U.S. Department of Justice Office of Justice Programs Bureau of Justice Statistics Bulletin HIV in Prisons and Jails, 1999 July 2001, NCJ 187456 ----------------------------------------------------------- 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/hivpj99.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 HIV-positive State and Federal prison inmates Percent of custody Year Number population 1995 24,256 2.3% 1996 23,881 2.2 1997 23,886 2.1 1998 25,680 2.2 1999 25,757 2.1 * Between 1995 and 1999 the number of HIV-positive prisoners grew at a slower rate (6%) than the overall prison population (19%). * At yearend 1999, 3.4% of all female State prison inmates were HIV positive, compared to 2.1% of males. HIV-positive prison inmates Percent of custody Jurisdiction Number population New York 7,000 9.7% Florida 2,633 3.8 Texas 2,520 1.8 California 1,570 1.0 Federal system 1,150 0.9 Based on jurisdictions with more than 1,000 HIV-positive inmates. * New York held more than a quarter of all prison inmates (7,000) known to be HIV positive at yearend 1999. * In State prisons 27% of HIV- positive inmates were confirmed AIDS cases; in Federal prisons, 37% had AIDS. * The overall rate of confirmed AIDS among the Nation's prison population (0.60%) was 5 times the rate in the U.S. general population (0.12%). AIDS-related deaths Rate per Year Number 100,000 inmates 1995 1,010 100 1996 907 90 1997 538 48 1998 350 30 1999 242 20 * The number of AIDS-related deaths has been dramatically decreasing since 1995. In 1999 there were fewer than a quarter of the number of AIDS-related deaths (242) than in 1995 (1,010). * Among jail inmates, the HIV infection rate was highest in the largest jail jurisdictions. In 43 of the 50 largest jurisdictions that reported data, 2.3% were HIV positive compared to 1.1% in jurisdictions with fewer than 100 inmates. * New York City, the second largest jail jurisdiction, held 1,165 jail inmates known to be HIV positive (7.1% of its inmates). * Between July 1, 1998, and June 30, 1999, 1 in 12 deaths among jail inmates were due to AIDS-related causes. ----------------------------------------------------------- In 1999, 2.3% of State prison inmates, 0.9% of Federal prison inmates, and 1.7% of local jail inmates were known to be infected with the human immunodeficiency virus (HIV). At yearend 1999 correctional authorities reported that 24,607 State inmates and 1,150 Federal inmates were HIV positive. At midyear 1999, when the last census was conducted, 8,615 local jail inmates were known to be HIV positive. Of those known to be HIV positive in all U.S. prisons, 6,642 were confirmed AIDS cases, while 17,718 either showed symptoms of HIV infection or were asymptomatic. Of those in jail, 3,081 had confirmed AIDS. During 1999, 242 State prisoners (20 per 100,000) died from AIDS-related causes, down from 1,010 in 1995. In 1999 about 1 in 12 State prison inmate deaths were attributed to AIDS; in 1995 about 1 in 3. Between July 1, 1998, and June 30, 1999, 78 jail inmates (13 per 100,000) died from AIDS-related causes. 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. Data for jail inmates were provided by 3,365 locally administered confinement facilities. Number of HIV-infected prison inmates up slightly from 1997 to 1999 At yearend 1999, 25,757 inmates in State and Federal prisons were known to be infected with the human immunodeficiency virus (HIV). Since 1997, among States that reported data in all three years, the number known to be HIV positive rose 6.4% from 23,779 to 25,296. On December 31, 1999, 24,607 State prison inmates and 1,150 Federal inmates were known to be HIV positive. The percent of the total prison population with HIV/AIDS -- 2.1% in 1997, 2.2% in 1998, and 2.1% in 1999 -- remained stable. HIV-positive inmates comprised 2.3% of the State prison population in 1999 down from 2.4% in 1995. In Federal prisons, HIV-positive inmates comprised 0.9% in 1999, unchanged from 1995. Percent of custody population known to be HIV positive Year State Federal 1995 2.4% 0.9% 1996 2.3 1.0 1997 2.2 1.0 1998 2.3 1.0 1999 2.3 0.9 HIV-infected inmates were concentrated in relatively few States. New York (7,000), Florida (2,633), and Texas (2,520) held the largest number of HIV-positive inmates. In 1999 these three States housed nearly half of all HIV-infected inmates in State prisons. Inmates in the Northeast had the highest rates of HIV infection Within the Northeast, 6.0% of the State prison population were HIV positive in 1999, followed by 2.2% in the South, 1.0% in the Midwest, and 0.9% in the West. New York had the highest percentage of inmates known to be HIV positive (9.7%), followed by the District of Columbia (7.8%) and Rhode Island (6.9%). Six States (Maine, Montana, North Dakota, South Dakota, West Virginia, and Wyoming) reported 10 or fewer cases of HIV-positive inmates in their prisons. In 1999 every State reported at least one HIV-positive inmate. Six States reported that fewer than 0.5% of their inmate population were HIV positive. Between 1998 and 1999 the largest decrease of HIV-positive inmates was reported in New York -- 7,000 in 1999, down from 7,500 in 1998. The largest increases were reported in Florida (up 172), Maryland (134), and Texas (127). The number of confirmed AIDS cases in U.S. prisons has increased every year since 1995 At the end of 1999, 6,642 inmates in U.S. prisons had confirmed AIDS: 6,211 State inmates and 431 Federal inmates. Confirmed AIDS cases made up 0.6% of all inmates in State and Federal prisons. Of those known to be HIV-positive inmates, over a quarter had confirmed AIDS. The States with the largest number of confirmed AIDS cases were New York (1,170), Texas (994), Florida (804), and California (553). Combined, these States made up more than half of all confirmed AIDS cases in State prisons. Nineteen States reported having fewer than 10 confirmed AIDS cases in their prisons. The District of Columbia (1.8%) reported the highest percentage of confirmed AIDS, followed by New York (1.6%), Connecticut (1.5%), Maryland (1.4%), and Massachusetts (1.3%). In 16 States confirmed AIDS cases comprised 0.1% or less of State inmates. Because some States each year did not report the number of cases according to the 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 6,809 in 1998 to 6,825 in 1999. Overall, since 1995 the estimated number of confirmed AIDS cases has increased by 1,668 -- an annual average increase of 7.3%. Number of confirmed AIDS cases Reported Estimated Year number/a number/b 1995 5,099 5,157 1996 5,874 6,092 1997 6,184 6,326 1998 6,282 6,809 1999 6,642 6,825 a/Excludes 3 States in 1999, 6 in 1998, 3 in 1997, 5 in 1996, and 2 in 1995. b/In States not reporting confirmed AIDS, estimates were made by applying the same percent break- down by type of HIV infection from the most recent year when data were provide. Rate of confirmed AIDS higher among prison inmates than in U.S. general population At the end of 1999, the rate of confirmed AIDS in State and Federal prisons was 5 times higher than in the total U.S. population. About 60 in 10,000 prison inmates had confirmed AIDS, compared to 12 in 10,000 persons in the U.S. population. In every year since 1995, the rate of confirmed AIDS has been higher among prison inmates than in the general population. Percent of population with confirmed AIDS State and U.S. general Federal Year population prisoners 1995 0.08% 0.51% 1996 0.09 0.54 1997 0.10 0.55 1998 0.11 0.53 1999 0.12 0.60 Note: The percent of the general population with confirmed AIDS in each year may be over-estimated due to delays in death reports. See Methodology for source of data. A greater percent of females than males known to have HIV infection At yearend 1999 in State prisons, 21,431 male inmates and 2,300 female inmates were known to be HIV positive. Overall, 2.1% of male inmates and 3.4% of all female inmates were known to be HIV positive. The rate of HIV infection was higher among females than among males in all regions and in most States. Among all States, New York reported the largest number of male and female HIV-positive inmates (6,240 and 760, respectively). The second largest number of HIV-positive male inmates were in Florida (2,439) followed by Texas (2,238). The second largest number of HIV-positive female inmates were in Texas (282) followed by Florida (194). Eight States reported no female HIV-positive inmates, and every State reported at least one male HIV-positive inmate. In nine States more than 5% of all female inmates were known to be HIV positive. In three States over 20% of all female inmates were known to be HIV-positive -- Nevada (30.6%), the District of Columbia (22.4%), and New York (21.5%). In all States fewer than 10% of all male inmates were reported to be HIV-positive. Because some States in each year did not report the number of HIV cases by gender, estimates were made for those States to provide comparable year-to-year data. Based on yearly estimates, between 1998 and 1999 the number of HIV-infected females decreased by 150 (from 2,552 to 2,402); the number of infected male inmates increased 130 (from 22,045 to 22,175). On average, from 1995 to 1999 the estimated number of male State prisoners infected with HIV increased 1.2% annually, and the estimated number of female prisoners, 1.9%. While the estimated number of both male and female HIV-positive inmates in State prisons has increased since 1995, the percentage of male HIV-positive inmates has remained relatively stable, fluctuating between 2.3% and 2.1%, and the percentage of female inmates has decreased from 4.0% in 1995 to 3.5% in 1999. State prison inmates Estimated Percent number of HIV/AIDS HIV-positive in custody Year inmates* population Males 1995 21,144 2.3% 1996 21,299 2.2 1997 20,608 2.1 1998 22,045 2.2 1999 22,175 2.2 Annual average change, 1995-99 1.2% Females 1995 2,230 4.0 1996 1,938 3.1 1997 2,258 3.5 1998 2,552 3.8 1999 2,402 3.5 Annual average change, 1995-99 1.9% *To provide year-to-year comparisons, estimates were made for States not reporting a gender breakdown. For each State, estimates were made by applying the same percent breakdown by gender from the most recent year when data were provided. AIDS-related deaths in State prisons have dropped by more than 75% since 1995 The number of State inmates who died of Pneumocystis carinii pneumonia, Kaposi's sarcoma, or other AIDS-related diseases peaked in 1995 and has been steadily decreasing. Between 1995 and 1999 the number of AIDS-related deaths decreased 768 from 1,010 to 242. These AIDS deaths accounted for 8% of all deaths among State prisoners, down from 32% in 1995. Between 1995 and 1999, the number of AIDS-related deaths in State prisons has decreased by more than 75%. With the introduction of protease inhibitors and combination antiretroviral therapies, there has been vast improvement in the effectiveness of HIV/AIDS care. Number of AIDS- Rate of AIDS related deaths among deaths per Year State prisoners 100,000 inmates 1991 520 71 1992 648 83 1993 761 89 1994 955 104 1995 1,010 100 1996 907 90 1997 538 48 1998 350 30 1999 242 20 Despite the sharp decrease, AIDS-related illnesses are still the second leading cause of death in State prisons behind natural causes other than AIDS. Among Federal inmates, 16 died from AIDS-related causes. For every 100,000 inmates, 12 died from AIDS-related causes. These AIDS-related deaths accounted for 6% of all deaths in Federal prison. Federal inmates, 1999 Rate of death per Number 100,000 Cause of death of deaths inmates Total 268 206 Natural causes other than AIDS 235 180 AIDS 16 12 Suicide 12 9 Accident 0 0 Execution 0 0 By another person 5 4 Other/unspecified 0 0 AIDS-related deaths accounted for about 11% of all deaths in State prisons and 6% in Federal prisons in 1999 In 1999, for every 100,000 State and Federal inmates, 24 died from AIDS-related causes. The most AIDS deaths were reported in the South (115), followed by the Northeast (64). Together, these two regions accounted for nearly two-thirds of AIDS-related deaths in State prisons. Florida reported the largest number of AIDS-related deaths (52), followed by California (32), and New York (26). Twenty-two States reported having no AIDS-related deaths. AIDS-related deaths accounted for more than half of all inmate deaths in Delaware (62%), and more than a quarter in Florida (29%), Massachusetts (29%), the District of Columbia (26%), and Nevada (26%). AIDS deaths as a percent of all deaths in State prison more than twice that in the general population The percentage of deaths because of AIDS was about 2 times higher in the State prison population than in the U.S. general population age 15-54. In 1998 about 1 in every 8 prisoner deaths were attributable to AIDS-related causes compared to about 1 in 20 deaths in the general population. AIDS-related deaths as a percent of all deaths U.S. general State population age Year prisoners/a 15-54/b 1991 28.0% 10.4% 1992 35.2 11.7 1993 33.2 11.9 1994 35.1 12.7 1995 34.2 13.1 1996 30.8 10.1 1997 18.9 5.8 1998 13.3 5.4 1999 11.2 -- Not available. a/Percents are based on the number of inmate deaths, excluding those in jurisdictions not reporting AIDS- related deaths. b/See Methodology for source of data. 19 States test all inmates either at admission or while in prison for HIV Data on HIV prevalence rates are reported in the National Prisoners Statistics series (NPS) by prison officials. The quality of the information reported may vary by the circumstances under which inmates were tested. Circumstances range from testing all inmates to testing only upon inmate request. Each State, the District of Columbia, and the Federal Bureau of Prisons tested their inmates for HIV based on certain criteria. Most jurisdictions (50) tested inmates if they had HIV-related symptoms or if the inmates requested a test. Thirty-nine States tested inmates after they were involved in an incident, and 16 States tested inmates who belonged to specific "high-risk groups." Number of Circumstances jurisdictions Upon inmate request 45 Upon clinical indica- tion of need 47 Upon involvement in an incident 39 All incoming inmates 19 High-risk groups 16 All inmates at time of release 3 All inmates currently in custody 3 Court order 35 Random sample 7 Note: Detail adds to more than 52 because a jurisdiction may test inmates under multiple circumstances. Missouri, Nevada, and the Federal Bureau of Prisons tested inmates upon release. Arkansas, South Carolina, and Nevada tested all inmates currently in custody. Six States and the Federal Bureau of Prisons tested inmates selected at random. More than 8,500 jail inmates HIV positive On June 30, 1999, when the last Census of Jails was conducted, 1.7% of jail inmates were reported to be HIV positive. Prior to 1999, a census of jails was conducted in 1993. While the number infected has increased from 6,711 in 1993 to 8,615 in 1999, the percent of the total jail population with HIV/AIDS has remained stable (1.8% in 1993). In 1999, jails in the South held the largest number of HIV-positive inmates, followed by the Northeast (3,822 and 3,105, respectively). Together, these two regions accounted for 80% of all jail inmates known to be HIV positive. On June 30, 1999, the District of Columbia had the highest percentage of jail inmates known to be HIV positive (7.6%), followed by New York (4.3%), and Massachusetts (4.0%). Nearly half of all jail inmates known to be HIV positive were housed in 43 of the 50 largest jurisdictions At midyear 1999, 43 of the 50 largest jail jurisdictions held 3,987 inmates who were known to be HIV positive. New York City alone held 1,165 HIV-positive inmates, accounting for almost 30% of those inmates known to be HIV positive in the 50 largest jurisdictions. The HIV-infection rate was highest in the largest jail jurisdictions. More than 2% of the inmates in the Nation's largest jail jurisdictions were reported to be HIV positive. In jurisdictions with 500 or more inmates, 1.9% were HIV positive; in jurisdictions with 250 to 499 inmates, 1%; and among those jails holding fewer than 250 inmates, about 1%. 1999 Census of Jails HIV/AIDS as Size of Number HIV a percent of jurisdiction/a positive/b jail inmates/c Total 8,615 1.7% 50 largest 3,987 2.3 500 or more/d 2,748 1.9 250-499 591 1.0 100-249 604 0.9 Fewer than 100 685 1.1 a/Number of inmates in each jurisdiction based on the average daily population between July 1, 1998, and June 30, 1999. b/Count as of June 30, 1999. c/Excludes inmates held in jurisdictions that did not report data on the number of HIV-positive inmates. d/Excludes inmates in the 50 largest jurisdictions. 1 in 12 deaths among jail inmates attributable to AIDS Between July 1, 1998, and June 30, 1999, 78 local jail inmates died from AIDS-related causes. These 78 deaths accounted for 8.5% of all deaths in local jails. The number of deaths due to AIDS-related causes was highest in the South (47), followed by the Northeast (26). The number of deaths in these two regions accounted for 94% of all AIDS-related deaths. Florida reported the greatest number of AIDS deaths (15), followed by New York and Georgia (both with 11). Twenty-eight jurisdictions reported having no HIV-related deaths. AIDS-related deaths were the third leading cause of death in jails. Natural causes is the leading cause of death (with 385 in the 12-month period ending June 30, 1999), followed by suicide (324). The rate of death in jails due to AIDS-related causes is lower than that in State prisons. Based on the average daily population of jails, the rate of deaths was 13 per 100,000 inmates (compared to 20 per 100,000 in State prisons). Jail inmates, July 1, 1998, to June 30,1999 Rate per Number 100,000 Cause of death of deaths inmates Total 919 155 Natural causes other than AIDS 385 66 AIDS 78 13 Suicide 324 55 By another person 28 5 Other/unspecified 92 16 Note: Detail does not add to the total because cause of death unknown for 12 inmates. Methodology National Prisoner Statistics The National Prisoner Statistics series (NPS-1) includes yearend counts of prisoners by jurisdiction, gender, race, Hispanic origin, and admissions and releases during the year. The series consists of reports from the departments of corrections of the 50 States, the District of Columbia, and the Federal Bureau of Prisons. Since 1991 respondents have indicated the circumstances under which inmates are tested for HIV and have provided the number of HIV-infected inmates in their custody. Census of Jails The 1999 Census of Jails included 3,365 locally administered confinement facilities that held inmates beyond arraignment and were staffed by municipal or county employees. The census also included 47 jails that were privately operated under contract to 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 integrated jail-prison systems. AIDS in the U.S. resident population The number of persons with confirmed AIDS in the U.S. general population (age 13 and over) was derived from the Centers for Disease Control and Prevention (CDC), HIV/AIDS Surveillance Report, yearend editions 1995-99. For each year the number of active AIDS cases in the United States was calculated by subtracting the number of cumulative AIDS deaths for people age 15 and older at yearend from the cumulative number of total AIDS cases for people age 13 and older at yearend as listed in the HIV/AIDS Surveillance Report. The rate of confirmed AIDS cases in the U.S. resident population was calculated by dividing the annual totals for individuals with AIDS by the population estimates for the U.S. resident population of individuals 13 and older. AIDS-related deaths in the United States The number of AIDS-related deaths for persons age 15-54 was derived from the CDC, HIV/AIDS Surveillance Report, yearend editions. Deaths in the U.S. population for persons age 15-54 were taken from the CDC, Monthly Vital Statistics Report, Vol. 42, No. 2(S); Vol. 43, No. 12; Vol. 43, No. 6(S); Vol. 45, No. 3(S); and Vol. 45, No. 11(S); and from CDC, National Vital Statistics Report, Vol. 47, No. 9; Vol. 47, No. 25; and Vol. 48, No. 11. 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. LawrenceA. Greenfeld is the acting director. BJS Bulletins present the first release of findings from permanent data collection programs such as the National Prisoner Statistics. Laura M. Maruschak wrote this report under the supervision of Allen J. Beck. Paige M. Harrison provided statistical review. Tom Hester edited the report. Jayne Robinson prepared the report for publication. July 2001, NCJ 187456 -------------------------------------- End of file 07/05/01 ih