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HIV in Prisons 1997, DOJ BJS, 1999

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U.S Department of Justice
Office of Justice Programs

Revised 12/9/99 th

Bureau of Justice Statistics

Bulletin
November 1999, NCJ 178284

HIV in Prisons 1997
By Laura M. Maruschak
BJS Statistician
At yearend 1997, 2.1% of all State and
Federal prison inmates were known to
be infected with the human immunodeficiency virus (HIV). The infection rate
was down from 2.2% in 1996. In 1997
a total of 23,548 prison inmates were
HIV positive (1,030 Federal and 22,518
State). HIV-positive inmates made up
1.0% of Federal prison inmates and
2.2% of State prison inmates. Of those
known to be HIV positive in all U.S.
prisons, 6,184 were confirmed AIDS
cases, while the remaining 16,503
either showed symptoms of HIV infection or were asymptomatic.
In 1997 there were 538 AIDS-related
deaths in State prisons, down from 907
in 1996. For every 100,000 State
prison inmates in 1997, 48 died of
AIDS-related causes. Between 1991
and 1996, about 1 in 3 State prison
inmate deaths were attributed to AIDSrelated causes; in 1997 about 1 in 5.
Data based on personal interviews
from the 1997 Survey of Inmates in
State Correctional Facilities show that
75% of State inmates were ever tested
for HIV. Of those who were ever tested
and reported results, 2.2% were HIV
positive — 2.2% of males and 3.4% of
females. As level of prior involvement
in drug use increased, so did the
percentage of HIV-positive inmates:
2.3% of those who said they had ever
used drugs, 2.7% of those who used
drugs in the month before the current
offense, 4.6% of those who injected
drugs, and 7.7% of those who ever
shared a needle were HIV positive.

Highlights

Year
1991
1992
1993
1994
1995
1996
1997

HIV-positive State and
Federal prison inmates
Percent of
custody
Number population
17,551
2.2%
20,651
2.5
21,475
2.4
22,717
2.4
24,256
2.3
23,881
2.2
23,548
2.1

• Between 1991 and 1997 the number
of HIV-positive prisoners grew at a
slower rate (34%) than the overall
prison population (49%).
• At yearend 1997, 3.5% of all female
State prison inmates were HIV
positive, compared to 2.2% of male
State prisoners.
HIV-positive prison inmates
Percent
of custody
Number population
Jurisdiction
New York
7,500
10.8%
Florida
2,325
3.6
Texas
2,126
1.5
California
1,328
.9
Federal system 1,030
1.0
New Jersey
Georgia
Connecticut
Maryland

867
861
798
766

3.4
2.4
5.1
3.5

Based on jurisdictions with more than 700
HIV-positive inmates.

• New York held about a third of all
inmates (7,500 inmates) known to be
HIV positive at yearend 1997.

• Of all HIV-positive prison inmates,
26% were confirmed AIDS cases.
In State prisons 26% of HIV-positive
inmates had AIDS; in Federal prisons,
36%.
• The overall rate of confirmed AIDS
among the Nation's prison population
(0.55%) was more than 5 times the
rate in the U.S. population (0.10%).
• The number of AIDS-related deaths
among prison inmates decreased
from 907 in 1996 to 538 in 1997.
• Of all State prison inmates, 2.8% of
black inmates and 2.5% of Hispanic
inmates, compared to 1.4% of white
inmates reported to survey interviewers that they were HIV positive.

All inmates

Tested inmates
who reported results
Percent
Number HIV positive
790,128
2.2%

Male
Female

734,327
55,800

2.2
3.4

White
Black
Hispanic

257,919
384,870
123,725

1.4%
2.8
2.5

Age 24 or younger 154,181
25-34
310,161
35-44
232,835
45 or older
92,168

.5%
2.3
3.1
2.7

Ever used drugs
Used in month
before offense

665,977

2.3%

460,685

2.7

From the 1997 Survey of Inmates in State
Correctional Facilities.

Revised 12/9/99 th

Data based on official records and
prisoner interviews

Table 1. Inmates in custody of State or Federal prison authorities and
known to be positive for the human immunodeficiency virus, 1995-97

Jurisdiction

Total known to be HIV positive
1995
1996
1997

HIV/AIDS cases as a percent of
total custody populationa
1995
1996
1997

U.S. totalb
Federal
State

24,256
822
23,434

23,881
947
22,934

23,548
1,030
22,518

2.3%
0.9
2.4

2.2%
1.0
2.3

2.1%
1.0
2.2

Northeast
Connecticut
Maine
Massachusetts
New Hampshire
New Jersey
New York
Pennsylvania
Rhode Island
Vermont

12,262
755
4
409
31
847
9,500
590
126
0

11,090
690
4
393
18
705
8,500
652
125
3

10,394
798
-402
17
867
7,500
697
107
6

7.8%
5.1
0.3
3.9
1.5
3.7
13.9
1.8
4.4
0

6.9%
4.6
0.3
3.6
0.9
3.0
12.2
1.9
3.9
0.3

6.4%
5.1
-3.7
0.8
3.4
10.8
2.0
3.2
0.5

Midwest
Illinois
Indiana
Iowa
Kansas
Michigan
Minnesota
Missouri
Nebraska
North Dakota
Ohio
South Dakota
Wisconsin

1,667
583
-20
24
379
46
173
19
2
346
3
72

1,874
634
-24
16
528
24
190
17
3
343
4
91

1,849
655
-34
4
419
31
227
22
7
365
1
84

0.9%
1.5
-0.3
0.3
0.9
1.0
0.9
0.6
0.3
0.8
0.2
0.6

1.0%
1.6
-0.4
0.2
1.2
0.5
0.9
0.5
0.4
0.7
0.2
0.7

0.9%
1.6
-0.5
0.1
0.9
0.6
0.9
0.7
0.9
0.8
0.0
0.6

South
Alabama
Arkansas
Delaware
District of Columbia
Florida
Georgia
Kentucky
Louisiana
Maryland
Mississippi
North Carolina
Oklahoma
South Carolina
Tennessee
Texas
Virginia
West Virginia

7,870
222
83
122
-2,193
858
41
314
724
138
526
115
380
120
1,890
134
10

8,162
234
77
--2,152
814
55
347
832
135
589
108
422
131
1,876
383
7

8,291
212
86
-75
2,325
861
55
397
766
189
519
107
432
131
2,126
-10

1.9%
1.1
1.0
2.5
-3.4
2.5
0.4
1.8
3.4
1.4
1.9
0.8
2.0
0.9
1.5
0.6
0.4

1.9%
1.1
0.9
--3.4
2.3
0.5
2.0
3.8
1.3
2.0
0.7
2.1
1.0
1.4
1.5
0.3

2.0%
1.0
1.0
-1.1
3.6
2.4
0.5
2.1
3.5
1.8
1.7
0.7
2.1
0.9
1.5
-0.4

West
Alaska
Arizona
California
Colorado
Hawaii
Idaho
Montana
Nevada
New Mexico
Oregon
Utah
Washington
Wyoming

1,635
5
140
1,042
93
12
11
4
147
24
29
31
92
5

1,808
10
205
1,136
94
23
17
6
133
11
39
31
99
4

1,984
10
105
1,328
110
16
10
8
139
23
54
60
119
2

0.8%
0.2
0.7
0.8
1.0
0.4
0.4
0.2
1.9
0.6
0.4
0.8
0.8
0.4

0.8%
0.3
0.9
0.8
0.9
0.7
0.5
0.4
1.6
0.2
0.5
0.7
0.8
0.3

0.8%
0.3
0.4
0.9
1.0
0.4
0.3
0.4
1.6
0.6
0.7
1.2
0.9
0.1

--Not reported.
a
The custody population includes only those inmates housed in a jurisdiction's facilities.
b
Totals exclude those inmates in jurisdictions that did not report data on HIV/AIDS.
Counts may differ from previous reports. Percentages for all years are based
on yearend custody counts.

2 HIV in Prisons, 1997

Departments of corrections in 50
States and the District of Columbia as
well as the Federal Bureau of Prisons
provided data on HIV/AIDS among
inmates. Since 1991 respondents
have reported their HIV-testing
policies and the number of HIVinfected inmates in their custody at
yearend. Those inmates are reported
to be asymptomatic, symptomatic, or
with confirmed AIDS. (See questionnaire items in figure 1, page 10.)
Respondents have also reported for
each year the number of inmate
deaths from HIV-related infections
and other causes.
Data on HIV/AIDS and demographics
for prison inmates were calculated
from the 1997 Surveys of Inmates in
State and Federal Correctional Facilities. Through personal interviews,
inmates held in prisons 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.
States report a small decrease
in the number of HIV-infected
inmates during 1997
At yearend 1997, 23,548 inmates in
State and Federal prisons were
known to be infected with the human
immunodeficiency virus (HIV) (table
1). Although the number of reported
HIV-positive inmates was down from
the total reported at yearend 1996
(23,881), Virginia and Maine (with 383
and 4 cases, respectively, in 1996) did
not report data in 1997. The District
of Columbia (with 75 cases in 1997)
had not reported data in 1996. Based
on comparable reporting jurisdictions
in both years, the number of HIVpositive inmates decreased slightly
in State prisons (down 104) and
increased in Federal prisons (up 83).

Revised 12/9/99 th

From 1991, when BJS began collecting
data annually on HIV/AIDS, to 1997,
the number of inmates reported to be
HIV positive increased at about the
same rate as the overall prison population. HIV-positive inmates comprised
2.2% of the State prison population
in 1997, down from 2.3% in 1991.
Infected inmates were 1.0% of Federal
prisoners in 1997, unchanged from
1991.
HIV-infected inmates were concentrated in a small number of States.
New York and Florida housed the
largest number of HIV-positive inmates
(7,500 and 2,325, respectively). In
1997 these two States housed more
than 40% of all HIV-infected inmates
in State prisons.

Year
1991
1992
1993
1994
1995
1996
1997

Percent of custody population
known to be HIV positive
State
Federal
2.3%
1.0%
2.6
1.2
2.6
1.2
2.5
1.1
2.4
0.9
2.3
1.0
2.2
1.0

Northeast prisons held the largest
number of HIV-infected inmates
Nearly half the State prison inmates
known to be HIV positive were in the
Northeast. Within the Northeast, 6.4%
of the prison population were HIV
positive, followed by 2.0% in the South,
0.9% in the Midwest, and 0.8% in the
West. New York had the highest
percentage of inmates known to be
HIV positive (10.8%), followed by
Connecticut (5.1%) and Massachusetts
(3.7%).
Nine States (Alaska, Idaho, Kansas,
Montana, North Dakota, South Dakota,
Vermont, West Virginia, and Wyoming)
reported 10 or fewer cases of
HIV-positive inmates in their prisons.
Of the 46 States that reported information in 1997, each reported having at
least one HIV-positive inmate. Nine
States reported that fewer than 0.5%
of their inmate population were HIV
positive.

Table 2. Inmates in custody of State or Federal prison authorities,
by type of HIV infection or confirmed AIDS, yearend 1997

Jurisdiction
U.S. total
Federal
State

Cases of HIV or confirmed AIDS
Symptom- Confirmed
AsympTotala
aticc
AIDS
tomaticb
23,548
13,532
2,971
6,184
1,030
662
-368
22,518
12,870
2,971
5,816

Confirmed AIDS cases
as a percent of
Total HIV Custody
cases
population
26.3%
0.5%
35.7
0.4
25.8
0.6

10,394
798
-402
17
867
7,500
697
107
6

7,053
171
-51
3
565
5,926
323
11
3

1,122
425
-214
7
-273
153
50
0

2,219
202
-137
7
302
1,301
221
46
3

21.3%
25.3
-34.1
41.2
34.8
17.3
31.7
43.0
**

1.4%
1.3
-1.3
0.3
1.2
1.9
0.6
1.4
0.2

Midwest
Illinois
Indiana
Iowa
Kansas
Michigan
Minnesota
Missouri
Nebraska
North Dakota
Ohio
South Dakota
Wisconsin

1,849
655
-34
4
419
31
227
22
7
365
1
84

910
418
-26
3
216
26
-18
0
155
0
48

365
36
----0
190
1
6
119
0
13

574
201
-8
1
203
5
37
3
1
91
1
23

31.0%
30.7
-23.5
**
48.4
16.1
16.3
13.6
**
24.9
**
27.4

0.3%
0.5
-0.1
‡
0.5
0.1
0.2
0.1
0.1
0.2
‡
0.2

South
Alabama
Arkansas
Delaware
District of Columbia
Florida
Georgia
Kentucky
Louisiana
Maryland
Mississippi
North Carolina
Oklahoma
South Carolina
Tennessee
Texas
Virginia
West Virginia

8,291
212
86
-75
2,325
861
55
397
766
189
519
107
432
131
2,126
-10

3,669
58
46
--1,499
-27
-272
151
349
103
64
-1,092
-8

1,147
103
26
----17
290
220
---197
89
205
-0

2,614
51
14
-75
826
-11
107
274
38
170
4
171
42
829
-2

31.5%
24.1
16.3
-100.0
35.5
-20.0
27.0
35.8
20.1
32.8
3.7
39.6
32.1
39.0
-**

0.6%
0.2
0.2
-1.1
1.3
-0.1
0.6
1.3
0.4
0.5
‡
0.8
0.3
0.6
-0.1

West
Alaska
Arizona
California
Colorado
Hawaii
Idaho
Montana
Nevada
New Mexico
Oregon
Utah
Washington
Wyoming

1,984
10
105
1,328
110
16
10
8
139
23
54
60
119
2

1,238
0
59
974
37
3
5
1
67
20
33
10
27
2

337
10
-197
42
9
2
0
29
0
14
34
-0

409
0
46
157
31
4
3
7
43
3
7
16
92
0

20.6%
**
43.8
11.8
28.2
25.0
**
**
30.9
13.0
13.0
26.7
77.3
**

0.2%
0
‡
0.1
0.3
0.1
0.1
0.4
0.5
0.1
0.1
0.3
0.7
0

Northeast
Connecticut
Maine
Massachusetts
New Hampshire
New Jersey
New York
Pennsylvania
Rhode Island
Vermont

Note: Totals and percentages exclude inmates in jurisdictions that did not report data on type
of HIV/AIDS infection. The custody population includes only inmates housed at the end of 1997.
--Not reported.
**Not calculated for 10 or fewer cases.
‡ Less than .05%.
a
Georgia reported the total of HIV-positive cases but not the type of HIV infection.
b
Includes all inmates who had tested positive for the HIV antibody but had no
HIV-related symptoms.
c
Includes inmates with symptoms of HIV infection but without a confirmed AIDS diagnosis.

HIV in Prisons, 1997 3

Revised 12/9/99 th

Between 1996 and 1997, 15 States
reported a decreased number of
HIV-positive inmates. The largest
decrease (1,000 cases) was reported
in New York — 7,500 in 1997, down
from 8,500 in 1996. Michigan (down
109), Arizona (down 100), North
Carolina (down 70), and Maryland
(down 66) also reported large
decreases. Twenty-eight States
reported an increased number of HIV
cases. Texas reported the largest
increase (up 250) during 1997,
followed by California (up 192) and
Florida (up 173).
Confirmed AIDS cases in prison
more than tripled from 1991 to 1997
At the end of 1997, 6,184 inmates had
confirmed AIDS: 5,816 were State
inmates and 368 were Federal
inmates (table 2). Of the remaining
HIV-positive inmates, 2,971 showed
symptoms of AIDS (symptomatic),
while 13,532 were HIV positive but
showed no symptoms of AIDS
(asymptomatic).
Confirmed AIDS cases made up 0.5%
of all inmates in State and Federal
prisons. Of those known to be
HIV-positive inmates, over a quarter
had confirmed AIDS.
HIV-positive State and Federal
inmates
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
1996
5,874
16,656
1997
6,184
16,503
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.

4 HIV in Prisons, 1997

During 1997 the number of confirmed
AIDS cases increased by 310.
Overall, after 1991 the number of
confirmed AIDS cases increased
4,502 — an annual average increase
of 24.2%. While the number of
confirmed AIDS cases increased, the
number of inmates with lesser or no
symptoms of HIV infection decreased
from 18,165 in 1995 to 16,503 in
1997.
The States with the largest number of
confirmed AIDS cases were New York
(1,301), Texas (829), and Florida
(826). Combined, these States made
up 51% of all confirmed AIDS cases
in State prisons. Seventeen States
reported having fewer than 10
confirmed AIDS cases in their prison.
The highest percentage of the State
prison population having confirmed
AIDS was in New York (1.9%),
followed by Rhode Island (1.4%),
Connecticut (1.3%), Florida (1.3%),
and Maryland (1.3%). In 17 States,
confirmed AIDS cases comprised
0.1% or less of State inmates.
The rate of AIDS in prison at least
5 times the rate in the general
population
At the end of 1997, the rate of
confirmed AIDS in State and Federal
prisons was 5½ times higher than in
the total U.S. population. About 55
per 10,000 prison inmates had
confirmed AIDS, compared to 10 per
10,000 persons in the U.S. population.

Percent of population with
confirmed AIDS
U.S.
Inmates in
general
State and
population Federal prisons
Year
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
1996
0.09
0.54
1997
0.10
0.55
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 since 1991, the rate of
confirmed AIDS has been higher
among prison inmates than in the
general population. In 1992 the rate
of AIDS was 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 1½ 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.

Revised 12/9/99 th

Table 3. State prison inmates known to be positive for the human
immunodeficiency virus, by gender, yearend 1997
Male HIV cases
Jurisdiction
Total

Number
20,153

Percent of
population
2.2%
6.0
4.6
-3.4
0.8
3.3
10.3
1.9
3.1
0.4

Female HIV cases
Number
2,185
1,072
139
-58
2
71
745
44
12
1

Percent of
population
3.5%

Northeast
Connecticut
Maine
Massachusetts
New Hampshire
New Jersey
New York
Pennsylvania
Rhode Island
Vermont

9,322
659
-344
15
796
6,755
653
95
5

12.7
13.1
-8.2
1.5
5.5
20.7
3.1
6.1
1.9

Midwest
Illinois
Indiana
Iowa
Kansas
Michigan
Minnesota
Missouri
Nebraska
North Dakota
Ohio
South Dakota
Wisconsin

1,708
591
-27
4
398
31
212
20
5
340
1
79

0.9%
1.5
-0.4
0.1
0.9
0.6
0.9
0.6
0.7
0.8
0
0.6

141
64
-7
0
21
0
15
2
2
25
0
5

1.2%
2.6
-1.3
0
1.0
0
0.9
0.9
3.0
0.9
0
0.7

South
Alabama
Arkansas
Delaware
District of Columbia
Florida
Georgia
Kentucky
Louisiana
Maryland
Mississippi
North Carolina
Oklahoma
South Carolina
Tennessee
Texas
Virginia
West Virginia

7,385
197
81
--2,082
765
50
372
682
171
455
97
409
127
1,887
-10

1.9%
1.0
1.0
--3.4
2.2
0.5
2.1
3.3
1.8
1.6
0.7
2.1
0.9
1.5
-0.4

831
15
5
--243
96
5
25
84
18
64
10
23
4
239
-0

3.1%
1.1
0.8
--7.1
4.2
0.8
2.7
7.6
2.0
3.6
0.8
1.8
0.7
2.3
-0

West
Alaska
Arizona
California
Colorado
Hawaii
Idaho
Montana
Nevada
New Mexico
Oregon
Utah
Washington
Wyoming

1,738
6
-1,248
102
16
10
7
108
22
51
57
109
2

0.9%
0.2
-0.9
1.0
0.4
0.3
0.4
1.4
0.7
0.7
1.2
0.9
0.2

141
4
-80
8
0
0
1
31
1
3
3
10
0

0.9%
1.9
-0.7
1.0
0
0
1.2
4.9
0.3
0.7
1.1
1.1
0

A greater percent of females than
males reported HIV infection
At yearend 1997, 20,153 male inmates
and 2,185 female inmates were known
to be HIV positive (table 3). Those
known to be HIV positive were 2.2%
of male inmates and 3.5% of female
inmates. In most States and in all
regions except the West, female
inmates had a higher HIV-positive
infection rate than male inmates.

Year
Males
1991
1992
1993
1994
1995
1996
1997
Annual
average
change,
1991-97*

State prison inmates
Percent HIVpositive in
Number of custody populaHIV-positive tion of reporting
inmates
States
16,150
18,266
18,218
19,762
20,690
21,046
20,153

2.2%
2.6
2.5
2.4
2.3
2.2
2.2

3.8%

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
1996
1,888
3.1
1997
2,185
3.5
Annual
average
change,
11.1%
1991-97*
*In 1991 North Carolina, South Dakota,
and the District of Columbia did not
report data by gender. In 1997 Maine,
Delaware, Indiana, Virginia, Arizona,
and the District of Columbia did not
report data by gender.

--Not reported.

HIV in Prisons, 1997 5

Revised 12/9/99 th

Following a decrease in 1996, the
number of HIV-infected females
increased during 1997 (from 1,888 to
2,185). The number of infected male
inmates decreased 4.2% (from 21,046
in 1996 to 20,153 in 1997). On
average, from 1991 to 1997 the
number of male inmates in State
prison infected with HIV increased
3.8%; the number of female infected
inmates increased 11.1%.
States in the Northeast reported the
largest number of HIV-positive male
and female inmates (9,322 and 1,072,
respectively). In seven States, more
than 5% of all female inmates were
known to be HIV positive. In New

York (20.7%) and Connecticut
(13.1%) over 10% of female inmates
were known to be HIV-positive. New
York (10.3%) was the only State in
which more than 10% of all male
inmates were HIV-positive.
New York also reported the largest
number of male and female
HIV-positive inmates (6,755 and 745,
respectively). The second largest
numbers of HIV-positive male and
female inmates were in Florida (2,082
and 243, respectively), followed by
Texas (1,887 and 239, respectively).
Seven States reported no female
HIV-positive inmates. Every State
reported at least one male inmate as
HIV positive.

Table 4. Number of inmate deaths in State prisons, by cause, 1995-97

Cause of death
Total
Natural causes other
than AIDS
AIDS
Suicide
Accident
Execution
By another person
Other/unspecified

1995
Rate of
death per
100,000
Number inmates
3,133
311
1,569
1,010
160
48
56
86
204

156
100
16
5
6
9
20

1996
Rate of
death per
100,000
Number inmates
3,095
308
1,715
907
154
43
45
65
166

170
90
15
4
4
6
16

1997
Rate of
death per
100,000
Number inmates
2,872
255
1,859
538
159
37
74
75
130

165
48
14
3
7
7
12

Note: 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.

6 HIV in Prisons, 1997

AIDS-related deaths in State
prisons dropped 41% during 1997
The number of State inmates who
died of Pneumocystis carinii pneumonia, Kaposis’s sarcoma, or other
AIDS-related diseases decreased
from 907 in 1996 to 538 in 1997 (table
4). These AIDS deaths accounted for
19% of all deaths among State prisoners, down from 29% in 1996. Even
with a sharp decline, AIDS-related
illnesses were still the second leading
cause of death in State prisons behind
natural causes other than AIDS.
In 1997 for every 100,000 inmates, 48
died from AIDS-related causes (table
5). Between 1995 and 1997, the
number of AIDS-related deaths in
State prisons decreased 47%. This
decrease may reflect improvement in
the effectiveness of HIV/AIDS care,
following the introduction of protease
inhibitors and combination antiretroviral therapies.

Revised 12/9/99 th

AIDS death rate in State prison
at least 3 times the rate in the
general population
In 1997 the rate of death because of
AIDS was over 3 times higher in the
prison population than in the total U.S.
population age 15-54. About 19% of
prisoner deaths were attributable to
AIDS-related causes; compared to 6%
of deaths in the general population.
AIDS-related deaths as a
percent of all deaths
U.S. general
State
population age
prison
Year
15-54*
inmates
1991
10.4%
28.0%
1992
11.7
35.2
1993
11.9
33.2
1994
12.7
35.1
1995
13.1
34.2
1996
10.1
29.3
1997
5.8
18.7
*See Methodology for source of data.

AIDS-related deaths accounted for
more than a third of all inmate deaths
in Florida (45%), New Jersey (41%),
Connecticut (39%), and South Carolina
(35%) (table 5). Prison officials in the
South reported the most AIDS-related
deaths (309); Florida accounted for
108 of those deaths. Nineteen States
reported having no AIDS-related
deaths, and 7 States reported 1 AIDSrelated death.

Table 5. AIDS-related deaths of sentenced prisoners under State jurisdiction, 1997

Jurisdiction
Total

Deaths from all causes
in State prisons
Rate per
Total 100,000 inmatesa
2,872
255

Total
538

AIDS-related deaths
As a percent of
Rate per
100,000 inmatesa all deathsb
48
18.7%

Northeast
Connecticut
Maine
Massachusetts
New Hampshire
New Jersey
New York
Pennsylvania
Rhode Island
Vermont

501
33
1
24
5
101
221
109
6
1

295
191
62
201
231
356
320
312
178
79

136
13
0
2
0
41
60
19
1
0

80
75
0
17
0
145
87
54
30
0

Midwest
Illinois
Indiana
Iowa
Kansas
Michigan
Minnesota
Missouri
Nebraska
North Dakota
Ohio
South Dakota
Wisconsin

488
101
45
9
24
99
6
48
10
1
117
6
22

223
248
251
130
303
221
113
200
294
125
244
268
135

50
16
1
0
1
18
1
6
0
0
6
0
1

23
39
6
0
13
40
19
25
0
0
12
0
6

10.2%
15.8
2.2
**
4.2
18.2
**
12.5
**
**
5.1
**
4.5

1,415
South
Alabama
91
Arkansas
31
Delaware
12
District of Columbia
25
Florida
242
Georgia
114
Kentucky
28
Louisiana
80
Maryland
54
Mississippi
47
North Carolina
56
Oklahoma
68
South Carolina
55
Tennessee
70
Texas
341
Virginia
92
West Virginia
9

288
408
309
221
267
374
312
192
273
243
329
177
331
260
420
243
324
286

309
14
0
0
-108
41
0
17
12
4
8
3
19
13
56
14
0

64
63
0
0
-167
112
0
58
54
28
25
15
90
78
40
49
0

21.8%
15.4
0
0
-44.6
36.0
0
21.3
22.2
8.5
14.3
4.4
34.5
18.6
16.4
15.2
**

468
4
61
268
34
8
10
4
25
7
19
3
23
2

188
96
260
172
253
161
256
159
277
149
238
70
174
129

43
0
0
36
0
1
2
0
3
0
0
0
1
0

17
0
0
23
0
20
51
0
33
0
0
0
8
0

9.2%
**
0
13.4
0
**
20.0
**
12.0
**
0
**
4.3
**

West
Alaska
Arizona
California
Colorado
Hawaii
Idaho
Montana
Nevada
New Mexico
Oregon
Utah
Washington
Wyoming

27.1
39.4
**
8.3
**
40.6
27.1
17.4
**
**

--Not reported.
**Not calculated for 10 or fewer deaths.
a
Based on the number of inmates under State jurisdiction on June 30, 1997,
with a sentence of more than 1 year.
b
National and regional totals exclude inmates in jurisdictions that did not report
data on cause of death.

HIV in Prisons, 1997 7

Revised 12/9/99 th

Eighteen States tested all inmates
for HIV either at admission or
while in prison
Prison officials report data on HIV and
AIDS in the National Prisoner Statistics series (NPS-1). The quality of the
reporting may vary by the nature and
extent of testing in each jurisdiction.
Testing policies range from testing all
inmates to testing only upon inmate
request.
In 1997 all States, the District of
Columbia, and the Federal Bureau of
Prisons tested their inmates for HIV
based on certain criteria (table 6).
Most jurisdictions (44 out of 52) tested
inmates if they had HIV-related
symptoms or if the inmates requested
a test. Twenty-nine States tested
inmates after they were involved in an
incident, and 15 States tested inmates
who belonged to specific “high-risk
groups.”
Of the 18 States that tested all entering inmates, 4 States (Alabama,
Missouri, Nevada, and Virginia) and
the Federal Bureau of Prisons tested
inmates at release.
Arkansas, Rhode Island, and Virginia
tested all inmates currently in custody.
New York was the only State that
tested inmates selected at random.
Testing policy
Upon inmate request
Upon clinical indication
of need
Upon involvement in
an incident
All incoming inmates
High-risk groups
All inmates at time
of release
All inmates currently
in custody
Random sample

Number of
jurisdictions
40
37
29
18
15
5
3
1

Note: Detail adds to more than 52
because a jurisdiction may have more
than one testing policy.

Table 6. Prison system testing policies for the antibody to the human
immunodeficiency virus, by jurisdiction, 1997

Federal*
Northeast
Connecticut
Maine
Massachusetts
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

All inmates
High
At
In
risk
Entering custody release group
X
X

Upon Clinical Involveinmate indica- ment in
request tion
incident
X
X
X
X
X

X

X

X
X
X
X
X

X
X

X

X
X

X
X

X
X

X
X

X
X

X

X
X

X
X
X
X

X
X
X
X
X

X
X
X
X
X

X

X

X

X

X
X
X

X

X
X

X
X
X
X
X

X

X

X
X
X
X

X
X

X
X

X

X
X
X
X

X
X

X
X
X
X
X
X

X

X

X
X
X
X
X

X
X
X

X
X
X
X
X
X
X

X
X
X
X
X
X
X

X
X
X
X
X
X

X
X
X
X

X
X
X
X

X
X
X

X
X
X
X

X
X

X
X

X

X
X

X

X
X
X

X
X

X

X

X

X

X
X
X

X

X
X
X

X

X

X

*The Bureau of Prisons tests a random sample of inmates on alternate years.

8 HIV in Prisons, 1997

Random
sample Other

X

Revised 12/9/99 th

Among State prisoners who were
In Federal prisons 0.6% of males and
tested for HIV, female inmates (3.4%)
of females reported an HIV infection.
were more likely than male inmates
HIV-positive rates were lowest for white
Data based on reports from correc(2.2%) to be HIV positive (table 8).
non-Hispanic inmates (0.3%).
tional authorities are limited in detail
Black non-Hispanic inmates (2.8%)
In both State and Federal prisons,
and may understate the number of
were twice as likely as white
inmates age 17-24 had the lowest
inmates infected with HIV. Additional
non-Hispanic inmates (1.4%) to report
rates (0.5% and 0.1%, respectively). In
information may be obtained through
being HIV positive. Among male
State prisons, inmates age 35-44 had
personal interviews of prisoners.
inmates, black non-Hispanics (2.7%)
the highest HIV-positive rate (3.1%).
Though some inmates may be relucwere nearly twice as likely as white
Those inmates age 25 or older were
tant to report that they are HIV positive non-Hispanics (1.4%) to be HIV
more likely to be HIV positive than
and others may not know, surveys
positive. Because of the small number those who were 24 or younger.
provide a means to track HIV infection of inmates interviewed, the rates of HIV In Federal prisons, inmates age 45 or
among demographic and “high-risk”
infection among female inmates were
older had the highest rate of HIV infecgroups not identified in official records. not significantly different between white tion (1.2%).
non-Hispanics (2.3%), black nonThe 1997 Surveys of State and Federal Hispanics (3.9%), and Hispanics
Correctional Facilities asked inmates if (4.2%).
they had ever been tested, if they had
Table 8. Inmates ever tested for the human immunodeficiency virus and results,
been tested since admission, and
by selected characteristics, 1997
whether they were HIV positive. (See
Methodology for further detail.)
HIV/AIDS reported in personal
interviews

Tested inmates who reported results

Rate of HIV infection higher among
State inmates than Federal inmates
Of inmates who reported being tested
since admission, 2.6% in State prison
and 0.7% in Federal prison reported
being HIV positive (table 7).
Table 7. Inmates ever tested or tested
since admission for the human
immunodeficiency virus and test
results, 1997

Inmate characteristic

Percent of
tested inmates
who reported results
State
Federal
prisons prisons

Ever tested
HIV positive

74.6%
2.2

79.6%
0.6

Tested since admission 59.1%
HIV positive
2.6

69.7%
0.7

Note: Data are from the 1997 Surveys of
Inmates in State and Federal Correctional
Facilities.

Characteristic

State prisons
Percent
Number
HIV positive

Federal prisons
Percent HIV
Number
positive

790,128

2.2%

70,902

0.6%

Gender
Male
Female

734,327
55,800

2.2%
3.4

65,723
5,179

0.6%
0.6

Race/Hispanic origin
White non-Hispanic
Male
Female
Black non-Hispanic
Male
Female
Hispanic
Male
Female

257,919
239,687
18,232
384,870
357,736
27,135
123,725
115,344
8,382

1.4%
1.4
2.3
2.8
2.7
3.9
2.5
2.4
4.2

21,128
19,565
1,563
28,178
26,387
1,791
18,466
16,892
1,573

0.3%
0.3
0.3
0.8
0.8
1.3
0.7
0.7
0

Age
17-24
25-34
35-44
45 or older

154,181
310,161
232,835
92,168

0.5%
2.3
3.1
2.7

5,528
26,262
22,228
16,884

0.1%
0.5
0.4
1.2

Marital status
Married
Widowed/divorced
Separated
Never married

128,834
161,468
45,435
453,664

1.7%
2.0
2.9
2.4

21,545
16,331
3,884
29,045

0.5%
0.4
0
0.8

Education
Less than high school
GED
High school or more

302,437
231,714
254,975

2.7%
1.4
2.4

17,226
16,389
37,237

0.8%
0.6
0.5

All inmates

Note: Data are from the 1997 Surveys of Inmates in State and Federal Correctional Facilities.

HIV in Prisons, 1997 9

Revised 12/9/99 th

Among State prisoners drug
offenders reported a higher
prevalence of HIV infection

Table 9. Inmates ever tested for the human immunodeficiency virus and results,
by offense and prior drug use, 1997
Tested inmates who reported results

Those inmates held on a drug offense
in State prisons had the highest HIVpositive rate (2.9%) (table 9). Of
property offenders, 2.4% reported
being HIV positive. Rates were
slightly lower for violent and publicorder offenders (1.9% each). Of
Federal prison inmates, 1.0% of
violent offenders, property offenders,
and public-order offenders reported
being HIV positive.
The percentage of State and Federal
prison inmates reporting that they
were HIV positive varied by level of
prior drug use. Of State prison
inmates who reported never using
drugs, 1.7% were HIV positive. An
estimated 2.3% of inmates who had
ever used drugs, 2.7% of those who
used drugs in the month before their
current offense, 4.6% of those who
had used a needle to inject drugs, and
7.7% of those who had shared a
needle reported being HIV positive.
Like State inmates, Federal inmates
who used a needle and shared a
needle had a higher rate of HIV infection than those inmates who reported
ever using drugs or using drugs in the
month before their current offense
(1.3% and 2.1% compared to 0.7%
and 0.3%).
Methodology
Data are based on yearly reports from
prison officials in the departments of
corrections of the 50 States and the
District of Columbia and in the Federal
Bureau of Prisons. The National
Prisoner Statistics series (NPS-1)
includes an annual yearend count of
prisoners by jurisdiction, gender, race,
Hispanic origin, and admissions and
releases during the year.

Characteristic
Current offense
Violent
Property
Drug
Public-order
Prior drug use
Never
Ever
In the month before
offense
Used needle to inject
drugs
Ever shared a needle

State prisons
Percent
Number
HIV positive

Number

Federal prisons
Percent
HIV positive

360,370
178,601
164,256
77,049

1.9%
2.4
2.9
1.9

10,681
4,660
43,815
10,029

1.0%
1.0
0.4
1.0

123,049
665,977

1.7%
2.3

18,917
51,847

0.3%
0.7

460,685

2.7

32,113

0.3

168,446
74,393

4.6
7.7

9,443
4,022

1.3
2.1

Note: Data are from the 1997 Surveys of Inmates in State and Federal Correctional
Facilities.

Key items on HIV/AIDS from National Prisoner Statistics
HIV testing, Jan. 1 - Dec. 31, 1997
During 1997 were any inmates tested for the antibody to the Human
Immunodeficiency Virus (HIV) that causes AIDS?
‰ Yes ‰ No
Which inmates were tested during 1997? Mark (X) all that apply.
‰ All incoming inmates
‰ All inmates currently in custody
‰ All inmates at time of release
‰ Certain inmates (Complete next item)
Who were the certain inmates tested? Mark (X) all that apply.
‰ High-risk groups - Specify
‰ Upon inmate request
‰ Upon clinical indication of need
‰ Upon involvement in incident
‰ Random sample
‰ Other - Specify
HIV infection/AIDS cases in custody on Dec. 31, 1997
Inmates who were asymptomatic HIV positive
Total _____ Male _____ Female _____
Inmates with lesser forms of symptomatic HIV disease
Total _____ Male _____ Female _____
Inmates with confirmed AIDS
Total _____ Male _____ Female _____
Total number of inmates who were HIV positive or confirmed AIDS cases
Total _____ Male _____ Female _____

10 HIV in Prisons, 1997

Revised 12/9/99 th

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.
To obtain more detailed information on
inmates, this report also used data
from the 1997 Surveys of Inmates in
State and Federal Correctional Facilities. Detailed descriptions of the
methodology and sample design of
each survey can be found in the following: Substance Abuse and Treatment
of State and Federal Prisoners, 1997
(NCJ 172871).

Accuracy of the survey estimates
The accuracy of the estimates from the
1997 Surveys of Inmates in State and
Federal Correctional Facilities 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.

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 in State prisons who were HIV
positive is approximately 2.2% plus or
minus 1.96 times 0.20 (or 1.8% to
2.6%).

Appendix table. Standard error
estimates for Surveys of State and
Federal Correctional Facilities, 1997
Estimated standard
error of the percent
of reporting inmates
who were HIV positive
State
Federal
prisons prisons

Characteristic
Gender
Male
Female

0.20
0.44

0.19
0.35

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.

Race/Hispanic origin
White non-Hispanic
Male
Female
Black non-Hispanic
Male
Female
Hispanic
Male
Female

0.29
0.31
0.80
0.37
0.38
0.72
0.58
0.61
1.67

0.31
0.33
0.63
0.48
0.51
1.15
0.52
0.56
0.00

Age
Under 24
25-34
35-44
45 or older

0.20
0.30
0.40
0.60

0.27
0.27
0.26
0.52

AIDS in the U.S. resident population

Marital status
Married
Widowed/divorced
Separated
Never married

0.40
0.39
0.88
0.25

0.30
0.31
0.00
0.33

0.33
0.27

0.42
0.38

0.34

0.23

0.25
0.40
0.46
0.55

0.60
0.91
0.19
0.62

0.41
0.21

0.25
0.23

0.27

0.19

0.57
1.09

0.73
1.41

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
1991-97. 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 sampling error, as measured by an the cumulative number of total AIDS
estimated standard error, varies by the cases for people age 13 or older at
size of the estimate and the size of the yearend as listed in the HIV/AIDS
Surveillance Report.
base population. Estimates for the
percentage of inmates ever tested for
The data for the U.S. general populaHIV and the percentage who tested
tion, excluding persons under age 13
from 1991 to 1997 were taken from the
Further reading
U.S. Population Estimates, by Age,
Sex, Race, and Hispanic Origin: 1990
More information about HIV among
to 1995, PPL-41, and update for 1996
jail inmates as well as about State
and 1997.
and Federal prison programs can be
found in Theodore M. Hammett,
The rate of confirmed AIDS cases in
Patricia Harmon, and Laura M.
the U.S. resident population was calcuMaruschak, 1996-1997 Update:
lated by dividing the annual totals for
HIV/AIDS, STDs, and TB in Correcindividuals with AIDS by the population
tional Facilities, National Institute of
estimates for the U.S. resident populaJustice report, NCJ 176344, July
tion of individuals 13 or older. The
1999. Obtain the report on the Interclassification system for HIV infection
net at http://www.ojp.usdoj.gov/
and the case definition for AIDS were
nij/pubs-sum/176344.htm
expanded in 1993. This expansion

Education
Less than high school
GED
High school graduate
or more
Current offense
Violent
Property
Drug
Public-order
Prior drug use
Never used
Ever used
Used month before
offense
Used needle to
inject drugs
Shared a needle

improved estimates of the number and
the 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.)

HIV in Prisons, 1997 11

Revised 12/9/99 th

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 the CDC,
National Vital Statistics Report, Vol.
47, No. 9, and Vol. 47, No. 25.
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.

U.S. Department of Justice
Office of Justice Programs
Bureau of Justice Statistics

Washington, DC 20531
Official Business
Penalty for Private Use $300

12 HIV in Prisons, 1997

The Bureau of Justice Statistics
is the statistical agency of the
U.S. Department of Justice.
Jan M. Chaiken, Ph.D., is director.

This report and others from the
Bureau of Justice Statistics are
available through the Internet 
http://www.ojp.usdoj.gov/bjs/

BJS Bulletins present the first
release of findings from permanent
data collection programs such as
the National Prisoner Statistics.
Laura Maruschak wrote this report,
under the supervision of Allen J.
Beck. Lauren E. Glaze and Christopher J. Mumola provided statistical review. Tom Hester and Tina
Dorsey edited the report. Jayne
Robinson, assisted by Yvonne
Boston, prepared the report for
publication.

The data from the 1997 Surveys of
Inmates in State and Federal
Correctional Facilities is available
from the National Archive of Criminal Justice Data, maintained by the
Institute for Social Research at the
University of Michigan, 1-800-9990960. The archive may also be
accessed through the BJS Internet
site.

November 1999, NCJ 178284

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