This article reviews the extent of HIV (human immunodeficiency virus) infection and AIDS (acquired immunodeficiency syndrome) among U.S. prison inmates and examines the policies and research needed to address the problem.
Compared to the general population, U.S. prison inmates have a high prevalence of HIV infection and an elevated incidence of the resulting AIDS. Inmates at highest risk of being HIV-positive are those with a preincarceration history of intravenous drug use. In some State prison systems, AIDS has become the leading cause of inmate deaths. Inmates have a constitutional right to adequate health care, which is interpreted by many to include voluntary HIV testing and treatment to delay the onset of AIDS. More research is required to facilitate better design and funding for HIV testing, treatment, and risk-reduction programs for inmates. In addition to more complete and up-to-date information on HIV prevalence and AIDS incidence among inmates, more data are needed on HIV and AIDS among specific groups of inmates, especially those with a history of intravenous drug use and among female inmates. Prison systems that implement voluntary HIV testing must assess the effectiveness of their programs, both in terms of the percentage of high-risk inmates who accept the testing and the proportion of all HIV-infected inmates who are identified through voluntary testing. Clinical and immunological data on HIV-infected inmates are needed to project their therapeutic needs. 47 footnotes