Black-White Disparities in HIV/AIDS: The Role of Drug Policy and the Corrections System (original) (raw)
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Incarceration, African Americans, and HIV: Advancing a Research Agenda
Journal of the National Medical …, 2008
Incarceration is a crisis among African-Americans, and the prevalence of HIV/AIDS in incarcerated men and women is three to five times that of the general population. We explore the potential implications of the widespread incarceration of African Americans on HIV risk and HIV outcomes in 1) the current and formerly incarcerated, 2) their sexual partners, and 3) the communities impacted by incarceration. We set forth a research agenda for understanding and ameliorating the negative impacts incarceration and conclude that African-American populations' ability to successfully address the HIV/AIDS epidemic requires a coordinated and evidence-based response to the challenge of effectively preventing, managing, and treating HIV in populations affected by incarceration.
Mass incarceration and the impact of prison release on HIV diagnoses in the US South
PLOS ONE, 2018
Background The purpose of this study was to determine the impact of prison release on HIV incidence in the southern region of the United States, the region with the highest rates of both incarceration and new HIV diagnoses nationwide. Methods 5-year HIV diagnoses rates were calculated at the ZIP code level for nine cities and metropolitan statistical areas in the US South (ZIP codes, N = 600). Multilevel regression models were constructed and adjusted rate ratios (ARRs) were estimated for overall, male and female HIV diagnoses rates. Results Across the nine cities, in multilevel, multivariate analysis, controlling for income inequality (GINI coefficient), percent living in poverty and percent Non-Hispanic Black population, the ZIP code level overall HIV diagnosis rate was significantly associated with prison release [ARR 1.004 (95%CI 1.0007, 1.006), p<0.01]. A 10-person increase in prison release rate would result in a 4% increase in overall 5-year HIV diagnosis rate-approximately 9.4 additional cases per 100,000 population. In gender-stratified models, prison release rate was significantly associated with the ZIP code level HIV diagnosis rate for males [ARR 1.004 (95%CI 1.0004, 1.007), p<0.01], but not for females. Conclusions In the southern region of the US, prison release is significantly associated with HIV incidence. HIV prevention interventions should promote timely linkage to ongoing treatment for released inmates living with HIV.
Journal of the National Medical Association, 2009
We examined the relationship between frequency of incarceration and preincarceration risk behaviors and determined the demographic factors associated with risk behaviors among a sample of African American inmates. We surveyed 229 (102 female and 127 male) randomly selected inmates. Risk behaviors between inmates serving their first prison sentence and those who had been incarcerated in prison more than once were compared using the chi2 test. Multivariate logistic regression analysis was used to determine factors associated with risk behaviors. For most risk behaviors, there were no significant differences between inmates serving their first prison sentence and inmates incarcerated more than once; however, male inmates who had been incarcerated more than once were more likely to report having had multiple vaginal sex partners (OR, 2.42; 95% CI, 1.10-5.32; P = .03). No demographic variable was found to be independently associated with risk behaviors. Frequency of incarceration did not...
Health Promotion Practice, 2002
A recent survey indicated that prison inmates are nearly six times more likely than the general population to have AIDS. The Centers for Disease Control and Prevention (CDC) reported that 6,184 prisoners had AIDS in 1997. This represents 5.5 cases per 1,000 inmates, whereas the rate among all Americans older than 18 years is 0.9 per 1,000. By the end of 1994, the number of AIDS deaths among inmates (during incarceration) reached 4,558 (" Continued Sexual Risk Behaviors," 1996). This problem is compounded by institutional policies designating condoms as contraband as well as extremely high rates of HIV and AIDS in the general community.
Culture, Health & Sexuality, 2012
This study investigated the role of incarceration in HIV/STD risk among 197 Black men who have sex with men in Massachusetts, USA. More than half (51%) reported a history of incarceration (28% , 90 days in jail/prison; 23% $ 90 days in jail/prison). Multivariable logistic regression models adjusted for age and sexual orientation examined associations between demographic, behavioural, social-psychological and cultural factors and incarceration history. Factors associated with , 90 days of incarceration were: unprotected sex with a man, STD history, injection drug use and substance abuse treatment. Factors associated with $ 90 days of incarceration were: unprotected sex with a woman, crack use during sex, STD history, injection drug use, substance abuse treatment, depressive symptoms, post-traumatic stress symptoms, HIV fatalism and social capital. Black men who have sex with men with incarceration histories may be at increased risk for HIV/STDs compared to those without such histories. HIV prevention efforts that focus on individual risk and cultural-contextual issues among Black men who have sex with men are warranted.
The influence of imprisonment on HIV and its impact on health-related inequalities in New York City
International Journal of Economics and Business Research, 2013
New York City has been the centre of the HIV epidemic where vulnerable populations disproportionately face negative health outcomes. This paper explains the behaviour of the HIV epidemic in terms of its racial/ethnic composition due to the effects of the criminal justice system, and sustains the necessity of more culturally tailored health interventions to prevent the spread of the disease. To achieve this goal, secondary data analysis and a panel regression device including individuals of specific racial/ethnic backgrounds periodically observed between 2002 and 2009, are required. This paper explores the fundamental characteristics of the HIV epidemic and its swings in terms of socioeconomic determinants as a result of the unbalanced prevalence of imprisonment amid historically underrepresented groups.
Aids and the health crisis of the U.S. urban poor; the perspective of critical medical anthropology
Social Science & Medicine, 1994
The social identity of HIV/AIDS in the U.S. has been shaped, for the most part, by two factors, the prevailing configuration of social relations across class, racial, gender, and sexual orientation, on the one hand, and the prevailing array of public health, especially epidemiological, categories of disease transmission, on the other. Focusing on the AIDS epidemic among inner city people of color, this paper challenges the distortions wrought in our understanding from both of these factors and instead develops an alternative perspective for AIDS research among medical anthropologists and health social scientists generally.
Mass incarceration, residential segregation and racial disparities in HIV
Journal of AIDS and HIV Research, 2016
Using a "mass incarceration" framework and county-level national data, this paper examines the relationship between incarceration, ex-offender reentry locations, and HIV rates in counties with different racial compositions. A series of "race-of-county" stratified regression models estimate HIV prevalence rates with incarceration and ex-offender reentry locations when taking into consideration residential segregation (that is, Black isolation and White isolation), region, high school graduation rates, sex ratios, unemployment rates, median income, healthcare professional shortages, percentage of residents without insurance, population density, and income inequality. As predicted, HIV rates are higher in counties with high incarceration rates or with ex-offender reentry facilities. A race-of-county stratified analysis, however, reveals nuanced patterns: In White counties and the highest-percentage Black counties, HIV rates increase as incarceration rates increase. In integrated counties, they do not. In the highest-percentage Black counties, the presence of reentry locations is associated with higher rates of HIV, but this is not true in White and integrated counties. In integrated counties, higher levels of Black isolation are associated with high HIV rates. In counties of all racial compositions, higher levels of White isolation are associated with lower rates of HIV. Implications of these results are discussed.