HIV/AIDS, sexually transmitted diseases, and incarceration among women: National and southern perspectives

Objective: The objective of this study was to explore the relationships between incarceration and emerging increases in HIV and sexually transmitted diseases (STDs) in the rural south, particularly among black women of low socioeconomic status. Study Design: The study used secondary data on correctional populations, incarceration rates, admissions to correctional facilities (prisons and jails), HIV and STD prevalence among inmates, and national and state HIV surveillance data. Results: Simultaneous consideration of these disparate data suggests some important patterns. Nationally, increasing proportions of inmates are women, and blacks and Latinos/as of low socioeconomic status are disproportionately represented in inmate populations. Incarceration rates are higher in the south (790 per 100,000) than in other regions and, within the south, rates are about the same for rural and urban counties (1194 and 1160). The prevalences of HIV and STDs are higher among female than male inmates (for HIV, approximately 3% to 2% nationally), and among the highest regional burdens of HIV are found among releasees from southern correctional facilities (26% of all people living with HIV in the south in 1999 were released from a prison or jail that same year) and among southern women releasees (15% of all women with HIV were correctional releasees). Taken together, these figures suggest that many southern women with HIV/AIDS and STDs, especially poor black women from rural areas, are found in prisons and jails, perhaps more so than in other parts of the country. At the same time, only small percentages of newly reported cases of AIDS among women in the south are diagnosed in correctional facilities (0.6-7%, depending on the state). Conclusions: Given the concentrations of rural black women with HIV/AIDS and STDs in southern correctional facilities, it is important to recognize that prisons and jails are critical settings in which to deploy programs for the prevention, diagnosis, and treatment of infectious diseases and other health problems. Such interventions, as well as interventions focused on the rural communities themselves, would benefit not only inmates and releasees, but also the larger public health.