Bjs Report Hiv in Prison 2005 Released 2007
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U.S. Department of Justice Office of Justice Programs Bureau of Justice Statistics Bulletin September 2007, NCJ 218915 HIV in Prisons, 2005 By Laura M. Maruschak BJS Statistician On December 31, 2005, correctional authorities reported that 20,888 State inmates (1.8%) and 1,592 Federal inmates (1.0%) were infected with the human immunodeficiency virus (HIV) or had confirmed AIDS. This was a total of 22,480 inmates, a slight decrease from 22,936 inmates in 2004. Half of the HIV/AIDS cases were in the South, nearly a third in the Northeast, and about a tenth in both the Midwest and the West. The Northeast reported the highest percentage of HIV/AIDS cases based on its custody population (3.9%). At yearend 2005, three states — New York (4,440), Florida (3,396), and Texas (2,400) — housed nearly half (49%) of all HIV/AIDS cases in State prisons. At yearend 2005, an estimated 18,953 males (1.8%) and 1,935 females (2.4%) in State prisons were HIV-infected or had confirmed AIDS. The number of cases for both males and females were down from 2004. At yearend 2005, five States reported no female HIV/AIDS cases: New Hampshire, North Dakota, West Virginia, Hawaii, and Montana. Among Federal inmates, 1,491 men (1.0%) and 101 women (0.9%) were HIV-infected or had confirmed AIDS. An estimated 5,620 inmates had confirmed AIDS, down from 5,969 in 2004. Of the confirmed cases, 5,026 were in State prisons and 594 were in Federal prisons. Four States accounted for nearly half (47%) of all confirmed AIDS cases: Texas (894), New York (700), Florida (645), and Maryland (408). Maryland (1.8%) had the highest percentage of confirmed AIDS cases among its custody population, followed by Connecticut, New York, and Delaware (1.1% each). Five States (New Hampshire, Indiana, North Dakota, Idaho, and Wyoming) reported having no confirmed AIDS cases. During 2005 an estimated 176 State inmates died from AIDS-related causes, down from 185 in 2004. For every 100,000 State inmates, 13 died from AIDS-related causes. AIDS-related deaths accounted for nearly 1 in 20 deaths reported in State prisons. New York reported the largest Reported HIV/AIDS cases and AIDS-related deaths, 2004 and 2005 2005 2004 Percent of cusPercent of cusNumber tody population Number tody population U.S. total 22,480 1.7% 22,936 1.8% 1,592 1.0% 1,680 1.1% State Northeast Midwest South West 20,888 6,456 2,104 10,423 1,905 1.8% 3.9 0.9 2.2 0.7 21,256 6,646 2,025 10,691 1,894 1.8% 4.1 0.9 2.1 0.7 Gendera Male Female 20,444 2,036 1.7% 2.3 19,294 1,962 1.8% 2.5 5,620 0.4% 5,969 0.5% Federal Confirmed AIDSa AIDS-related deaths in prisonb State Federal 176 27 185 18 a Includes estimates of the number inmates in States not reporting a breakdown of the total number of HIV/AIDS cases. Estimates are based on the most recent data available. See Methodology. bTotal number of deaths are based on a combination of data collected in the National Prisoners Statistics (NPS) and the Death in Custody Reporting Program (DCRP). number of AIDS-related deaths (19), followed by Florida (17) and California (14). Relative to the number of inmates in custody, the Northeast reported the highest rate of AIDSrelated deaths (28 per 100,000 inmates), followed by the South (13 per 100,000 inmates). Among Federal inmates, 27 died from AIDS-related causes in 2005, up from 18 in 2004. For every 100,000 Federal inmates, 15 died from AIDS-related causes. AIDS-related deaths accounted for 7% of all deaths in Federal prisons. State-level data and other detailed information are available in appendix tables on the BJS website at <http://www. ojp.usdoj.gov/bjs/pub/hivp05.pdf>. HIV/AIDS cases in State and Federal prisons steadily declining since 1999 Table 1. Number of HIV/AIDS cases in State and Federal prisons at yearend, 1999 and 2005 The Bureau of Justice Statistics (BJS) began collecting official data on HIV infection in State and Federal prisons in 1991 (see Methodology). At that time, 17,551 State and Federal inmates were HIV-infected or had confirmed AIDS (figure 1). This number steadily increased through yearend 1995, but fluctuated thereafter until reaching a high of 25,807 at yearend 1999. Since then, the number of HIV/ AIDS cases has steadily declined, reaching 22,480 at yearend 2005. Jurisdiction New York accounted for more than three-quarters of the decline in HIV/AIDS cases between 1999 and 2005 Between 1999 and 2005, the number of inmates who were HIV-infected or had confirmed AIDS increased in 18 States and the Federal system, while the number decreased in 27 States (table 1). The remaining five States and the District of Columbia either reported no change or did not report data for 1999 or 2005. The largest increases were reported in Florida (up 763), the Federal system (up 436), Georgia (up 196), and North Carolina (up 164). New York reported the largest decrease, with 2,560 fewer HIV-infected or confirmed AIDS inmates, followed by New Jersey (down 329), and California (down 321). New York alone accounted for more than threequarters (83%) of the total reported decrease in comparable HIV/AIDS cases.1 1New York estimates the number of HIV/AIDS cases based on data obtained through blind sero-prevalence studies conducted biennially by the New York State Department of Health. See Methodology for details on the estimation procedures. HIV/AIDS cases in State and Federal prisons, 1991-2005 Number of HIV/AIDS cases 30,000 25,000 Total reported 20,000 Excluding New York 15,000 10,000 5,000 Reported in New York 0 1991 1993 1995 Figure 1 2 HIV in Prisons, 2005 1997 1999 2001 2003 2005 U.S. total Comparablea Reported Federal State Total HIV/AIDS cases 2005 1999 Change from 1999-2005 22,346 22,480 1,592 20,888 25,438 25,807 1,156 24,651 -3,092 -3,327 436 -3,763 Northeast Connecticut Maine Massachusetts New Hampshire New Jersey New York Pennsylvania Rhode Islandb Vermont 6,456 463 10 221 21 540 4,440 692 58 11 10,030 632 9 346 17 869 7,000 939 203 15 -3,574 -169 1 -125 4 -329 -2,560 -247 -145 -4 Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota Wisconsin 2,104 474 134 28 34 525 41 301 19 2 410 14 122 2,171 635 / 30 41 578 32 290 20 2 391 5 147 -67 -161 : -2 -7 -53 9 11 -1 0 19 9 -25 10,423 268 94 124 / 3,396 1,042 83 488 671 302 718 136 489 210 2,400 / 2 10,243 283 99 170 359 2,633 846 122 381 820 192 554 122 617 185 2,520 330 10 180 -15 -5 -46 : 763 196 -39 107 -149 110 164 14 -128 25 -120 : -8 South Alabama Arkansas Delaware District of Columbiac Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia West Virginia West 1,905 2,207 -302 Alaska / 16 : Arizona 152 144 8 California 1,249 1,570 -321 Colorado 148 131 17 Hawaii 23 30 -7 Idaho 26 15 11 Montana 6 10 -4 Nevada 124 125 -1 New Mexico 25 26 -1 Oregon / 23 : Utah 38 34 4 Washington 107 75 32 Wyoming 7 8 -1 Note: For detailed State-level data for 2005, see Appendix table 1 at <http://www.ojp.usdoj.gov/bjs/pub/hivp05.pdf>. /Not reported. :Not calculated. a The comparable numbers for 1999 and 2005 include data from the Federal system, 46 States, and the District of Columbia. b In 2005 Rhode Island changed their method for reporting HIV/AIDS cases. As a result, Rhode Island revised their HIV/AIDS counts for 2000-2004. c The percentage change was not calculated for the District of Columbia because at yearend 2001 responsibility for housing sentenced felons was transferred to the Federal Bureau of Prisons. Number of confirmed AIDS cases fluctuated between 1999 and 2005 Between 1999 and 2005, the estimated number of confirmed AIDS cases in State and Federal prisons fluctuated, reaching a high of 7,039 in 1999 and a low of 5,607 in 2002 (table 2). Overall, the estimated number of confirmed cases decreased by 1,419 cases between 1999 and 2005. Since 2000, the estimated confirmed AIDS cases as a percent of all HIV/AIDS cases have remained stable at about 25%. The number of confirmed AIDS cases was estimated because not all States reported counts in every year during the 7-year period between 1999 and 2005. For States that reported counts, the number of confirmed AIDS cases ranged between 6,642 in 1999 and 4,862 in 2002. A total of 31 States and the Federal system provided data in all 7 years (see comparable column in table 2). The pattern of change in confirmed AIDS cases was similar across the three measures — estimated, reported, and comparable confirmed AIDS cases. The number fluctuated but decreased overall during the period. Difference between the rate of confirmed AIDS cases in prisons and the general population shrinking In each year since 1991, the rate of confirmed AIDS has been higher among prison inmates than in the U.S. general population, but the gap has been narrowing. At yearend 2005, the estimated rate of confirmed AIDS in State and Federal prisons was more than 2½ times higher than in the general population (table 3). In 1999 it was nearly 5 times higher. Table 2. Number of confirmed AIDS cases in State and Federal prisons, at yearend 1999-2005 Number of confirmed AIDS cases Yearend 1999 2000 2001 2002 2003 2004 2005 Estimateda Reportedb Comparablec 7,039 6,275 6,240 5,607 5,892 5,969 5,620 6,642 5,676 5,708 4,862 5,175 5,425 5,422 5,973 5,453 5,399 4,788 5,095 5,206 5,011 Estimated confirmed AIDS cases as a percent of total HIV/ AIDS cases 27.3% 24.8 25.9 23.5 25.0 26.0 25.0 Note: For State-level data for 2004 and 2005, see Appendix table 3 at <http://www.ojp.usdoj.gov/bjs/pub/hivp05.pdf>. aIn States that did not report confirmed AIDS cases, estimates were made by applying to the total the percentages by type of HIV infection from the most recent year for which data were available. For each year, estimates do not include data from States that did not report sufficient data on HIV/AIDS cases. bExcludes 6 States in 1999, 9 in 2000, 7 in 2001, 13 in 2002, 14 in 2003, 11 in 2004, and 9 in 2005. cThe Federal system and 31 States reported data for all 7 years shown in the table. Table 3. Percent with confirmed AIDS among State and Federal prisoners and U.S. general population, 1999-2005 Yearend Percent of population estimated to have confirmed AIDS State and Federal U.S. general prisoners population* The shrinking difference between the rate of confirmed AIDS cases in prisons and the general population between 1999 and 2005 resulted from a decrease in the number of confirmed AIDS cases in prisons (down 20%) and an increase in cases (up 44%) among the general population. 1999 2000 2001 2002 2003 2004 2005 HIV/AIDS cases among both male and female State inmates declining, but at a faster rate for females Note: See Methodology for data sources and calculations. *Based on persons age 13 or older in 1999 and age 15 or older thereafter. Excludes confirmed AIDS cases in State and Federal prisons. Since 1999 the estimated number of both male and female inmates who had HIV infection or confirmed AIDS has decreased. Among men, HIV/AIDS dropped from 22,175 cases to 18,953 between 1999 and 2005 (table 4). For women, the number of cases dropped from 2,402 to 1,935. The percentage of male inmates who were HIV positive or had confirmed AIDS decreased from 2.2% to 1.8%; the percentage for female inmates fell from 3.4% to 2.4%. While both groups experienced a decrease in the number of HIV/AIDS cases, females had a larger decrease in the percentage of HIV/AIDS cases. This can be explained by the faster growing female population in prisons and a larger decrease in the number of HIV/AIDS cases among women. 0.58% 0.51 0.50 0.45 0.47 0.46 0.43 Percent of AIDS cases in prisons by percent in U.S. general population 0.12% 0.13 0.14 0.14 0.15 0.15 0.16 4.8 3.9 3.6 3.2 3.1 3.1 2.7 Table 4. HIV/AIDS cases in State and Federal prisons, by gender, 1999-2005 Yearend 1999 2000 2001 2002 2003 2004 2005 Male inmates in custody Estimated Percent of number population 22,175 21,889 20,357 20,265 20,010 19,294 18,953 2.2% 2.2 2.0 1.9 1.9 1.8 1.8 Female inmates in custody Estimated Percent of number population 2,402 2,467 2,196 2,153 2,126 1,962 1,935 3.4% 3.6 3.1 2.9 2.8 2.5 2.4 Note: To provide year-to-year comparisons, estimates were made for States that did not report data by gender. For each State, estimates were calculated by applying to the total the percentages by gender from the most recent year for which data were available. For State-level data for 2005, see Appendix table 2 at <http://www.ojp. usdoj.gov/bjs/pub/hivp05.pdf>. HIV in Prisons, 2005 3 Inmate survey data support decline in HIV infection in 1997 and 2004 Data reported by inmates in personal interviews, collected in the BJS Survey of Inmates in State Correctional Facilities, were consistent with the decline in HIV infection observed in National Prisoner Statistics (NPS-1) official records. Personal interview data are obtained every 5 to 6 years. The most recent data collections were in 1997 and 2004. In each year, inmates were asked if they had been tested for HIV at admission or had ever been tested and the results of the test. In 2004, 1.6% of tested State inmates reported being HIV positive, down from 2.2% in 1997. Decreases found in the percent of HIV positive among male and female inmates and inmates ages 25 to 34 The inmate survey data provide a broad range of individual characteristics, including gender, race, age, current offense, and prior drug use, that can be used to describe trends. Despite apparent declines within each category, not all declines were statistically significant (see table footnote “a” for statistically significant items). Overall, the percentage of State inmates reporting HIV infection in 2004 was down from 1997. Both male and female inmates were less likely to report being HIV positive in 2004 than in 1997. In 2004, 1.6% of male inmates, compared to 2.2% in 1997, were HIV positive. For female inmates, 1.9% in 1997, down from 3.4% in 2004, reported being HIV positive. Among State inmates ages 25 to 34, there was a sharp decline in the number who reported being HIV positive between 1997 and 2004 (2.3% compared to 0.8%). Over the same time period, inmates in each of the other age categories were equally likely to report being HIV positive. Decrease in HIV infection found among drug offenders and inmates who reported prior drug involvement Drug offenders were less likely in 2004 to report being HIV positive than in 1997. In 2004, 1.8% of drug offenders reported being HIV positive, down from 2.9% in 1997. Between 1997 and 2004, significant decreases in the percentage of inmates who reported being HIV positive were found among inmates who ever used drugs, used drugs in the month before arrest, and used needles to inject drugs. Among inmates who reported 4 HIV in Prisons, 2005 Characteristic State inmates who were ever tested for HIV and reported results 2004 1997 Percent HIV Percent Number positive Number HIV positive All inmates Gender Malea Femalea 967,200 1.6% 790,100 2.2% 897,700 69,500 1.6% 1.9 734,300 55,800 2.2% 3.4 Race/Hispanic origin 336,700 Whiteb Black or African Americanb 409,000 Hispanic or Latino 166,500 1.0% 257,900 1.4% 2.0 1.8 384,900 123,700 2.8 2.5 Age 24 or younger 25-34a 35-44 45 or older 159,600 328,900 300,600 178,000 0.3% 0.8 2.5 2.6 154,200 310,200 232,800 92,200 0.5% 2.3 3.1 2.7 Current offense Violent Druga Property Public-order 457,900 201,800 183,800 110,700 1.3% 1.8 2.6 0.9 360,400 164,300 178,600 77,000 1.9% 2.9 2.4 1.9 155,400 809,900 1.3% 1.7 123,000 666,000 1.7% 2.3 552,300 1.9 460,700 2.7 183,800 77,900 2.8 5.1 168,400 74,400 4.6 7.7 Prior drug use Never Evera In month before arresta Used needle to inject drugsa Shared a needle Note: See Appendix table 7 for standard error estimates at <http://www. ojp.usdoj.gov/bjs/pub/hivp05.pdf>. aDifferences significant at the 95% confidence interval. b Not Hispanic or Latino. ever using drugs, 1.7% reported being HIV positive in 2004, down from 2.3% in 1997. Inmates who used drugs in the month before arrest were less likely to report being HIV positive in 2004 (1.9%) than in 1997 (2.7%). Among inmates who said they had used a needle to inject drugs, 2.8% reported being HIV positive in 2004, down from 4.6% in 1997. Number of AIDS-related deaths declined dramatically between 1995 and 2000 The number of State inmates who died of AIDS-related diseases, such as Pneumocystis carinii pneumonia and Kaposi's sarcoma,2 peaked in 1995 at 1,010 deaths and declined through 2000 to 185 deaths. In 2001 the number of AIDS-related deaths reported in the NPS-1 increased to 256 and has steadily declined since (figure 2). In 2001 BJS began collecting individual-level information about deaths in State prisons, under the Death in Custody Reporting Program (DCRP).3 The estimated number of AIDS-related deaths calculated using data from both the NPS-1 and the DCRP followed the same downward trend between 2001 and 2005 that was found using data from NPS-1 only. The estimated number of AIDS-related deaths was 176 in 2005, down from 311 in 2001. Between 1995 and 2000, New York reported the largest decline in AIDS-related deaths (down 250), followed by Florida (down 102) and California (down 68). These three States combined accounted for more than half of the total decline (825) in the number of AIDS-related deaths. New Jersey (down 46) and Georgia (down 42) also had large declines. 2Center for Disease Control, 1993, Revised Classification System for HIV Infection and Expanded Surveillance Case Definition for AIDS Among Adolescents and Adults. MMWR 1992; 41(RR-17). 3In 2001 BJS began to estimate the number of AIDS-related deaths using data from the NPS-1 and the DCRP. The most complete data for each State's number of deaths were used to calculate the estimated number of AIDS-related deaths. See Methodology. Trends in AIDS-related deaths, 1991-2005 Number of AIDS-related deaths in State prisons 1,200 Reported in NPS-1 1,000 800 600 400 Estimated* 200 0 1991 1993 1995 1997 1999 2001 2003 2005 *See Methodology. Figure 2 Almost all of the decrease in AIDS-related deaths attributed to male inmates Using the individual records collected under the DCRP, estimates of AIDS-related deaths by gender, age, and race were calculated by applying the percentages in DCRP in each year to the estimated total number of deaths. The number of AIDS-related deaths decreased across gender, age, race and Hispanic origin. Between 2001 and 2005, male inmates, inmates ages 35 to 44, and black non-Hispanic inmates accounted for most of the decrease (table 5). In 2005, 166 male inmates died from AIDS-related causes, down from 295 in 2001. This decrease of 129 AIDS-related deaths among male inmates was almost all (96%) of the total decrease of 135 deaths among all inmates. Table 5. Profile of inmates who died of AIDS-related causes in State prisons, 2001-2005 Characteristic State total Gender Male Female Age 19 or younger 20-24 25-34 35-44 45-54 55 or older Race/Hispanic origin Whitec Black or African Americanc Hispanic or Latino Estimated number of AIDS-related deathsa 2005 2004 2003 2002 2001 Rate of AIDS-related deaths per 100,000 inmatesb 2005 2004 2003 2002 2001 176 185 268 283 311 14 15 22 24 26 166 10 176 9 258 10 273 10 295 16 14 12 15 11 23 12 24 13 27 21 0 0 25 82 55 14 0 3 26 88 57 11 0 1 48 124 75 19 0 0 32 139 96 16 0 5 52 150 86 18 0 0 6 21 31 22 0 1 6 23 33 19 0 1 12 33 44 31 0 0 8 38 57 27 0 3 13 41 52 31 33 120 21 46 122 11 46 186 32 58 188 35 56 208 46 8 24 9 11 24 5 10 34 15 13 35 17 13 39 22 Note: For State-level data for 2005, see appendix table 4 at <http://www.ojp.usdoj.gov/bjs/pub/hivp05.pdf>. a Estimates of the number of AIDS-related deaths by gender, age, and race/Hispanic origin were made by applying the percentages based on DCRP data to the estimated total number of AIDS-related deaths. b To calculate the rate, the number of State prisoners by age was first estimated by applying the age distribution reported in the 2004 Survey of Inmates in State Correctional Facilities to the 2001-2005 midyear custody counts in NPS-1. c Not Hispanic or Latino. HIV in Prisons, 2005 5 Between 2001 and 2005, inmates ages 35 to 44 accounted for half of the decrease (down 68) in the total number of AIDS-related deaths. AIDS-related deaths of black nonHispanic inmates accounted for 65% of the total decline of 88 AIDS-related deaths reported between 2001 and 2005 (down from 208 to 120). AIDS-related deaths as a percent of all deaths decreasing more rapidly in State prison than in the general population AIDS-related deaths as a percent of total deaths in State prisons also decreased significantly between 1995 and 2000, from 34.2% to 5.3% (table 6). Over a slightly different time period (1995 to 2004, the most recent year for which data are available), AIDS-related deaths among the general population ages 15 to 54 decreased 68%, from 44,233 to 14,315. AIDS-related deaths as a percent of all deaths in the general population declined from 12.9% to 4.3% during the period. Between 2001 and 2004, the rate of AIDS-related deaths among prison inmates as a percent of all deaths in the prison population was nearly cut in half (from 10.3% to 5.6%). However, the rate in the general population remained stable at about 4.3%. Table 6. Percent of AIDS-related deaths among all deaths in State prisons and U.S. general population Percent of deaths State prisonsa Yearend 1995 34.2% 2001 2002 2003 2004 2005 10.3 9.1 8.0 5.6 5.3 Between 1995 and 2001, the rate of AIDS-related deaths declined from 100 deaths per 100,000 inmates to 25 per 100,000 (table 7). In the general population the rate dropped from 29 per 100,000 to 9 per 100,000. After 2001, while the rate of AIDS-related deaths in the State prison population continued to decline, from 25 to 13 per 100,000 inmates, the rate in the general population ages 15 to 54 remained stable between 8 and 9 deaths per 100,000 persons. Older persons in State prisons had a higher rate of AIDS-related deaths than those in the general population Older inmates were more likely to die from AIDS-related causes than persons in the same age group in the general population. In 2005, inmates ages 35 to 44 were almost twice as likely to die from AIDS-related causes (21 per 100,000 State inmates) than their counterparts in the general population (12 per 100,000 persons) (table 8). Among persons ages 45 to 54, State inmates were more than twice as likely as those in the general population to die from AIDS-related causes (31 per 100,000 compared to 14 per 100,000). 12.9% 2.6 4.3 4.1 4.2 4.3 ... 2.4 2.2 1.9 1.3 : ... Not available. :Not calculated. a Percentages were based on the number of inmate deaths, excluding those in jurisdictions not reporting AIDS-related deaths. b Excludes deaths reported in State prisons. See Methodology for data sources. Table 7. Rate of AIDS-related deaths in State prisons and U.S. general population Rate per 100,000 persons State prisons Yearend Rate of AIDS-relate deaths declining in prisons, stabilizing in the general population Percent of deaths in State prisons by percent in U.S. U.S. general popu- general populalation, ages 15-54b tion, ages 15-54 U.S. general population, ages 15-54a Rate of deaths in State prisons by rate in U.S. general population, ages 15-54b 1995 100 29 3.5 2001 2002 2003 2004 2005 25 22 21 14 13 9 9 9 9 8 2.9 2.6 2.4 1.7 1.7 aExcludes deaths reported in State prisons. See Methodology for data sources. bCalculation based on unrounded rates. Table 8. Rate of AIDS-related deaths per 100,000 persons in State prisons and U.S. general population, by age, 20012005 Age 20-24 25-34 35-44 45-54 Rate of AIDS-related deaths per 100,000 persons, by agea U.S. general State prisons populationb 2005 2001 2005 2001 0 6 21 31 3 13 42 52 1 4 12 14 1 6 15 13 Percent of population U.S. general State prisons population 2004 2005 2001 15.5% 33.1 30.5 14.1 7.1% 6.9% 13.5 13.8 14.7 15.8 14.3 13.8 Note: Data on AIDS-related deaths by age were not collected in prisons prior to 2001. a To calculate the rate, the number of State prisoners by age was first estimated by applying the age distribution reported in the 2004 Survey of Inmates in State Correctional Facilities to the 2005 and 2001 midyear custody counts in NPS-1. b Excludes deaths reported in State prisons. See Methodology for data sources. 6 HIV in Prisons, 2005 Methodology National Prisoner Statistics The National Prisoner Statistics collection (NPS-1), which primarily measures prison population movement, began in 1926. The 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 in the 50 States and the Federal Bureau of Prisons. In 1991 BJS began collecting data on HIV/AIDS in prisons in NPS-1. BJS respondents have indicated the circumstances under which inmates are tested for HIV and have provided the number of HIV-infected inmates in their custody. Surveys of Inmates in State Correctional Facilities The Survey of Inmates in State Correctional Facilities provides nationally representative data on State prison inmates. The 1997 and 2004 surveys used the same questionnaire and a stratified two-stage sample design. Facilities were selected in the first stage and inmates were selected for interviews in the second stage. Detailed descriptions of each survey’s methodology and links to other reports or findings are available on the BJS Website <http://www.ojp.usdoj.gov/bjs/abstract/sicf04.htm>. Accuracy of the survey estimates The accuracy of the estimates in this report depends on two types of error: sampling and nonsampling. Sampling error is the 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 nonresponses, 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. Testing for differences in the proportions of inmates reporting that they were HIV positive within subgroups in the 1997 and 2004 surveys compared a calculated z-value against the critical value of 1.645 (the 95% level for a onetail test). Given the overall declines in HIV cases reported in the administrative data, a one-tail test showed that the difference in proportions was less than zero. The z-value was calculated by taking the ratio of the estimated difference in proportions to the square root of the pooled variances of the two samples. (See standard errors in appendix table 7 at <http://www.ojp.usdoj.gov/pub/hiv05.pdf>.) Deaths in Custody Reporting Program To implement the Death in Custody Reporting Act of 2000 (PL 106-297), BJS developed four quarterly data collections of death records from local jails (begun in 2000), State prisons (2001), State juvenile correctional agencies (2002), and State and local law enforcement agencies (2003). Records include data on the deceased’s characteristics (such as age, gender, and race/Hispanic origin), criminal background (such as legal status, offenses, and time in custody), and the death itself (such as cause, time, location, and medical conditions and treatment). Estimation of HIV/AIDS cases in New York State New York estimates the number of HIV/AIDS cases based on data from blind sero-prevalence studies conducted biennially by the New York State Department of Health. Blood samples are taken from all inmates entering New York State prisons. Every other year an extra sample from 1,000 sequential admissions at reception in four reception centers is tested for various diseases, including HIV. The percentage with HIV infection is applied to the total inmate population, then adjusted for length of stay and data from other studies. Projections for interim years are made without blind studies. AIDS in the U.S. resident population The number of persons with confirmed AIDS in the U.S. general population (age 13 and older) was derived from the Centers for Disease Control and Prevention (CDC), HIV/ AIDS Surveillance Report, yearend editions 1995-2005. For each year the number of active AIDS cases in the United States was calculated by taking the — • cumulative number of total AIDS cases for persons age 13 or older at yearend (from the HIV/AIDS Surveillance Report), minus estimated confirmed AIDS cases in State and Federal prisons, and subtracting the • cumulative number of AIDS deaths for people age 15 or older at yearend, minus estimated number of AIDS-related deaths in State and Federal prisons. The rate of confirmed AIDS cases in the U.S. general population was calculated by — • dividing the annual total number of individuals with AIDS by • the estimated U.S. general population (age 13 or older before 2000; age 15 or older since 2000) minus the State and Federal custody population. AIDS-related deaths in the United States The number of AIDS-related deaths for persons ages 15 to 54 was based on the CDC, HIV/AIDS Surveillance Report, yearend editions. Deaths in the U.S. population for persons ages 15 to 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). Also deaths were taken from the CDC, National Vital Statistics Report, Vol. 47, No. 9; Vol. 47, No. 25; Vol. 48, No. 11; Vol. 49, No. 8; Vol. 50, No. 15; Vol. 53, No. 15; and Vol. 54, No. 19. HIV in Prisons, 2005 7 U.S. Department of Justice Office of Justice Programs Bureau of Justice Statistics *NCJ~218915* PRESORTED STANDARD POSTAGE & FEES PAID DOJ/BJS Permit No. G-91 Washington, DC 20531 Official Business Penalty for Private Use $300 For 2001 to 2005, AIDS-related deaths were calculated as a percent of all deaths among persons ages 15 to 54 in the U.S. general population. The difference of the national estimate of AIDS deaths of persons ages 15 to 54 minus AIDSrelated deaths of persons ages 15 to 54 in State prison was divided by the national mortality estimates of persons ages 15 to 54 minus total deaths in State prisons. For 2001 through 2005, the rates of AIDS-related deaths in the general population were calculated by taking the difference of the national estimate of AIDS-related deaths for persons ages 15 to 54 minus AIDS-related deaths for those ages 15 to 54 in State prisons and dividing it by the U.S. general population estimate minus the State prison population ages 15 to 54. Because data on AIDS-related deaths by age in State prisons were not collected prior to 2001, the total number of AIDS-related deaths in State prison were subtracted from the national estimate of AIDS-related deaths for the 1995 rate calculations. Office of Justice Programs Innovation • Partnerships • Safer Neighborhoods http://www.ojp.usdoj.gov 8 HIV in Prisons, 2005 The Bureau of Justice Statistics is the statistical agency of the U.S. Department of Justice. Jeffrey L. Sedgwick is the director. BJS Bulletins present the first release of findings from permanent data collection programs. This Bulletin was written by Laura M. Maruschak. Margaret Noonan and Heather Couture verified the report. Theresa M. Reitz carried out the data collection and processing under the supervision of Charlene M. Sebold, Governments Division, Census Bureau, U.S. Department of Commerce. Duane H. Cavanaugh and Diron J. Gaskins provided technical assistance. Tina Dorsey and Carolyn C. Williams edited the report and Jayne Robinson prepared it for final printing, under the supervision of Doris J. James. September 2007, NCJ 218915 This report in portable document format and in ASCII and its related statistical data and tables are available at the BJS World Wide Web Internet site: <http://www.ojp.usdoj.gov/bjs/ abstract/hivp05.htm>. Appendix table 1. Inmates in custody of State or Federal prison authorities and reported to be positive for the human immunodeficiency virus (HIV) or to have confirmed AIDS, 2003-05 HIV/AIDS cases as a percent of total custody populationb 2005 2004 2003 Jurisdiction Total HIV/AIDS casesa 2005 2004 2003 U.S.total Comparable reportingc Reportedd Federal State 22,263 22,480 1,592 20,888 22,560 22,936 1,680 21,256 23,247 23,608 1,631 21,977 1.7% 1.0% 1.8 1.8% 1.1% 1.8 1.9% 1.1% 2.0 Northeast Connecticut Maine Massachusetts New Hampshire New Jersey New York Pennsylvania Rhode Island Vermont 6,456 463 10 221 21 540 4,440 692 58 11 6,646 477 11 215 31 655 4,500 693 51 13 7,339 572 10 230 21 657 5,000 775 65 9 3.9% 2.6 0.5 2.1 0.9 2.3 7.0 1.7 1.7 0.7 4.1% 2.7 0.6 2.2 1.3 2.9 7.0 1.7 1.6 0.9 4.4% 3.2 0.5 2.3 0.9 2.8 7.6 1.9 1.8 0.6 Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota Wisconsin 2,104 474 134 28 34 525 41 301 19 2 410 14 122 2,025 488 / 32 41 575 44 294 20 6 387 9 129 2,087 551 / 31 32 579 40 268 21 2 416 11 136 0.9% 1.1 0.6 0.3 0.4 1.1 0.5 1.0 0.4 0.2 1.0 0.4 0.6 0.9% 1.1 / 0.4 0.5 1.2 0.6 1.0 0.5 0.5 0.9 0.3 0.6 1.0% 1.3 / 0.4 0.3 1.2 0.5 0.9 0.5 0.2 1.0 0.4 0.7 South Alabama Arkansas Delaware Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia West Virginia 10,423 268 94 124 3,396 1,042 83 488 671 302 718 136 489 210 2,400 / 2 10,691 270 102 149 3,250 1,109 74 487 792 254 647 133 489 215 2,405 302 13 10,740 270 94 105 3,112 1,095 / 511 988 200 640 162 520 208 2,460 361 14 2.2% 1.1 0.8 1.8 3.9 2.1 0.7 2.5 3.0 2.7 / 0.8 2.2 1.5 1.7 / 0.0 2.1% 1.1 0.8 2.2 3.9 2.2 0.6 2.5 3.4 2.2 1.8 0.8 2.2 1.5 1.7 1.0 0.3 2.2% 1.0 0.7 1.6 3.9 2.3 / 2.6 4.2 1.6 1.9 1.0 2.3 1.5 1.8 1.2 0.4 West 1,905 1,894 1,811 0.7% 0.7% 0.7% Alaska / / / / / / Arizona 152 155 123 0.5 0.5 0.4 e 1,249 1,212 1,196 0.7 0.7 0.7 California Colorado 148 185 162 0.9 1.1 1.0 Hawaii 23 15 27 0.6 0.4 0.7 Idaho 26 33 26 0.6 0.7 0.6 Montana 6 5 4 0.3 0.2 0.2 Nevada 124 116 107 1.1 1.1 1.0 New Mexico 25 25 29 0.4 0.4 0.5 Oregon / / / / / / Utah 38 39 37 0.8 0.8 0.8 Washington 107 102 93 0.6 0.6 0.6 Wyoming 7 7 7 0.6 0.6 0.6 /Not reported. a Counts published in previous reports may have been revised. b Percentages are based on custody counts, except for New Mexico for which percentages are based on its yearend jurisdiction count. c Excludes data from Indiana, Kentucky, Virginia, Alaska, and Oregon for all 3 years due to incomplete reporting. d Exclude inmates in jurisdictions that did not report data. eThe 2005 number of HIV/AIDS cases in California was based on the count on 2/3/06. HIV in Prisons, 2005 9 Appendix table 2. Inmates in custody of State and Federal prison authorities reported to be positive for the human immunodeficiency virus (HIV) or to have confirmed AIDS, by gender, 2005 Jurisdiction Male HIV/AIDS cases Number Percent of population Female HIV/AIDS cases Number Percent of population U.S. total Estimateda,b Reported Federal State 20,444 20,320 1,491 18,829 1.7% 1.0% 1.8 2,036 2,024 101 1,923 2.3% 0.9% 2.5 Northeast Connecticut Maine Massachusetts New Hampshire New Jersey New York Pennsylvania Rhode Island Vermont 5,839 411 9 195 21 463 4,040 636 54 10 3.7% 2.5 0.5 2.0 0.9 2.1 6.7 1.6 1.7 0.7 617 52 1 26 0 77 400 56 4 1 7.2% 4.0 0.8 3.3 0 6.8 14.1 2.9 2.1 0.7 Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota Wisconsin 1,950 430 117 24 33 487 40 287 18 2 380 13 119 0.8% 1.0 0.6 0.3 0.4 1.0 0.5 1.0 0.5 0.2 1.0 0.4 0.6 154 44 17 4 1 38 1 14 1 0 30 1 3 0.9% 1.6 0.9 0.5 0.1 1.8 0.2 0.6 0.2 0 0.9 0.3 0.2 South Alabama Arkansas Delaware Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia West Virginia 9,306 256 85 103 3,054 949 70 455 597 262 654 / 452 203 2,164 / 2 2.2% 1.1 0.7 1.6 3.8 2.1 0.6 2.5 2.8 2.7 1.9 / 2.2 1.6 1.7 / 0.1 981 12 9 21 342 93 13 33 74 40 64 / 37 7 236 / 0 3.1% 1.0 1.2 3.9 5.7 3.2 1.4 3.2 6.9 2.5 2.4 / 2.5 0.6 2.3 / 0 West 1,734 0.7% 171 0.8% Alaska / / / / Arizona 138 0.5 14 0.5 California 1,149 0.7 100 0.9 Colorado 135 0.9 13 0.7 Hawaii 23 0.7 0 0 Idaho 23 0.6 3 0.6 Montana 6 0.4 0 0 Nevada 99 0.9 25 2.7 New Mexico 23 0.4 2 0.3 Oregon / / / / Utah 32 0.7 6 1.3 Washington 100 0.7 7 0.5 Wyoming 6 0.5 1 0.9 /Not reported. a Includes estimates of the number of inmates with HIV/AIDS by gender for Oklahoma. b In States that did not report HIV/AIDS cases by gender, estimates were made by applying to the total the percentages by gender from the most recent year for which data were available. For each year, estimates do not include data from States that did not report sufficient data on HIV/AIDS cases. 10 HIV in Prisons, 2005 Appendix table 3. Inmates in custody of State or Federal prison authorities and reported to have confirmed AIDS, yearend 2004 and 2005 Confirmed AIDS casesa Number Percent of custody populationb 2004 2005 2004 Jurisdiction 2005 U.S. total Estimatedc Reported Federal State 5,620 5,422 594 4,828 5,969 5,425 641 4,784 0.5% 0.4% 0.5 0.5% 0.4% 0.5 Northeast Connecticut Maine Massachusetts New Hampshire New Jersey New York Pennsylvania Rhode Island Vermont 1,322 200 1 101 0 118 700 197 / 5 1,500 213 0 83 6 202 800 192 / 4 0.8% 1.1 -1.0 0 0.5 1.1 0.5 / 0.3 0.9% 1.2 0 0.8 0.2 0.9 1.2 0.5 / 0.3 497 96 0 13 4 223 21 / 8 0 89 3 40 389 167 / 16 6 / 18 4 8 1 141 1 27 0.2% 0.2 0 0.1 -0.5 0.3 / 0.2 0 0.2 0.1 0.2 0.2% 0.4 / 0.2 0.1 / 0.2 -0.2 0.1 0.3 -0.1 2,670 29 24 74 645 / 12 / 408 46 295 / 196 45 894 / 2 2,565 133 13 61 721 / 53 / 204 51 249 / 212 66 801 / 1 0.7% 0.1 0.2 1.1 0.7 / 0.1 / 1.8 0.4 0.8 / 0.9 0.3 0.6 / -- 0.7% 0.5 0.1 0.9 0.9 / 0.5 / 0.9 0.4 0.7 / 0.9 0.5 0.6 / -- 339 / 11 196 33 2 0 1 / 4 / 22 70 0 330 / / 191 38 2 / 0 19 4 / 11 65 0 0.1% / -0.1 0.2 0.1 0 0.1 / 0.1 / 0.4 0.4 0 0.1% / / 0.1 0.2 0.1 / 0 0.2 0.1 / 0.2 0.4 0 Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota Wisconsin South Alabama Arkansas Delaware 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 /Not reported. --Less than .05%. a Counts published in previous reports have been revised. b Percents exclude inmates in jurisdictions that did not report type of HIV/AIDS infection. cIncludes estimates of the number of inmates with confirmed AIDS for Georgia, Louisiana, and Oklahoma in 2004 and 2005; for Arizona, Idaho, Indiana, Michigan, and Virginia in 2004; and for Missouri and Nevada in 2005. Also see table 2, footnote a. HIV in Prisons, 2005 11 Appendix table 4. Deaths of State prisoners, 2005 Jurisdiction Total Prisoner deaths reported In NPS-1 In DCRPa AIDSAIDSTotal related Total related Total estimated deathsb All causes AIDS-related Rate per Rate per Number 100,000 inmates Number 100,000 inmates 3,308 121 3,179 172 3,316 249 176 13 Northeast Connecticut Maine Massachusetts New Hampshire New Jersey New York Pennsylvania Rhode Island Vermont 477 41 1 37 8 61 172 149 2 6 41 9 0 0 0 5 17 10 0 0 474 40 0 37 8 61 171 149 2 6 48 11 0 0 0 6 19 11 0 1 477 41 1 37 8 61 172 149 2 6 276 208 48 353 312 217 273 359 55 304 48 11 0 0 0 6 19 11 0 1 28 56 0 0 0 21 30 26 0 51 Midwest Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota Wisconsin 557 74 50 19 19 141 13 75 8 1 122 4 31 10 5 2 0 0 0 0 0 0 0 1 0 2 542 73 45 19 19 140 13 70 8 1 121 4 29 24 6 2 0 0 6 1 4 0 0 3 0 2 557 74 50 19 19 141 13 75 8 1 122 4 31 220 166 204 221 210 288 142 238 187 75 271 120 137 24 6 2 0 0 6 1 4 0 0 3 0 2 9 13 8 0 0 12 11 13 0 0 7 0 9 1,565 75 58 22 248 128 41 103 57 65 73 79 76 75 371 84 10 50 0 3 0 14 10 1 / / 2 1 2 3 0 10 3 1 1,483 66 38 19 244 122 43 89 57 64 70 75 75 76 351 84 10 79 2 3 3 17 10 1 7 12 2 1 2 3 2 10 3 1 1,568 75 58 22 248 128 43 103 57 65 73 79 76 76 371 84 10 259 270 431 306 283 268 228 276 245 312 201 333 318 290 217 236 190 79 2 3 3 17 10 1 7 12 2 1 2 3 2 10 3 1 13 7 22 42 19 21 5 19 52 10 3 8 13 8 6 8 19 South Alabama Arkansas Delaware Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia West Virginia West 709 20 680 21 714 241 25 8 Alaska 0 / 4 0 4 86 0 0 Arizona 77 1 78 1 78 239 1 3 California 374 9 366 14 374 225 14 8 Colorado 65 4 54 3 65 312 4 19 Hawaii 8 0 8 0 8 132 0 0 Idaho 16 / 13 0 16 261 0 0 Montana 14 0 12 0 14 416 0 0 Nevada 33 0 29 0 33 285 0 0 New Mexico 19 0 18 0 19 288 0 0 Oregon 41 2 37 2 41 308 2 15 Utah 8 0 8 0 8 133 0 0 Washington 46 4 45 1 46 276 4 24 Wyoming 8 0 8 0 8 395 0 0 /Not reported. aBased on individual reports submitted to the Deaths in Custody Reporting Program (DCRP). b Data from the National Prisoners Statistics (NPS-1) and DCRP were combined to provide the number of total deaths in each State. The most complete data for each State were used to calculate a total for each State. 12 HIV in Prisons, 2005 Appendix table 5. Circumstances under which inmates were tested for the antibody to the human immunodeficiency virus (HIV), by jurisdiction, 2005 All inmates Jurisdiction Entering In custody Upon release Total Federal system* 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 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 High-risk Inmate Clinical Involvement Random group request indication in incident sample Court order Other / / / / / / / / / / /Not reported. *The Bureau of Prisons tests a random sample of inmates in alternate years. HIV in Prisons, 2005 13 Appendix table 6. Inmate deaths in Federal prisons, by cause, 2004 and 2005 Cause of death Total Natural causes other than AIDS AIDS Suicide Accident By another person Appendix table 7. Standard error estimates for Survey of Inmates in State Correctional Facilities, 1997 and 2004 Deaths of Federal inmates reported in the NPS-1 Number Rate per 100,000 inmates* 2005 2004 2005 2004 388 333 210 186 327 27 13 6 15 295 18 11 6 3 177 15 7 3 8 165 10 6 3 2 *Detail may not add to total due to rounding. Characteristic Gender Male Female 0.20% 0.35 0.20% 0.44 Race/Hispanic origin White* Black or African American* Hispanic or Latino 0.30% 0.34 0.47 0.29% 0.37 0.58 Age 24 or younger 25-34 35-44 45 or older 0.23% 0.25 0.46 0.61 0.20% 0.30 0.40 0.60 Current offense Violent Drug Property Public-order 0.27% 0.48 0.60 0.46 0.25% 0.46 0.40 0.55 Prior drug use Never Ever In month before arrest Used needle to inject drugs Shared a needle 0.46% 0.23 0.29 0.62 1.27 0.41% 0.21 0.27 0.57 1.09 *Not Hispanic or Latino. 14 HIV in Prisons, 2005 Estimated standard error of the percent of inmates who were HIV positive 2004 1997