HIV in Prisons

by

Michael Caudy, Roberto Potter, Narim Lee

• LAST REVIEWED: 26 May 2023
• LAST MODIFIED: 26 May 2023
• DOI: 10.1093/obo/9780195396607-0331

Introduction

The human immunodeficiency virus (HIV) is a global health problem. While the burden of the disease is widespread, HIV disproportionately affects certain groups and regions. One population disproportionately impacted by HIV is prisoners (i.e., people incarcerated in prisons, jails, or other detention facilities). Global estimates consistently demonstrate a higher prevalence of HIV (and other infectious diseases) among prisoners relative to nonincarcerated persons. The high prevalence of HIV among incarcerated persons has been attributed to several factors, including socioeconomic status, history of injection and other drug use, and high rates of risky sexual behavior. Mass incarceration and the criminalization of drug use have exacerbated this issue in many places around the globe. This has been further complicated by the global COVID-19 pandemic and the ongoing opioid epidemic in the United States. With over 10.5 million people incarcerated worldwide (2.1 million in the United States), HIV in prisons presents a global public health challenge. The high prevalence of HIV in prisons presents both challenges and opportunities for surveillance, prevention, and treatment.

General Overviews

Several comprehensive overviews contextualize key issues related to HIV in prisons and highlight contemporary challenges. A series from The Lancet dedicated to HIV and related infections in prisoners offers an excellent starting point for review. Commentary articles Das and Horton 2016, Beyrer, et al. 2016, and Shrage 2016 provide context for the series. Das and Horton 2016 and Beyrer, et al. 2016 provide general calls for justice reform in the context of the HIV epidemic, while Shrage 2016 highlights the disparate impact of HIV and mass incarceration on Black Americans. The dual epidemics of HIV and mass incarceration are also highlighted in the commentary article Wohl 2016. Jurgens, et al. 2011 and Rubenstein, et al. 2016 offer critical reviews of mass incarceration and the conditions of confinement as they relate to HIV and other infectious diseases. Both articles offer a global perspective. Potter 2017 provides a summary of issues related to HIV-positive inmates in the United States, including historical context and trend data. Contemporary challenges related to the COVID-19 pandemic and opioid epidemic are identified by Mukherjee and El-Bassel 2020 and Hodder, et al. 2021.

• Beyrer, C., A. Kamarulzaman, and M. McKee. 2016. Prisoners, prisons, and HIV: Time for reform. The Lancet 388.10049: 1033–1035.

  DOI: 10.1016/S0140-6736(16)30829-7

  Commentary and introduction to series dedicated to HIV and related infections in prisoners. Highlights health disparities and calls for justice reform on public health and moral grounds.

• Das, P., and R. Horton. 2016. On both sides of the prison walls—Prisoners and HIV. The Lancet 388.10049: 1032–1033.

  DOI: 10.1016/S0140-6736(16)30892-3

  Commentary and introduction to series dedicated to HIV and related infections in prisoners. Broad overview of scope, consequences, and causes of dual epidemics of HIV and mass incarceration. Call for justice reform to support broader public health reforms.

• Hodder, S. L., J. Feinberg, S. A. Strathdee, et al. 2021. The opioid crisis and HIV in the USA: Deadly synergies. The Lancet 397:1139–1150.

  DOI: 10.1016/S0140-6736(21)00391-3

  Commentary highlighting the impact of the opioid epidemic on HIV in the United States. Notes the changing demographics of HIV populations and highlights barriers to reform.

• Jurgens, R., M. Nowak, and M. Day. 2011. HIV and incarceration: Prisons and detention. Journal of the International AIDS Society 14.26: 1–17.

  DOI: 10.1186/1758-2652-14-26

  Critical overview of challenges posed by mass incarceration and the conditions of confinement. Contextualizes the dual epidemics of HIV and mass incarceration. Provides global information on prevalence, incidence, and prevention of HIV in prisons.

• Mukherjee, T. I., and N. El-Bassel. 2020. The perfect storm: COVID-19, mass incarceration and the opioid epidemic. International Journal of Drug Policy 83:102819.

  DOI: 10.1016/j.drugpo.2020.102819

  Commentary highlighting the risk of COVID-19 in correctional facilities. Notes the opioid epidemic and HIV as risk factors for negative health outcomes.

• Potter, R. H. 2017. HIV-positive inmates. In The Encyclopedia of Corrections. Edited by K. R. Kerley, 395–401. Hoboken, NJ: Wiley-Blackwell.

  Summary of issues related to HIV-positive inmates in the United States, including historical context, sources of prevalence data, and trends over time. Includes information about HIV in community corrections. Also available online.

• Rubenstein, L. S., J. J. Amon, M. McLemore, et al. 2016. HIV, prisoners, and human rights. The Lancet 388.10050: 1202–1214.

  DOI: 10.1016/S0140-6736(16)30663-8

  Contextualizes HIV in prisons as a human rights issue. Identifies laws, policies, and policing practices that drive health disparities and inhibit prevention, care, and treatment of HIV in prisons.

• Shrage, L. 2016. African Americans, HIV, and mass incarceration. The Lancet 388.10049: e2–e3.

  DOI: 10.1016/S0140-6736(16)30830-3

  Commentary with data demonstrating the disparate impacts of HIV and incarceration among Black Americans. Calls for structural reforms to address these overlapping issues.

• Wohl, D. A. 2016. HIV and mass incarceration: Where infectious diseases and social justice meet. North Carolina Medical Journal 77.5: 359–364.

  DOI: 10.18043/ncm.77.5.359

  Commentary highlighting the dual epidemics of HIV and mass incarceration in the United States. Highlights historical context, causes, and consequences.