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Addressing the Intersection of HIV/AIDS & Prisons

The HIV/AIDS epidemic in U.S. prisons is fueled by the ever-growing number of people spending time incarcerated.
Currently, the U.S. has the highest incarceration rate of any country in the world. Last year, more than 2 million individuals served time in prisons or jails, and in the year 2000, the U.S. detained over a quarter of the world's prison population(1).

Correctional facilities have alarming rates of HIV/AIDS.
The prevalence of HIV/AIDS is believed to be 14 times higher among inmates than among the general population(2). According to the U.S. Department of Justice, 2% of inmates in state prisons are known to be HIV-positive(3). More than 22,000 HIV-positive state prisoners were reported across the U.S. in 2002(4). Actual cases are estimated to be twice as high. Approximately 20% to 26% of all Americans living with HIV/AIDS (180,000 - 235,000) have been incarcerated at one time(5).

HIV/AIDS among inmates and ex-prisoners is a serious issue facing Illinois.
Illinois reported 471 prisoners with HIV/AIDS in 2002 (28 females and 443 males), and an HIV rate of 1.1%(6). The actual number of HIV-positive inmates could be as high as 900 based on the national average for state correctional facilities. The overall statewide rate of HIV/AIDS is .21%.

Risk factors for HIV, including unprotected sex and syringe sharing, are the same for inmates as for non-incarcerated individuals.
Estimates of the number of male inmates who engage in sexual behavior range as high as 65%(7), and additional research found that up to 28% of inmates are sexually assaulted while incarcerated(8). However, the taboo nature of sexual assault and the reluctance of inmates to report it makes the full impact of this phenomenon difficult to measure.

Assessing the extent of injection drug use within prisons is equally difficult. According to a 1995 study, more injection drug users were incarcerated than were in drug treatment centers, hospitals, or social service centers(9). Research suggests that inmates frequently obtain illegal drugs as contraband or purchase them from other inmates or guards(10). Because of the scarcity of syringes, which are often stolen, bartered, or handmade from other objects, inmates frequently share syringes.

The phenomenal growth in the prison industry is driven by increased penalties for drug-related offenses.
Another contributing factor is the increased emphasis on law enforcement rather than substance abuse prevention and treatment services. U.S. drug arrests have tripled and drug-related incarcerations have quadrupled since 1980(11). The Illinois prison population has grown over 266% since 1980, and during this time, 20 new correctional centers have been built-all downstate(12). In 1996, Illinois ranked third in the nation for drug-related incarcerations(13).

Despite documented high-risk behaviors, condoms and other HIV prevention supplies are virtually non-existent in prisons.
Jails and prisons in seven jurisdictions in the U.S. allow access to condoms, and none allow access to sterile syringes(14). Additionally, correctional HIV prevention education programs vary greatly across the nation, from comprehensive to non-existent services. In Illinois, the Department of Corrections (IDOC) neither supplies nor allows condoms and syringes in prison facilities. While IDOC does fund a single staff position to coordinate peer HIV prevention education, the program is severely under-funded and inadequate to cover all facilities statewide.

People of color are disproportionately impacted by the growth in incarceration, and when incarceration is related to a drug offense, the racial divide widens.
Nationwide, African Americans comprise 62% of drug offenders sent to state prisons-an incarceration rate 13 times higher than their white counterparts(15). In 2000, African Americans accounted for approximately 12% of the U.S. population but comprised nearly 44% of the 2 million Americans behind bars(16). Latinos accounted for 12.5% of the nation's population and 16.5% of its inmates(17).

In Illinois, African Americans comprised 15% of the state's population in 2001 but nearly two-thirds (65%) of the 45,600 state prisoners(18); Latinos comprised 12% of the population and 10% of state prisoners(19); and whites comprised 68% of the state's population and 25% of its prisoners(20).

Partners of prisoners and ex-prisoners may be at risk for HIV.
Each year, nearly 650,000 individuals are released from prisons in the U.S. with little or no support for transitioning back into the community. Without assistance, HIV-positive ex-prisoners may resume former risk-taking behaviors, which can result in a serious decline in health, risk to others, and/or a return to prison.

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1 Rapposelli et. al. (2002) "HIV/AIDS in Correctional Settings: A Salient Priority for the CDC and HRSA." AIDS Education and Prevention, 14, Supplement B(103).
2 Perez, H. (1997) "AIDS Behind Bars: We should all care." Body Positive, 10(1).
3 Department of Justice. (2002).
4 Health Care Survey Summary, Part 2. (2003) Corrections Compendium, 28(11).
5 National Commission on Correctional Health Care. (March 2002).
6 Health Care Survey Summary, Part 2. (2003) Corrections Compendium, 28(11). 7 Swartz et. al. (2004) "Correlates of HIV-Risk Behaviors Among Prison Inmates: Implications for Tailored AIDS Prevention Programming." The Prison Journal, Vol. 84 No. 4(487). 8
8 Krebs, Christopher P. and Melanie Simmons. (2002) "Intraprison HIV Transmission: An Assessment of Whether it Occurs, How it Occurs, and Who is at Risk." AIDS Education and Prevention, 14, Supplement B(54).
9 AIDS Research Institute. (1995).
10 Krebs, Christopher P. and Melanie Simmons. (2002) "Intraprison HIV Transmission: An Assessment of Whether it Occurs, How it Occurs, and Who is at Risk." AIDS Education and Prevention, 14, Supplement B(54).
11 Human Rights Watch. (2000) "The Impact of the War on Drugs on U.S. Incarceration." United States-Punishment and Prejudice: Racial Disparities in the War on Drugs.
12 Street, Paul. Chicago Urban League. (2001) The Color and Geography of Prison Growth in Illinois(1).
13 National Corrections Reporting Program.
14 May, John P. and Earnest L. Williams. (2002) "Acceptability of Condom Availability in a U.S. Jail." AIDS Education and Prevention, 14, Supplement B(85).
15 Human Rights Watch. (2000) "The Impact of the War on Drugs on U.S. Incarceration." United States-Punishment and Prejudice: Racial Disparities in the War on Drugs.
16 Wagner, Peter. Prison Policy Initiative. (2004) "Blacks are overrepresented in United States' prisons and jails." Source: U.S. Census 2000.
17 Wagner, Peter. Prison Policy Initiative. (2004) "Latinos are overrepresented in United States' prisons and jails." Source: U.S. Census 2000.
18 Wagner, Peter. Prison Policy Initiative. (2004) "Blacks are overrepresented in Illinois' prisons and jails." Source: U.S. Census 2000.
19 Wagner, Peter. Prison Policy Initiative. (2004) "Latinos are overrepresented in Illinois' prisons and jails." Source: U.S. Census 2000.
20 Wagner, Peter. Prison Policy Initiative. (2004) "Whites are underrepresented in Illinois' prisons and jails." Source: U.S. Census 2000.

Printable Document (PDF)

Introduction

The Intersection of HIV/AIDS & Prisons

Illinois must Address HIV/AIDS in Prisons

State Policy Priorities

Federal Policy Priorities

HIV/AIDS in Illinois

Additional HIV/AIDS statistics

This page last modified: September 21, 2006.