U.S. Department of Justice Office of Justice Programs Bureau of Justice Statistics Bulletin Hiv in Prisons and Jails, 1995 August 1997, NCJ-164260 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 The full text of this report is available through: *the BJS Clearinghouse, 1-800-732-3277 *on the Internet at http://www.ojp.usdoj.gov/bjs/ *on the BJS gopher: gopher://www.ojp.usdoj.gov:70/11/bjs/ *on the National Criminal Justice Reference Service Electronic Bulletin Board (set at 8-N-1, call 301-738-8895, select BJS). By Laura Maruschak, BJS Statistician ************ Highlights ************ HIV-positive State and Federal prison inmates ------------------------- Percent of custody Year Number population ------------------------------------------ 1991 17,551 2.2% 1992 20,651 2.5 1993 21,475 2.4 1994 22,717 2.4 1995 24,226 2.3 Between 1991 and 1995 the number of HIV-positive prisoners grew at about the same rate (38%) as the overall prison population (36%). At yearend 1995, 4.0% of all female State prison inmates were HIV positive, compared to 2.3% of male State prisoners. HIV-positive prison inmates ---------------------------- Percent of custody Jurisdiction Number population -------------------------------------------- New York 9,500 13.9% Florida 2,193 3.4 Texas 1,890 1.5 California 1,042 .8 New Jersey 847 3.7 Georgia 828 2.4 Federal system 822 .9 Connecticut 755 5.1 Maryland 724 3.4 Based on jurisdictions with more than 700 HIV-positive inmates. *New York held more than a third of all inmates (9,500 inmates) known to be HIV positive at yearend 1995. *Of all HIV-positive prison inmates, 21% were confirmed AIDS cases. In State prisons, 21% of HIV-positive inmates had AIDS; in Federal prisons, 16%. *The overall rate of confirmed AIDS among the Nation's prison population (0.51%) was more than 6 times the rate in the U.S. population (0.08%). Inmates in local jails, who have been tested for HIV, report similar HIV-infection rates: Tested jail inmates who reported results --------------------- Percent Number HIV positive -------- -------------- All inmate 289,991 2.2% Male 258,019 2.1 Female 31,972 2.4 White 110,023 1.4% Black 125,259 2.6 Hispanic 45,759 3.2 Age 24 or younger 81,228 .7% 25-34 116,532 2.1 35-44 70,776 3.8 45 or older 21,455 3.0 From the 1995-96 Survey of Inmates in Local Jails. *Jail officials in the last national Census of Jails (conducted in 1993) reported that 6,711 inmates were known to be HIV positive and 1,888 had confirmed AIDS. The infection rate was highest in the largest jail jurisdictions. By Laura Maruschak BJS Statistician At yearend 1995, 2.3% of all State and Federal prison inmates were reported by prison authorities to be infected with the human immunodeficiency virus (HIV). In State prisons 23,404 inmates were HIV positive (2.4% of the total), and in Federal prisons, 822 (0.9%). Of all inmates in U.S. prisons, 5,099 prisoners (0.5%) had confirmed AIDS, and 18,165 prisoners were HIV positive without having confirmed AIDS. In 1995, 1,010 State inmates died of AIDS-related causes, up from 955 in 1994. For every 100,000 State inmates in 1995, 100 died of AIDS-related causes. Between 1991 and 1995 about 1 in 3 inmate deaths were attributable to AIDS-related causes. Based on personal interviews conducted from October 1995 through March 1996 in the Survey of Inmates in Local Jails, almost 6 in 10 jail inmates reported ever being tested for HIV. Of those tested, 2.2% reported being HIV positive. Among female inmates, 2.4% said they were HIV positive; among male inmates, 2.1%. An estimated 1.6% of tested jail inmates who said they never used drugs were HIV positive, as were 2.3% who ever used drugs, 3.0% who used drugs in the month before arrest, 4.0% who used needles to inject drugs, and 6.3% who shared needles. ************* Data sources ************* Data on HIV/AIDS for prison inmates were provided by the departments of corrections in 50 States and the District of Columbia and by the Federal Bureau of Prisons. Since 1991 respondents have reported their HIV-testing policies and the number of HIV-infected inmates in their custody at yearend. Those inmates are reported to be asymptomatic, symptomatic, or with confirmed AIDS. Respondents have also reported for each year the number of inmate deaths from HIV-related infections as well as other causes. Data on HIV/AIDS and demographics for jail inmates were calculated from the 1993 Census of Jails and the 1995-96 Survey of Inmates in Local Jails. Through personal interviews conducted from October 1995 through March 1996, inmates held in locally operated jails were questioned about current offenses, prior drug use and treatment, personal characteristics, and other aspects of their life. Questions on whether inmates had ever been tested for HIV and the results of the test were included in the interviews. The 1993 Census of Jails provides the latest complete count of HIV-positive jail inmates and AIDS-related deaths as well as an overview of HIV testing policies in jail facilities. When combined with estimates from the 1995-96 survey of inmates, the jail census provides the most up-to date information available on HIV/AIDS in local jails. **************************************** Trends in HIV infection in U.S. prisons **************************************** At yearend 1995, 24,226 inmates in State and Federal prisons were known to be infected with the human immunodeficiency virus (HIV). In 1993, 20,516 State prisoners were HIV positive; in 1995, 23,404 were HIV positive, a 14% increase. The Federal Bureau of Prisons held 959 HIV-positive inmates in 1993 and 822 in 1995, a 14% decrease. ************************************************************************* Table 1. Inmates in custody of State or Federal prison authorities and and known to be positive for the human immunodeficiency virus, 1993-95 Total known to be HIV/AIDS cases as a percent HIV positive of total custody population/a ----------------------- ------------------------------ Jurisdiction 1993 1994 1995 1993 1994 1995 --------------------------------------------------------------------------- U.S. total/b 21475 22717 24226 2.4 2.4 2.3 Federal 959 964 822 1.2 1.1 0.9 State 20516 21753 23404 2.6 2.5 2.4 Northeast 10690 11001 12262 7.5 7.4 7.8 Connecticut 886 940 755 6.6 6.6 5.1 Maine 8 8 4 0.6 0.5 0.3 Massachusetts 394 388 409 3.9 3.4 3.9 New Hampshire 17 26 31 0.9 1.3 1.5 New Jersey 881 770 847 4.4 3.6 3.7 New York 8000 8295 9500 12.4 12.4 13.9 Pennsylvania 409 461 590 1.6 1.6 1.8 Rhode Island 89 113 126 3.4 3.8 4.4 Vermont 6 0 0 0.5 0 0 Midwest 1671 1750 1667 1.1 1.1 0.9 Illinois 591 600 583 1.7 1.6 1.5 Indiana -- -- -- -- -- -- Iowa 11 25 20 0.2 0.5 0.3 Kansas 39 20 24 0.7 0.3 0.3 Michigan 434 384 379 1.1 0.9 0.9 Minnesota 30 35 46 0.7 0.8 1 Missouri 136 146 173 0.8 0.8 0.9 Nebraska 17 16 19 0.7 0.6 0.6 North Dakota 2 3 2 0.3 0.5 0.3 Ohio 355 454 346 0.9 1.1 0.8 South Dakota -- 2 3 -- 0.1 0.2 Wisconsin 56 65 72 0.6 0.6 0.6 South 6657 7410 7840 2.1 2 1.9 Alabama 194 210 222 1.1 1.1 1.1 Arkansas 80 81 83 1 1 1 Delaware 113 34 122 2.7 0.8 2.5 District of Columbia -- -- -- -- -- -- Florida 1780 1986 2193 3.4 3.5 3.4 Georgia 745 854 828 2.7 2.6 2.4 Kentucky 42 44 41 0.5 0.5 0.4 Louisiana 262 285 314 1.6 1.8 1.8 Maryland 769 774 724 3.8 3.7 3.4 Mississippi 118 119 138 1.4 1.2 1.4 North Carolina 485 521 526 2.2 2.2 1.9 Oklahoma 102 102 115 0.8 0.8 0.8 South Carolina 452 434 380 2.7 2.5 2 Tennessee 88 89 120 0.8 0.7 0.9 Texas 1212 1584 1890 1.7 1.6 1.5 Virginia 207 285 134 1.1 1.4 0.6 West Virginia 8 8 10 0.4 0.4 0.4 West 1498 1592 1635 0.8 0.8 0.8 Alaska -- -- 5 -- -- 0.2 Arizona 89 143 140 0.5 0.7 0.7 California 1048 1055 1042 0.9 0.8 0.8 Colorado 74 79 93 0.8 0.9 1 Hawaii 21 14 12 0.7 0.5 0.4 Idaho 26 20 11 1 0.8 0.4 Montana 5 7 4 0.3 0.4 0.2 Nevada 100 122 147 1.6 1.8 1.9 New Mexico 11 19 24 0.3 0.5 0.6 Oregon 29 24 29 0.4 0.3 0.4 Utah 26 48 31 0.9 1.5 0.8 Washington 63 55 92 0.6 0.5 0.8 Wyoming 6 6 5 0.5 0.6 0.4 ---------------------------------------------------------------------------- --Not reported. /aThe custody population includes only those inmates housed in a jurisdiction's facilities. /bTotals exclude those inmates in jurisdictions that did not report data on HIV/AIDS. *************************************************************************** Between 1991 and 1995 the number of HIV-positive inmates grew at about the same rate as the overall prison population (38% compared to 36%). HIV-positive inmates comprised 2.3% of the State prison population in 1991 and 2.4% in 1995. In Federal prisons, HIV-positive inmates were 1.0% of all prisoners in 1991 and 0.9% in 1995. ********************************************* Percent of custody population known to be HIV-positive ------------------------------- Year State Federal -------------------------------------- 1991 2.3% 1.0% 1992 2.6 1.2 1993 2.6 1.2 1994 2.5 1.1 1995 2.4 .9 ********************************************* HIV-infected inmates are concentrated in a small number of States. New York and Florida house the largest number of HIV-positive inmates. In 1995 these two States held a little less than half of all HIV-positive inmates in the Nation. New York had the highest percentage of inmates known to be HIV positive (13.9%), followed by Connecticut (5.1%), Rhode Island (4.4%), Massachusetts (3.9%), and New Jersey (3.7%). Eight States reported having 10 or fewer cases of HIV-positive inmates in their prisons. Vermont reported no HIV-positive inmates. Twenty-seven States reported that fewer than 1.0% of their inmate population were HIV positive. New York reported the largest growth in the number of HIV-positive inmates, from 8,000 in 1993 to 9,500 in 1995. Substantial increases were also reported in Texas (an increase of 678 inmates) and Florida (413). ********************** Confirmed AIDS cases in U.S. prisons ********************** At the end of 1995, 5,099 confirmed AIDS cases were in U.S. prisons--4,965 State inmates and 134 Federal inmates. Of the remaining HIV-positive inmates, 3,058 showed symptoms of HIV infection and 15,107 were asymptomatic. ************************************************************************** Table 2. Inmates in custody of State and Federal prison authorities, by type of HIV infection or confirmed AIDS, yearend 1995 Confirmed AIDS case Cases of HIV or confirmed AIDS as a percent of -- -------------------------------- ---------------------- Asympto- Sympto- Confirmed Total HIV Custody Jurisdiction Total/a matic/b matic/c AIDS cases populatio ------------------------------------------------------------------------------------ U.S. total 24226 15107 3058 5099 21 0.5 Federal 822 118 570 134 16.3 0.1 State 23404 14989 2488 4965 21.2 0.5 Northeast 12262 9227 917 2118 17.3 1.4 Connecticut 755 254 314 187 24.8 1.3 Maine 4 0 0 4 ** 0.3 Massachusetts 409 94 155 160 39.1 1.5 New Hampshire 31 10 7 14 45.2 0.7 New Jersey 847 504 -- 343 40.5 1.5 New York 9500 8019 299 1182 12.4 1.7 Pennsylvania 590 337 67 186 31.5 0.6 Rhode Island 126 9 75 42 33.3 1.5 Vermont 0 0 0 0 ** Midwest 1667 1020 233 414 24.8 0.2 Illinois 583 351 55 177 30.4 0.5 Indiana -- -- -- -- -- -- Iowa 20 15 -- 5 25 0.1 Kansas 24 18 0 6 25 0.1 Michigan 379 272 -- 107 28.2 0.3 Minnesota 46 34 6 6 13 0.1 Missouri 173 -- 158 15 8.7 0.1 Nebraska 19 12 -- 7 36.8 0.2 North Dakota 2 1 0 1 ** 0.1 Ohio 346 270 -- 76 22 0.2 South Dakota 3 0 0 3 ** 0.2 Wisconsin 72 47 14 11 15.3 0.1 South 7840 3810 1138 1930 24.6 0.5 Alabama 222 180 -- 42 18.9 0.2 Arkansas 83 40 20 23 27.7 0.3 Delaware 122 80 -- 42 34.4 0.9 District of Columbia -- -- -- -- -- -- Florida 2193 1501 -- 692 31.6 1.1 Georgiaa 828 -- -- -- -- -- Kentucky 41 29 0 12 29.3 0.1 Louisiana 314 -- 228 86 27.4 0.5 Maryland 724 362 104 258 35.6 1.2 Mississippi 138 110 -- 28 20.3 0.3 North Carolina 526 -- 397 129 24.5 0.5 Oklahoma 115 107 -- 8 7 0.1 South Carolina 380 299 -- 81 21.3 0.4 Tennessee 120 -- 86 34 28.3 0.3 Texas 1890 1092 303 495 26.2 0.4 Virginiaa 134 -- -- -- -- -- West Virginia 10 10 0 0 ** 0 West 1635 932 200 503 30.8 0.2 Alaska 5 0 0 5 ** 0.2 Arizona 140 125 -- 15 10.7 0.1 California 1042 577 80 385 36.9 0.3 Colorado 93 28 46 19 20.4 0.2 Hawaii 12 11 0 1 8.3 *** Idaho 11 6 0 5 45.5 0.2 Montana 4 4 0 0 ** 0 Nevada 147 90 27 30 20.4 0.4 New Mexico 24 22 0 2 8.3 *** Oregon 29 11 11 7 24.1 0.1 Utah 31 21 4 6 19.4 0.2 Washington 92 36 28 28 30.4 0.2 Wyoming 5 1 4 0 ** 0 --------------------------------------------------------------------------------- Note: Totals and percentages exclude inmates in jurisdictions that did not report of HIV/AIDS infection. The custody population includes only inmates housed at the end of 1995. --Not reported. **Not calculated for fewer than 10 cases. ***Less than 0.05%. /aGeorgia and Virginia reported the total of HIV-positive cases but not the stage of HIV infection. /bIncludes inmates who tested positive for the HIV antibody but had no HIV-relate symptoms. /cIncludes inmates with symptoms of HIV infection but without a confirmed AIDS diagnois. ************************************************************************************ The number of prison inmates with confirmed AIDS more than tripled after 1991. The number of inmates with lesser or no symptoms of HIV infection grew by 15%. ***************************************** Other than Confirmed confirmed Year AIDS cases AIDS cases ---------------------------------------- 1991 1,682 15,797 1992 2,644 18,087 1993 3,765 17,773 1994 4,849 17,864 1995 5,099 18,165 ---------------------------------------- Note: Care should be exercised when comparing the number of reported cases over time. In January 1993 the Centers for Disease Control and Prevention revised the HIV classification system and expanded the surveillance case definition for AIDS to include specific CD4+ T-lymphocyte criteria and three additional clinical conditions--pulmonary tuberculosis, recurrent pneumonia, and invasive cervical cancer. This expansion resulted in a substantial increase in the number of reported AIDS cases during 1993. See Methodology. ******************************************* The States with the largest number of confirmed AIDS cases were New York (1,182), Florida (692), and Texas (495), which accounted for 48% of all confirmed AIDS cases in State prisons. Eighteen States reported having fewer than 10 inmates with confirmed AIDS in their prison systems. Confirmed AIDS cases comprised a half of one percent of all inmates in State and Federal prisons. Of those HIV-positive inmates in prison,about a fifth were confirmed AIDS cases. As a percentage of the total prison population in each State, the highest number of confirmed AIDS cases was in New York (1.7% of inmates in the State), followed by Massachusetts, New Jersey, and Rhode Island (each 1.5%). In 16 States, confirmed AIDS cases comprised 0.1% or less of State inmates. ****************************************** Comparison to the U.S. resident population ****************************************** At the end of 1995, the rate of confirmed AIDS in State and Federal prisons was more than 6 times higher than in the total U.S. population. Approximately 0.51% of all prisoners had confirmed AIDS, compared to 0.8 of the population. ****************************************** Percent of population with confirmed AIDS -------------------------------- U.S. Inmates in general State and Year population Federal prisons ---------------------------------------- 1991 0.03% 0.21% 1992 0.03 0.33 1993 0.06 0.50 1994 0.07 0.52 1995 0.08 0.51 ----------------------------------------- Note: The percent of the general population with confirmed AIDS in each year may be overestimated due to delays in death reports. Care should be exercised when comparing percentages over time, because of changes in the case definition for AIDS. See Methodology. ******************************************* In every year after 1991 the rate of confirmed AIDS was significantly higher among prison inmates than in the general population. In 1992 the rate of AIDS was nearly 10 times higher for prisoners than the general population. In 1993, following a revision of the HIV classification system and an expansion of the case definition for AIDS, the rate of confirmed AIDS increased 1 1/2 times among prisoners and doubled in the general population. After the adoption of these new measures, the incidence of AIDS grew somewhat faster in the general population (from 0.06% in 1993 to 0.08% in 1995) than in prison (from 0.50% to 0.51%). At yearend 1995, the rate of confirmed AIDS was over 6 times higher in prisons than in the general population. ************************************** AIDS-related deaths in State prisons ************************************** In 1995, 1,010 State inmates died of Pneumocystis carinii pneumonia, Kaposi's sarcoma, or other AIDS-related diseases. These AIDS-related deaths comprised about a third of all deaths of State prisoners. ********************************************* AIDS-related deaths as a percent of all deaths --------------------------------- U.S. general State population, prison Year age 15-54 * inmates ------------------------------------------- 1991 10.4% 28.0% 1992 11.7 35.2 1993 11.9 33.2 1994 12.7 35.1 1995 -- 34.2 ------------------------------------------- --Not available. *See Methodology for source of data. ******************************************* ******************************************************************************** Table 3. Number of inmate deaths in State prisons, by cause, 1993-95 1993 1994 1995 ------------------- --------------- ---------------- Rate of Rate of Rate of death death death Cause per 100,000 per 100,000 per 100,000 of death Number inmates Number inmates Number inmates ------------------------------------------------------------------------------------ Total 2477 290 2878 314 3133 311 Illness/natural causes 1188 139 1393 152 1569 156 AIDS 761 89 955 104 1010 100 Suicide 145 17 155 17 160 16 Accident 38 4 33 4 48 5 Execution 37 4 30 3 56 5 By another person 84 10 68 7 86 9 Other/unspecified 224 26 244 27 204 20 ------------------------------------------------------------------------------------ Note: In each year some States did not report complete data on cause of death. To calculate the rate of death, the number of inmates under State jurisdiction on June 30 of each year was used as an approximation of the average population exposed to the risk of death during the year. Inmates in States that did not report data on inmate deaths were excluded in 1993 and 1994. All States reported data on inmate deaths in 1995. *********************************************************************************** The rate of death because of AIDS is about 3 times higher in the prison population than in the total U.S. population age 15 to 54. Between 1991 and 1995 about 1 in every 3 prisoner deaths were attributable to AIDS-related causes, compared to about 1 in 10 deaths in the general population. From 1991 to 1995 "AIDS-related causes" was the second leading cause of death for State prisoners behind "illness and natural causes." For every 100,000 State inmates in 1995, 109 died of AIDS-related causes. The number of AIDS-related deaths in prison increased 94% from 1991 to 1995. ********************************************************************************** Table 4. AIDS-related deaths of sentenced prisoners under State jurisdiction, 1995 Deaths from all causes in State prisons AIDS-related deaths --------------------- -------------------------------- Rate per Rate per As a 100,000 100,000 percent of Jurisdiction Total inmates/ Total inmates/a all deaths/b --------------------------------------------------------------------------- Total 3133 311 1010 109 34.2% Northeast 740 468 402 254 54.3 Connecticut 42 280 24 160 57.1 Maine 0 0 0 0 ** Massachusetts 34 296 14 122 41.2 New Hampshire 2 97 2 97 ** New Jersey 137 535 66 258 48.2 New York 396 578 258 376 65.2 Pennsylvania 122 409 38 127 31.1 Rhode Island 7 223 0 0 ** Vermont 0 0 0 0 ** Midwest 481 252 63 42 16.7 Illinois 103 273 31 82 30.1 Indiana 44 280 1 6 2.3 Iowa 9 158 0 0 ** Kansas 13 188 0 0 ** Michigan 104 251 -- -- -- Minnesota 9 189 1 21 ** Missouri 53 280 4 21 7.5 Nebraska 13 464 0 0 0 North Dakota 1 164 0 0 ** Ohio 114 262 23 53 20.2 South Dakota 5 275 0 0 ** Wisconsin 13 122 3 28 23.1 South 1455 325 432 105 31.3 Alabama 88 438 20 100 22.7 Arkansas 26 286 1 11 3.8 Delaware 9 194 0 0 ** District of Columbia 7 67 -- -- -- Florida 254 410 150 242 59.1 Georgia 127 372 50 147 39.4 Kentucky 29 243 2 17 6.9 Louisiana 68 270 -- -- -- Maryland 54 252 25 117 46.3 Mississippi 42 337 5 40 11.9 North Carolina 69 257 28 104 40.6 Oklahoma 66 375 4 23 6.1 South Carolina 63 323 34 175 54 Tennessee 64 429 12 80 18.8 Texas 399 314 74 58 18.5 Virginia 83 304 27 99 32.5 West Virginia 7 287 0 0 ** West 457 217 113 54 24.7 Alaska 5 154 0 0 ** Arizona 58 277 0 0 0 California 262 199 91 69 34.7 Colorado 25 232 6 56 24 Hawaii 11 307 1 28 9.1 Idaho 1 31 0 0 ** Montana 11 581 0 0 0 Nevada 25 334 6 80 24 New Mexico 8 194 0 0 ** Oregon 21 280 5 67 23.8 Utah 6 183 0 0 ** Washington 23 202 4 35 17.4 Wyoming 1 76 0 0 ** ------------------------------------------------------------------------- --Not reported. **Not calculated for fewer than 10 deaths. /aBased on the number of inmates under State jurisdiction on June 30, 1995. /bNational and regional totals exclude inmates in jurisdictions that did not report data on cause of death. ****************************************************************************** In 1995 AIDS-related causes accounted for over half of all inmate deaths in New York (65%), Florida (59%), Connecticut (57%), and South Carolina (54%). Seventeen States reported having no AIDS-related deaths, and 4 States reported only 1 AIDS-related death. ********************************* HIV infection of male and female State inmates ********************************* At the end of 1995, there were 20,690 male and 2,182 female State inmates infected with HIV--2.3% of all male and 4.0% of all female State inmates. The rate of HIV infection was higher for women than men in every region and in most States. Table 5. State prison inmates known to be positive for the human immunodeficiency virus, by sex, yearend 1995 Male HIV cases Female HIV cases --------------- ------------------ Percent of Percent of Jurisdiction Number population Number population -------------------------------------------------------------------- Total 20690 2.3 2182 4 Northeast 11080 7.5 1182 14.7 Connecticut 627 4.6 128 13.4 Maine 4 0.3 0 0 Massachusetts 340 3.5 69 10.5 New Hampshire 17 0.9 14 11.4 New Jersey 748 3.4 99 9.8 New York 8678 13.4 822 22.7 Pennsylvania 561 1.8 29 2 Rhode Island 105 3.9 21 14.5 Vermont 0 0 0 0 Midwest 1553 0.9 114 1.2 Illinois 528 1.5 55 2.5 Indiana -- -- -- -- Iowa 18 0.3 2 0.5 Kansas 24 0.4 0 0 Michigan 364 0.9 15 0.8 Minnesota 41 0.9 5 2.5 Missouri 164 0.9 9 0.8 Nebraska 19 0.7 0 0 North Dakota 1 0.2 1 2.7 Ohio 324 0.8 22 0.8 South Dakota 3 0.2 0 0 Wisconsin 67 0.6 5 1 South 6598 1.8 740 3.2 Alabama 209 1.1 13 1 Arkansas 79 1 4 0.7 Delaware -- -- -- -- District of Columbia -- -- -- -- Florida 1971 3.3 222 6.1 Georgia 747 2.3 81 4 Kentucky 40 0.4 1 0.2 Louisiana 299 1.8 15 2.4 Maryland 665 3.3 59 5.5 Mississippi 136 1.4 2 0.3 North Carolina 437 1.7 89 5.3 Oklahoma 105 0.8 10 0.8 South Carolina -- -- -- -- Tennessee 118 0.9 2 0.5 Texas 1648 1.4 242 3 Virginia 134 0.6 0 0 West Virginia 10 0.4 0 0 West 1459 0.7 146 1 Alaska 5 0.2 0 0 Arizona 128 0.6 12 0.8 California 957 0.8 85 0.9 Colorado 87 1 6 0.8 Hawaii 12 0.5 0 0 Idaho 11 0.4 0 0 Montana 4 0.3 0 0 Nevada 93 1.3 24 4.6 New Mexico 23 0.6 1 0.3 Oregon 25 0.3 4 0.9 Utah 29 0.8 2 0.9 Washington 81 0.7 11 1.4 Wyoming 4 0.3 1 1.1 -------------------------------------------------------------------------- Note: The sex of inmates was not reported for 502 HIV cases. Totals exclude inmates in jurisdictions that did not report data on HIV/AIDS or sex of inmates. --Not reported. ************************************************************************* From 1991 to 1995 the number of male State inmates infected with HIV increased 28%, while the number of female inmates infected increased at a much faster rate--88%. Percent of custody Number population HIV in reporting Year positive States -------------------------------------------- Male 1991 16,150 2.2% 1992 18,266 2.6 1993 18,218 2.5 1994 19,762 2.4 1995 20,690 2.3 Percent change, 1991-95* 28.1% Females 1991 1,159 3.0% 1992 1,598 4.0 1993 1,796 4.2 1994 1,953 3.9 1995 2,182 4.0 Percent change, 1991-95* 88.3% -------------------------------------------- Note: Includes State inmates only. *In 1991 North Carolina, South Dakota, and the District of Columbia did not report data by sex. In 1995 Delaware, Indiana, South Carolina, and the District of Columbia did not report data by sex. In 1995 delaware. Indiana, South Carolina, and the District of Columbia did not report data by sex ******************************************** In five States, all in the Northeast, more than 10% of female inmates were known to be HIV positive--New York (22.7%), Rhode Island (14.5%), Connecticut (13.4%), New Hampshire (11.4%), and Massachusetts (10.5%). New York (13.4%) was the only State in which more than 10% of the male inmates were known to be infected with HIV. ********************* HIV-testing policies ********************* Each State, the District of Columbia, and the Federal Bureau of Prisons test their inmates for HIV based on certain criteria. Most jurisdictions (45 out of 52) test inmates if they have HIV-related symptoms or if the inmates request a test. Twenty-four States test inmates after they are involved in an incident, and 15 States test inmates who belong to specific "high-risk groups." ********************************************************************************************** Table 6. Prison system testing policies for the antibody to the human immunodeficiency virus, by jurisdiction, 1995 Involve- High Clinical ment In Upon risk Inmate indica- in Random Jurisdiction Entering custody release group request tion incident sample Other ----------------------------------------------------------------------------------------------- Federal *** *** *** *** Northeast Connecticut *** *** *** Maine * * Massaxhusetts * New Hampshire *** *** *** New Jersey *** *** New York *** *** *** *** *** *** Pennsylvania *** *** *** Rhode Island *** *** *** *** *** Vermont *** Midwest Illinois *** *** *** *** Indiana *** *** *** Iowa *** Kansas *** *** *** Michigan *** *** *** *** Minnesota *** *** *** *** Missouri *** *** *** *** *** *** Nebraska *** *** *** *** North Dakota *** Ohio *** *** *** *** *** South Dakota *** *** Wisconsin *** *** South Alabama *** *** *** *** Arkansas *** *** *** *** Delaware *** *** *** District of Columbia *** Florida *** *** *** *** Georgia *** *** *** Kentucky *** *** *** *** Louisiana *** *** Maryland *** *** *** Mississippi *** North Carolina *** *** *** *** *** Oklahoma *** *** *** South Carolina *** *** *** *** Tennessee *** *** *** Texas *** Virginia *** *** West Virginia *** *** West Alaska *** *** *** Arizona *** *** *** California *** *** *** Colorado *** *** *** *** *** Hawaii *** Idaho *** *** *** Montana *** *** *** Nevada *** *** New Mexico *** *** Oregon *** *** *** Utah *** *** Washington *** *** *** Wyoming *** *** ********************************************************************************************* Sixteen States test all inmates who enter their facilities. Three of these States (Alabama, Missouri, and Nevada) and the Federal Bureau of Prisons test inmates upon their release. Rhode Island, Utah, and Wyoming test all inmates currently in custody. Massachusetts, New York, and the Federal Bureau of Prisons test inmates selected at random. ******************************************** Testing policy Number ofjurisdictions -------------- ------------------------ Upon inmate request 40 Upon clinical indication ofneed 39 Upon involvement in an incident 24 All incoming inmates 16 High-risk groups 15 All inmates at time of release 4 Random sample 3 All inmates currently in custody 3 -------------------------------------------- Note: Detail adds to more than 52 because a jurisdiction may have more than one policy. ********************************************* ************************************* HIV infection of local jail inmates ************************************* At midyear 1993, when the last national census of local jails was conducted, 1.8% of the inmates were known to be HIV positive. Among jails reporting data, a total of 6,711 inmates were HIV positive and 1,888 had confirmed AIDS. 1993 Census of Jails ------------------------ Number HIV/AIDS as Size of HIV a percent of jurisdictiona positiveb jail inmates -------------------------------------------- Total 6,711 1.8% 50 largest 3,926 2.9 500 or more 1,374 1.6 250-499 490 1.2 100-249 470 1.0 Fewer than 100 451 .8 -------------------------------------------- aBased on the average daily population between July 1, 1992, and June 30, 1993. bExcludes inmates in facilities that did not report data. Source: HIV in Prisons and Jails, 1993. ******************************************* The infection rate was highest in the largest jail jurisdictions. Almost 3% of the inmates in the Nation's largest jurisdictions were reported to be HIV positive. Among the remaining jurisdictions, the larger the size, the greater the percentage of inmates with HIV/ AIDS. In jurisdictions with 500 or more inmates, 1.6% were infected; in jurisdictions with 250 to 499 inmates, 1.2% of the inmates; and in jurisdictions holding fewer than 250 inmates, 1% or less of the inmates. *************************************** HIV test results for local jail inmates, by inmate characteristic **************************************** More detailed data, based on interviews of a national sample of inmates in local jails, are available from the 1995-96 Survey of Inmates in Local Jails. Conducted between October 1995 and March 1996, the survey provides national estimates of the numbers of jail inmates tested for HIV/AIDS and the percent HIV positive. An estimated 62% of all respondents in the survey said they had ever been tested for HIV. Of those who had been tested and reported HIV test results (289,991), 2.2% said they were HIV positive. Among men, 2.1% said they were HIV positive; among women, 2.4%. An estimated 2.6% of black non-Hispanic inmates, compared to 1.4% of white non-Hispanic inmates, said they tested HIV positive. ************************************************************************* Table 7. Local jail inmates ever tested for the human immunodeficiency virus and results, by selected characteristics, 1995-96 1995-96 Survey of Local Jail Inmates --------------------------------------------- Tested inmates who reported results -------------------------- Percent of all inmates who Percent who Characteristics were ever tested Number were HIV positive ------------------------------------------------------------------------ All inmates 61.5 289991 2.2 Sex Male 62.1 258019 2.1 Female 68.6 31972 2.4 Race/Hispanic origin White non-Hispanic 62.4 110023 1.4 Male 62.0 98745 1.3 Female 65.7 11278 2.1 Black non-Hispanic 67.2 125259 2.6 Male 66.3 110453 2.5 Female 74.5 14806 3.2 Hispanic 55.1 45759 3.2 Male 53.9 40985 3.5 Female 67.6 4774 1.3 Other 55.3 8950 0 Age 24 or younger 57.6 81228 0.7 25-34 66.9 116532 2.1 35-44 64.4 70776 3.8 45 or older 57.8 21455 3 Marital status Married 62.3 45890 1.4 Widowed/divorced 61.4 48695 3 Separated 64.7 25929 2.1 Never married 62.9 169270 2.1 Education Less than high school 57.8 121589 2.3 GED 68.8 45431 1.3 High school graduate or more 66.5 122597 2.3 *********************************************************************** Among male inmates, black non-Hispanics (66%) were more likely to have been tested for HIV than white non-Hispanics (62%) and Hispanics (54%). Among those tested, black male inmates (2.5%) were nearly twice as likely as white male inmates (1.3%) to report being HIV positive. Among female inmates, black non-Hispanics (75%) were also more likely to have ever been tested for HIV than white non-Hispanics (66%). Although the percent who said they were HIV positive was higher among black females than white or Hispanic female inmates, the differences were not statistically significant. (See Methodology for sample design and accuracy of the survey methods.) Inmates in the age groups 25 to 34 and 35 to 44 were more likely to report having been tested for HIV than inmates in other age groups. Inmates age 24 or younger had the lowest rates of HIV positive (0.7%), while those 35 to 44 had the highest rates (3.8%). Inmates with a GED (69%) and those who completed high school (67%) were more likely to have ever been tested for HIV than inmates who had not completed high school (58%). Inmates who had completed high school were as likely as those who had not completed high school to say they tested HIV positive (2.3%). **************************************** Percent HIV positive among jail inmates, by offense and prior drug use **************************************** Among jail inmates who said they had been tested for HIV/AIDS, those held for drug offenses were the most likely to be HIV positive (3.3%). Drug offenders were twice as likely as violent offenders (1.5%) to report that they tested positive for HIV. property and public-order offenders reported somewhat lower rates--2.2% and 1.7%, respectively. The percentage of jail inmates reporting that they were HIV positive varied by level of prior drug use. An estimated 2.3% of inmates who had ever used drugs, 3.0% of convicted inmates who used drugs in the month before their current offense, 4.0% of inmates who said they had used needles to inject drugs, and 6.3% of those who had shared a needle with someone else were HIV positive. ************************************************************************************ Table 8. Local jail inmates testing HIV positive, by offense and prior drug use, 1995-96 1995-96 Survey of Inmates in Local Jails ----------------------------------------------- Tested inmates who All jail inmates reported results -------------------- ------------------------ Percent Percent Characteristic Number ever tested Number HIV positive --------------------------------------------------------------------------------- Current offense/a Violent 130583 61.5 72846 1.5 Property 133513 66.3 79936 2.2 Drug 109180 65.7 65780 3.3 Public-order 120882 57.6 64820 1.7 Prior drug use/b Never used 88553 52.3 42242 1.6 Ever used 413285 65.0 247233 2.3 Used month before offense/c 172840 67.4 107900 3.0 Used needle to inject drugs/d 85622 77.6 61862 4.0 Shared a needlee 34850 78.6 25476 6.3 --------------------------------------------------------------------------------- /aExcludes jail inmates whose offense was unknown. /bInmates were asked a detailed set of questions about past use of illegal drugs. These drugs included marijuana, barbiturates, methaqualone, tranquilizers (without a doctor's prescription), methamphetamine, other amphetamines, crack, cocaine other than crack, heroin, other opiates, PCP, LSD, inhaled or sniffed substances, and other drugs. /cInmates who were unconvicted (awaiting arraignment, awaiting trial or on trial) were not asked any questions about drug use during the month before the arrest for which they were currently detained. /dAll inmates who reported prior drug use were asked: "Have you ever used a needle to get any drug injected under your skin, into a muscle or into a vein for non-medical reasons?" /eInmates who reported ever using a needle to inject drugs were asked: "Have you ever used a needle that you knew or suspected had been used by someone else for injecting drugs or shared a needle that you had used with someone else?" ***************************************************************************************** ************* Methodology ************* National Prisoner Statistics ------------------------------ The National Prisoner Statistics series (NPS-1) includes an annual yearend count of prisoners by jurisdiction, sex, race, Hispanic origin, and admissions and releases during the year. The series consists of yearly reports to BJS from the departments of corrections of the 50 States and the District of Columbia and from the Federal Bureau of Prisons. Since 1991 respondents have been asked to indicate their policies for testing for HIV and to provide the number of HIV-infected inmates in their custody on the last day of the calendar year. 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 1991-95. 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 data for the U.S. general population, excluding persons under age 13, for 1991 to 1995 were taken from U.S. Population Estimates, by Age, Sex, Race, and Hispanic Origin: 1990 to 1995. Population Projections Branch, Population Division: U.S. Bureau of the Census, February 14, 1996, PPL-41. 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 age 13 or older. The classification system for HIV infection and the case definition for AIDS were expanded in 1993. This expansion improved estimates of the number and characteristics of persons with HIV disease, but complicated interpretation of AIDS trends. The increase in reported AIDS cases in 1993 was largely the consequence of the added surveillance criteria. (See CDC, Morbidity and Mortality Weekly Report, Vol. 43, No. 45, November 18, 1994.) 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 1994 and 1995. 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); and Vol. 45, No. 3(S). 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. Data on jail inmates ---------------------- A jail is defined as a confinement facility administered by a local government agency that holds persons detained pending adjudication and persons committed after adjudication, usually for sentences of a year or less. Convicted jail inmates are either awaiting sentencing, serving sentences to jail confinement, awaiting transfer to a prison, or serving a prison sentence in jail by arrangement with prison authorities. Unconvicted inmates are those who have been unable to obtain pretrial release, those detained pending trial, those on trial at the time the survey was being conducted, and those held for other governmental entities. Census of Jails ---------------- The 1993 Census of Jails included all locally administered confinement facilities (3,287) that held inmates beyond arraignment and were staffed by municipal or county employees. The census also included 17 jails that were privately operated under contract for local governments. Excluded from the census were temporary holding facilities, such as drunk tanks and police lockups, that do not hold persons after being formally charged in court (usually within 72 hours of arrest). Also excluded were State-operated facilities in Alaska, Connecticut, Delaware, Hawaii, Rhode Island, and Vermont, which have combined jail-prison systems. Survey of Inmates in Local Jails --------------------------------- The 1995-96 Survey of Inmates in Local Jails was conducted for BJS by the U.S. Bureau of the Census. Through personal interviews conducted from October 1995 through March 1996, data were collected on individual char-acteristics of jail inmates, current of-fenses, 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. Similar surveys of jail inmates were conducted in 1972, 1978, 1983, and 1989. ***************************************************************** Appendix table. Standard error estimates for the Survey of Inmates in Local Jails, 1995-96 Estimated standard error ------------------------------- Percent of all inmates Percent who were who were Characteristic ever tested HIV positive --------------------------------------------------------------- Sex Male 0.94 0.33 Female 1.66 0.44 Race/Hispanic origin White non-Hispanic 1.35 0.38 Male 1.45 0.41 Female 2.37 0.68 Black non-Hispanic 1.21 0.47 Male 1.3 0.53 Female 2.06 0.74 Hispanic 1.79 0.98 Male 1.93 1.09 Female 3.03 0.76 Age 24 or younger 1.48 0.3 25-34 1.21 0.42 35-44 1.57 0.85 45 or older 2.68 1.13 Marital status Married 1.97 0.58 Widowed/divorced 1.9 0.9 Separated 2.34 0.97 Never married 1.06 0.38 Education Less than high school 1.29 0.47 GED 2.02 0.46 High school graduate or more 1.2 0.49 Current offense Violent 1.69 0.49 Property 1.47 0.52 Drug 1.58 0.79 Public-order 1.75 0.66 Prior drug use Never used 1.88 0.62 Ever used 0.93 0.33 Used in month before offense 1.28 0.58 Used needle to inject drugs 1.57 0.85 Shared a needle 2.49 1.71 ***************************************************************************** Sample design --------------- The sample for the 1995-96 survey was selected from a universe of 3,328 jails that were enumerated in the 1993 Census of Jails. The sample design was a stratified two-stage selection. In the first stage six separate strata were formed based on the size of the male and female populations. In two strata all jails were selected--those jails housing only females, and those with either more than 1,000 males or more than 50 females or both. In the remaining four strata a systematic sample of jails was selected. Each jail within a stratum had an equal probability of selection. Equal probabilities were used instead of probability proportional to size because jail populations were likely to change between 1993 and 1995. Overall, 462 jails were selected. Interviews were conducted in 431 jails; 19 refused, 8 were closed, and 4 were on the universe list in error. In the second sampling stage, interviewers visited each selected facility and systematically selected a sample of male and female inmates using predetermined procedures. As a result,approximately 1 in every 100 males were selected in 4 strata and 1 in 83 in the other male stratum. Depending on the stratum, 1 in 50, 25, 24, or 21 females were selected. A total of 6,133 inmates were interviewed, and 738 refused to participate, for a second stage nonresponse of 10.8%. The total nonresponse from both stages was 13.7%. Based on the completed interviews, estimates for the entire population were developed using weighting factors derived from the original probability of selection in the sample. These factors were adjusted for variable rates of nonresponse across strata and inmate characteristics. Further adjustments were made to control the survey estimates to counts of jail inmates obtained from the 1993 Census of Jails and the 1995 Annual Survey of Jails. Accuracy of the survey estimates ----------------------------------- The accuracy of the estimates from the 1995-96 Survey of Inmates in Local Jails depends on two types of error: sampling and nonsampling. Sampling error is variation that may occur by chance because a sample rather than a complete enumeration of the population was conducted. Nonsampling error can be attributed to many sources, such as nonresponse, differences in the interpretation of questions among inmates, recall difficulties, and processing errors. In any survey the full extent of the nonsampling error is never known. 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 (see appendix table). These standard errors may be used to construct confidence intervals around percentages. For example, the 95-percent confidence interval around the percentage of males who were HIV positive is approximately 2.1% plus or minus 1.96 times 0.33% (or 1.5% to 2.7%). These standard errors may also be used to test the statistical significance of the difference between two sample estimates by pooling the standard errors of the estimates (that is, by taking the square root of the sum of the squared standard errors for each sample estimate). All comparisons discussed in this report were statistically significant at the 95-percent confidence level. Other reports on HIV/AIDS ---------------------------- HIV/AIDS-related data are collected through regularly scheduled BJS censuses and surveys of correctional agencies and offenders under correctional supervision. Annual publications provide only the most recently obtained information. See previous BJS reports for HIV/AIDS data in local jails and HIV test results reported by State prisoners (HIV in U.S. Prisons and Jails, NCJ-143292; HIV in Prisons and Jails, 1993, NCJ-152765; and HIV in Prisons 1994, NCJ-158020). The data published from the BJS collections complement those collected in surveys sponsored by the National Institute of Justice (NIJ) and the Centers for Disease Control and Prevention (CDC). The most recent report by Theodore M. Hammett and others, 1994 Update: HIV/AIDS and STDs in Correctional Facilities (December 1995, NCJ-156832), contains detailed reporting about the prevalence, testing, education, and prevention for HIV and AIDS in Federal, State, and 29 large city/county correctional systems. The 1994 update provides cumulative total inmate deaths by region, total current AIDS cases, and HIV-seroprevalence data by both jurisdiction and type of testing policy. Currently, the NIJ and CDC are working on the ninth national survey of HIV/AIDS in Correctional Facilities. The survey sample will include the Federal Bureau of Prisons, all 50 State departments of corrections plus Puerto Rico, all 50 State-operated juvenile commitment facilities, 50 of the largest jail systems, 30 of the largest region- or county-based juvenile detention centers, 50 State health departments, and other public health agencies in the United States as identified by CDC. In addition, 50 adult correctional facilities and 50 juvenile facilities within the surveyed Federal, State, and regional/ county jail systems will be included in the survey sample to validate system responses related to policy issues. The NIJ-CDC study will also collect information on the impact of infectious disease on correctional policy-related questions and related legal issues, prevalence of HIV/AIDS and TB, confirmed AIDS case rates, and AIDS-related deaths among correctional populations. --------------------------------------------- The Bureau of Justice Statistics is the statistical agency of the U.S. Department of Justice. Jan M. Chaiken, Ph.D., is director. BJS Bulletins present the first release of findings from permanent data collection programs such as the National Prisoner Statistics Program. State and Federal corrections officials have cooperated in reporting the data presented. Laura Maruschak wrote this report, under the supervision of Allen J. Beck. Darrell Gilliard, Caroline Wolf Harlow, Valerie Tumminia, and Doris James Wilson provided statistical review. Tom Hester edited the report. Marilyn Marbrook, assisted by Yvonne Boston and Jayne Robinson, administered final production. Data collection and processing for the NPS program were carried out by Elizabeth Griffin and Laarni Verdolin under the supervision of Gertrude Odom and Kathleen Creighton, Demographic Surveys Division, U.S. Bureau of the Census. August 1997, NCJ-164260 ----------------------------------------------------------------- ----------------------------------------------------------------- The report and NPS data are available on the Internet: http://www.ojp.usdoj.gov/bjs/ ----------------------------------------------------------------- ************************ BJS corrections reports ************************ Available on the Internet at the above address, or call 1-800-732-3277, or fax your order with your name, address, report title, and NCJ number (up to 5 titles free) to 1-410-792-4358. ************ Forthcoming ************ Profile of jail inmates, 1995-96, NCJ 164620 Characteristics of adults on probation, 1995, NCJ-164267 Census of State and Federal correctional facilities, 1996, NCJ 164266 ******* Recent ******* Probation and parole 1996 (press release), NCJ 166364, 8/97, 8pp HIV in prisons and jails, 1995,NCJ-164260, 8/97, 11pp Prisoners in 1996, NCJ-164619, 6/97, 15pp Correctional populations in the United States, 1995: Full report, NCJ 163916, 6/97,215pp Executive summary, NCJ 163917, 7/97, 3pp Lifetime likelihood of going to State or Federal prison, NCJ 160092, 3/97, 13pp Prison and jail inmates at midyear 1996, NCJ162843, 1/97, 11pp Prison and jail inmates 1995, NCJ-161132, 8/96, 16pp Capital punishment 1995, NCJ-162043, 12/96, 16pp Probation and parole 1995, NCJ-161722, 6/96, 8pp HIV in prisons, 1994, NCJ 158020, 3/96, 8pp Child victimizers: Violent offenders and their victims, NCJ 153258, 3/96, 31pp Comparing Federal and State prison inmates, 1991, NCJ- 145864, 10/94, 35pp Profile of inmates in the U.S. and in England and Wales, 1991, NCJ 145863, 10/94, 24pp Survey of State prison inmates, 1991, NCJ 136949, 5/93, 34pp