U.S. Department of Justice Office of Justice Programs Bureau of Justice Statistics Bulletin HIV in Prisons and Jails, 2002 December 2004, NCJ 205333 Revised March 29, 2005 ---------------------------------------------------------------- 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/hivpj02.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 1998 and 2002 the number of HIV-positive prisoners decreased about 7%, while the overall prison population grew almost 11%. * At yearend 2002, 3.0% of all female State prison inmates were HIV positive, compared to 1.9% of males. * During 2002, 19 States reported a decrease in the number of HIV-positive prisoners, and 23 States reported an increase. * New York held a fifth of all inmates (5,000 inmates) known to be HIV positive at yearend 2002. * In 2002 the overall rate of confirmed AIDS in the prison population (0.48%) was nearly 3½ times the rate in the U.S. general population (0.14%). * Among jail inmates in 2002 who had ever been tested for HIV, Hispanics (2.9%) were more than 3 times as likely as whites (0.8%) and twice as likely as blacks (1.2%) to report being HIV positive. * Among jail inmates reporting past drug use, 1.5% were HIV positive; of those who had used a needle to inject drugs, 3.2%; and of those who had shared a needle with others, 7.5%. Number of AIDS-related deaths in State prisons decreased in 2002 * In 2002, 342 inmates died from AIDS-related causes -- 283 State prisoners, 17 Federal prisoners, and 42 jail inmates. * The number of AIDS-related deaths in State prisons decreased 72% between 1995 and 2002. * Based on reports from NPS-1 and the newly implemented Deaths in Custody Act, 68 additional AIDS-related deaths were identified in 2002; 55 in 2001. --------------------------------------------------------------------- On December 31, 2002, 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 22,317 State inmates and 1,547 Federal inmates were HIV positive. The number known to be HIV positive totaled 23,864, down from 24,147 at yearend 2001. Of those known to be HIV positive in all U.S. prisons at yearend 2002, an estimated 5,643 were confirmed AIDS cases, down from 6,286 in 2001. Among State inmates, 0.5% had AIDS; among Federal inmates, 0.4%. In personal interviews conducted in 2002, nearly two-thirds of local jail inmates reported ever being tested for HIV; of those, 1.3% disclosed that they were HIV positive. During 2002, 283 State prisoners died from AIDS-related causes (down from 311 in 2001); 17 Federal prisoners (down from 22 in 2001); and 42 local jail inmates (down from 55). HIV/AIDS data for prisoners are from the National Prisoner Statistics (NPS-1) and for jail inmates from the 2002 Survey of Inmates in Local Jails. Data on deaths are based on the Deaths in Custody Reporting Act collection (DICRA), which began in 2000 for jail inmates and in 2001 for State prisoners. (See Methodology for details.) Number of HIV-infected prison inmates at yearend 2002, down from 2001 At yearend 2002, 23,864 inmates in State and Federal prisons were known to be infected with the human immunodeficiency virus (HIV), down from 24,147 in 2001. Among State prison inmates, 22,317 were known to be HIV positive; among Federal inmates, 1,547. HIV-infected inmates were concentrated in a small number of States. New York (5,000), Florida (2,848), and Texas (2,528) held the largest number of HIV-positive inmates. These three States housed nearly half of all HIV- infected inmates in State prisons in 2002. 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.**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 2002 the number has fluctuated between 18,180 and 19,333. --------------------------------------------- HIV-positive inmates constituted 2.0% of the State prison population in 2002, down from 2.3% in 1998. In Federal prisons HIV-positive inmates constituted 1.1% in 2002. Overall, the percentage of the total prison population with HIV remained unchanged between 2001 and 2002. Inmates in the Northeast had the highest rate of HIV infection In the Northeast 4.6% of the prison population were known to be HIV positive in 2002, followed by 2.2% in the South, 1.0% in the Midwest, and 0.7% in the West. New York had the highest percent of inmates known to be HIV positive (7.5%), followed by Maryland (4.0%) and Florida (3.8%) Vermont, North Dakota, South Dakota, Montana, and Wyoming reported fewer than 10 HIV-positive inmates in their prisons. In 2002 every reporting jurisdiction held at least one HIV-positive inmate. Eight States reported that fewer than 0.5% of their inmate population were HIV positive. Between 2001 and 2002, 19 States reported a decrease in the number of HIV-positive inmates. Excluding New York, the largest decrease was reported in California -- 1,181 in 2002, down from 1,305 in 2001. Twenty-three States and the Federal system reported an increase. The largest increases were reported in Florida (up 246), Texas (140), Maryland (127), and Pennsylvania (65). A greater percentage of females than males with HIV infection On December 31, 2002, 19,297 male inmates and 2,053 female inmates in State prisons were known to be HIV positive. Overall, 1.9% of male inmates and 3.0% of all female inmates were known to be HIV positive. New York reported the largest numbers of male and female HIV-positive inmates (4,590 and 410, respectively). The second largest numbers of HIV-positive male and female inmates were in Florida (2,508 and 340, respectively), followed by Texas (2,261 and 267, respectively). Four States (Vermont, Minnesota, North Dakota, and Oregon) 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 (13.6%) and Maryland (12.1%). New York (with 7.2%) was the only State with more than 5% of the male inmates known to be HIV positive. ----------------------------------------------- ----------------------------------------------- Number of HIV-positive male and female inmates in State prisons declined during 2002 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 2,212 to 2,164 in 2002. The number of infected male inmates decreased from 20,415 to 20,273 in 2002. The estimated number of both male and female State inmates has declined since 1998. Between 1998 and 2002 the percentage of male HIV-positive inmates decreased from 2.2% to 1.9%, as the percentage of female inmates fell from 3.8% to 2.9%. Confirmed AIDS cases in U.S. prisons decreased during 2002 At the end of 2002, a reported 4,898 inmates in U.S. prisons had confirmed AIDS, down from 5,754 in 2001. Among those with confirmed AIDS, 4,354 were in State prisons, and 544 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 decreased from 6,286 in 2001 to 5,643 in 2002. Between 1998 and 2002, 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 2002, from 5,864 to 4,571. -------------------------------------------- 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, about 1 in 5 had confirmed AIDS. The States with the largest number of confirmed AIDS cases were New York (860), Texas (559), and Florida (520). Combined, these States held nearly half of all confirmed AIDS cases in State prisons. The Federal system held 544 inmates with confirmed AIDS. Thirteen States reported having fewer than 10 confirmed AIDS cases in their prisons; 4 reported having none. Connecticut (1.4%) reported the highest percentage of confirmed AIDS, followed by New York (1.3%), Massachusetts (1.1%), Maryland (1.1%), and South Carolina (1.1%). In 18 States confirmed AIDS cases comprised 0.1% or less of State inmates. During 2002, 14 States reported a decrease in the number of confirmed AIDS cases. Both New York and Texas, with a decrease of 300, had the largest drop in the number of confirmed AIDS cases. Sixteen States reported an increase in the number of confirmed AIDS cases, led by Alabama, up from 26 in 2001 to 81 in 2002. Rate of confirmed AIDS 3½ times 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 2002 the rate of confirmed AIDS in State and Federal prisons was about 3½ times higher than in the total U.S. population. About 48 in every 10,000 prison inmates had confirmed AIDS, compared to 14 per 10,000 persons in the U.S. general population. AIDS-related deaths in State prisons dropped from 1995 to 2002 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 (215) in 2002 was less than that in 2001 (256). Overall, after 1995 the number of AIDS-related deaths was down 795 from 1,010 in 1995 to 215 in 2002. Among Federal inmates 17 died from AIDS-related causes, down from 22 in 2001. In 2002 for every 100,000 inmates, 11 died from AIDS-related causes. These AIDS-related deaths accounted for 5% 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.) New reporting system identifies more AIDS-related deaths in State prisons Pursuant to The Death in Custody Reporting Act of 2000, BJS began in 2001 collecting information about deaths in custody in State prisons (DICRA). This data collection is based on individual level death records. Death records for 2001 and 2002 have identified more AIDS-related deaths than the NPS-1. Overall, 15 States under-reported AIDS-related deaths in the NPS-1 collection, while 8 States under-reported AIDS-related deaths in DICRA. To get a total count of the number of AIDS-related deaths in prisons, data from DICRA were combined with data from the NPS-1. The most complete data for each State's number of deaths were used to calculate the totals for 2001 and 2002. An additional 68 AIDS-related deaths were identified in 2002 and 55 in 2001. Adjusted for underreporting, the number of AIDS-related deaths per 100,000 State prison inmates in 2002 totaled 22, down from 25 per 100,000 in 2001. In 2001 for the first time since 1995, the percentage of deaths due to AIDS increased in the general population, although it remained lower than that among State prisoners. 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. In 2001 about 1 in every 10 prisoner deaths were attributable to AIDS-related causes compared to 1 in 22 deaths in the general population. About 1 in 11 deaths in State prisons due to AIDS-related illnesses In 2002 an estimated 22 State prison inmates per 100,000 died from AIDS-related causes. The most AIDS deaths were reported in the South (151), followed by the Northeast (74). These two regions accounted for more than three-quarters of AIDS-related deaths in State prisons. New York reported the largest number of AIDS-related deaths (38), followed by Florida (36) and California (26). Seventeen States reported having no AIDS-related deaths. Relative to the number of inmates, New York reported the highest rate of AIDS-related death (57 per 100,000), followed by Vermont (56 per 100,000), Florida (49 per 100,000), and Maryland (45 per 100,000). AIDS-related deaths reported in DICRA show variations by gender, race/Hispanic origin, and age Of the 245 inmates who died of AIDS-related causes in 2002, 236 were male and 9 were female. About half of all AIDS-related deaths were accounted for by inmates between ages 35 and 44 (119). AIDS-related deaths among black inmates (163) accounted for two-thirds of all AIDS-related deaths. Over the 2-year period a total of 594 State prison inmates died from AIDS-related illnesses. Relative to the total number of inmates in custody in 2002, males (21 deaths per 100,000) were nearly twice as likely as females (11 per 100,000) to die from AIDS-related causes; black inmates (30 per 100,000) were twice as likely as Hispanics (15 per 100,000) and 2½ times as likely as whites (12 per 100,000) to die from AIDS-related causes. Inmates age 45 or older had the highest rates of AIDS-related death (64 per 100,000), nearly double the rate among those age 35 to 44, and 10 times the rate among those age 25 to 34. HIV/AIDS reported by jail inmates in personal interviews The 2002 Survey of Inmates in Local Jails asked inmates if they had ever been tested for HIV, if they had been tested since admission for HIV, and whether they were HIV positive. (See Methodology for further detail.) Though some inmates may refuse to report that they are HIV positive and others may not know, surveys provide a means to track HIV infection among demographic and "high-risk" groups. About 1 in 5 jail inmates reported being tested for HIV after admission Of those inmates who indicated that they were tested after admission to jail, 2.5% reported being HIV positive. Nearly two-thirds of jail inmates reported ever being tested for HIV; 1.3% of those inmates disclosed that they were HIV positive. Among jail inmates who were tested for HIV, Hispanic inmates (2.9%) were more than 3 times as likely as white inmates (0.8%) and more than twice as likely as black inmates (1.2%) to report being HIV positive. Female inmates (2.3%) were more likely than male inmates (1.2%) to be HIV positive. Hispanic male inmates (2.9%) were as likely as Hispanic female inmates (2.9%) to be infected with HIV. White female inmates (1.6%) were twice as likely as white male inmates (0.6%) to be HIV-positive; black non-Hispanic female inmates (3.0%) were 3 times as likely as black male inmates (1.0%). Among male inmates, blacks (1.0%) were nearly twice as likely as whites (0.6%) to be HIV positive. The rate of HIV infection among white female inmates (1.6%) was nearly half that of black (3.0%) and Hispanic female inmates (2.9%). Jail inmates age 24 or younger reported the lowest rate of being HIV positive (0.2%), followed by those age 25-34 (1.1%), those 35-44 (2.1%), and those 45 or older (2.7%). Property and drug offenders most likely to report being HIV positive Those inmates held for a property offense in local jails reported the highest HIV positive rate (1.8% ) . Drug offenders reported a slightly lower rate (1.6%). The percentage of public-order offenders who were HIV positive was 1.1%; the percentage of violent offenders, 0.7%. The percentage of jail inmates reporting that they were HIV positive varied by level of prior drug use. Of jail inmates who reported never using drugs, 0.4% were HIV positive. An estimated 1.5% of inmates who had ever used drugs, 1.5% of those who used drugs in the month before their current offense, 3.2% of those who had used a needle to inject drugs, and 7.5% of those who had shared a needle reported being HIV positive. The number of AIDS-related deaths in jails declined between 2000 and 2002 In 2002 the number of AIDS-related deaths in local jails was 42, down from 58 in 2000. The rate of AIDS-related deaths was down from 9 per 100,000 inmates in 2000 to 6 per 100,000 in 2002. Of the 42 inmates who died from AIDS-related illnesses in 2002, 38 were male and 4 were female. Those who died from AIDS-related illnesses were most likely black (31 inmate deaths) and between the ages 35 and 44 (21 inmate deaths). Over the 3-year period beginning in 2000, a total of 155 local jail inmates died from AIDS-related causes. 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. Survey of Inmates in Local Jails, 2002 The 2002 Survey of Inmates in Local Jails was conducted for BJS by the U.S. Census Bureau. Through personal interviews conducted from January through April, 2002, data were collected on individual characteristics of jail inmates, current offenses, sentences and time served, criminal histories, jail activities, conditions and programs, prior drug and alcohol use and treatment, and health care services provided while in jail. The sample for the 2002 survey was selected from a universe of 3,365 jails that were enumerated in the 1999 Census of Jails. Overall, 465 jails were selected. Interviews were conducted in 420 jails; 38 refused and 7 were closed. A total of 6,982 inmates were interviewed, and 768 refused to participate. Similar surveys of jail inmates were conducted in 1972, 1978, 1983, 1989, and 1996. The accuracy of the 2002 Survey of Inmates in Local Jails depends on sampling and measurement errors. Sampling errors occur by chance because a sample rather than a complete enumeration of the population was conducted. Measurement error can be attributed to many sources, such as nonresponse, recall difficulties, differences in the interpretation of questions among inmates, and procession errors. The sampling error, as measured by an estimated standard error, varies by the size of the estimate and the size of the base population. Estimates for the percentage of inmates ever tested for HIV and the percentage who tested HIV positive have been calculated. These standard errors may be used to construct confidence intervals around percentages. For example, the 95-percent confidence interval around the percentage of males in local jails who were HIV positive is approximately 1.2% plus or minus 1.96 times .20% (or .8% to 1.6%). Deaths in Custody Collections In order to implement The Death in Custody Reporting Act of 2000 (PL 106-297), BJS has developed four data collections of death records covering the Nation's criminal justice custodial populations. BJS began collection from local jails in 2000, and added State prisons in 2001, State juvenile correctional agencies in 2002, and State and local law enforcement agencies in 2003. These new collections are conducted on a quarterly basis and provide BJS with individual records for each death. Records include data on the deceased's individual characteristics (such as age, gender, race/ Hispanic origin), criminal background (such as legal status, offenses, time in custody), and the death itself (such as cause, time, location, and medical conditions and treatment). As a result, these new collections will provide the public with a richer source of data on such deaths, and on a more frequent basis. 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 1995-2002. 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. 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; Vol. 50, No. 15; and Vol. 52, No. 3. 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. Jennifer C. Karberg provided statistical review. Carolyn Williams and Tina Dorsey edited the report. Jayne Robinson prepared the report for publication. December 2004, NCJ 205333 Office of Justice Programs Partnerships for Safer Communities Http://www.ojp.usdoj.gov --------------------------------------------- End of file 12/03/04 ih 3/29/05 revised th