearly three-quarters (73%) of state prisoners who died of AIDS-related illness were ages 35 to 54. Nearly two-thirds (65%) of AIDS-related deaths were among black, non-Hispanic inmates. Between 1995 and 2001, AIDS-related deaths as a percentage of all deaths in state prisons decreased from 34.2% to 10.3% (table 6). Over he next 6 years (between 2001 and 2007) the percentage dropped to 3.5%. Between 1995 and 2001, the percent of AIDS-related deaths in the general population fell from 12.9% to 4.3%. That percent had fallen to 3.4% by 2006. The rate of AIDS-related deaths in state prisons and in the U.S. general population ages 15 to 54 has continued to decline (table 7). Between 1995 and 2001 the rate in the state prison population fell from 100 per 100,000 inmates to 25 per 100,000 inmates, while the rate in the U.S general population ages 15 to 54 fell from 29 per 100,000 persons to 9 per 100,000 persons. By 2007 the rate had fallen to 9 per 100,000 state prison inmates and to 6 per 100,000 persons in the general population. Among federal inmates, 13 died from AIDS-related causes in 2008, up from 10 in 2007. The AIDS-related death rate among federal inmates was 5 per 100,000 in 2007 and 6 per 100,000 in 2008 (table 8). HIV testing in prisons During 2008, a total of 24 states reported testing all inmates for HIV at admission or sometime during custody (appendix table 5). Among these 24 states, 23 tested prisoners at admission, 5 tested while in custody, and 6 tested upon release. All fifty states and the federal system tested inmates if they had clinical indication of HIV infection or if they requested an HIV test. Forty-two states and the federal system tested inmates after they were involved in an incident in which an inmate was exposed to a possible HIV transmission, and 18 states and the federal system tested inmates who belonged to specific "high-risk" groups. Methodology National Prisoner Statistics The National Prisoner Statistics collection (NPS-1), which primarily measures prison population movement, began in 1926. The 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 in the 50 states and the Federal Bureau of Prisons. In 1991 BJS began collecting data on HIV and confirmed AIDS in prisons in NPS-1. BJS respondents have indicated the circumstances under which inmates are tested for HIV and have provided the number of HIV-infected inmates in their custody. Deaths in Custody Reporting Program To implement the data collection required by the Death in Custody Reporting Act of 2000 (PL 106-297), BJS developed four quarterly data collections of death records from 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, race, and 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). Estimation of HIV and confirmed AIDS cases in New York State New York estimates the number of HIV and confirmed AIDS cases based on data from blind seroprevalence studies conducted biennially by the New York State Department of Health. Blood samples are taken from all inmates entering New York State prisons. Every other year an extra sample from 1,000 sequential admissions at reception in four 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 data from other studies. Projections for interim years are made without blind studies. AIDS in the U.S. resident population The number of persons with confirmed AIDS in the U.S. general population (age 13 and older) was derived from the Centers for Disease Control and Prevention (CDC), HIV/ AIDS Surveillance Report, yearend editions 1999 to 2007. For each year the number of active AIDS cases in the United States was calculated by taking the cumulative number of total AIDS cases for persons age 13 or older at yearend (from the HIV/AIDS Surveillance Report), minus estimated confirmed AIDS cases in state and federal prisons, and subtracting the cumulative number of AIDS deaths for people age 15 or older at yearend, minus estimated number of AIDS-related deaths in state and federal prisons. The rate of confirmed AIDS cases in the U.S. general population was calculated by dividing the annual total number of individuals with AIDS by the estimated U.S. general population (age 13 or older before 2000; age 15 or older since 2000) minus the state and federal custody population. AIDS-related deaths in the United States The number of AIDS-related deaths for persons ages 15 to 54 was based on the CDC, HIV/AIDS Surveillance Report, yearend editions. Deaths in the U.S. population for persons ages 15 to 54 were taken from the CDC, Monthly Vital Statistics Report, Vol. 45, No. 11(S). Also, deaths were taken from the CDC, National Vital Statistics Report, Vol. 52, No. 3; Vol. 53, No. 5; Vol. 53, No. 15; Vol. 54, No. 19; and Vol. 57, No. 14. For 2005, U.S. general population deaths can be found in National Center for Health Statistics, Deaths: Preliminary Data for 2005. For 2001 to 2006, AIDS-related deaths were calculated as a percent of all deaths among persons ages 15 to 54 in the U.S. general population. The difference of the national estimate of AIDS deaths of persons ages 15 to 54 minus AIDS-related deaths of persons ages 15 to 54 in state prisons was divided by the national mortality estimates of persons ages 15 to 54 minus total deaths in state prisons. For 2001 through 2006, the rates of AIDS-related deaths in the general population were calculated by taking the difference of the national estimate of AIDS-related deaths for persons ages 15 to 54 minus AIDS-related deaths for those ages 15 to 54 in state prisons, and dividing it by the U.S. general population estimate minus the state prison population ages 15 to 54. Because data on AIDS-related deaths by age in state prisons were not collected prior to 2001, the total number of AIDS-related deaths in state prison was subtracted from the national estimate of AIDS-related deaths for the 1995 rate calculations. ------------------------------------------------------------- ------------------------------------------------------------- The Bureau of Justice Statistics is the statistics agency of the U.S. Department of Justice. Michael D. Sinclair is acting director. BJS Bulletins present the first release of findings from permanent data collection programs. The Bulletin was written by Laura M. Maruschak and Randy Beavers. Todd Minton verified the report and provided statistical support. Steve Simoncini and Joshua Giunta carried out the 2008 data collection and processing under the supervision of Jill R. O'Brien, Governments Division, Census Bureau, U.S. Department of Commerce. Theresa Reitz carried out the 2007 data collection and processing under the supervision of Charlene M. Sebold, Governments Division, Census Bureau, U.S. Department of Commerce. Duane H. Cavanaugh provided technical assistance in both years. Catherine Bird and Jill Duncan edited the report. Tina Dorsey produced the report. Jayne E. Robinson prepared the report for final printing under the supervision of Doris J. James. December 2009, NCJ 228307 ------------------------------------------------------------- ------------------------------------------------------------- This report in portable document format and in ASCII and its related statistical data and tables are available at the BJS World Wide Web Internet site: . Office of Justice Programs Innovation - Partnerships - Safer Neighborhoods http://www.ojp.usdoj.gov ------------------------------------------------------------- ------------------------------------------------------------- 1/27/2010 TLD 12:20PM