Objective: To compare demographic, behavioral, and geographic characteristics of incarcerated persons with AIDS and those of all persons with AIDS reported from January 1994 through December 1996.
Design: Population-based surveillance.
Setting: Medical records of persons for whom AIDS diagnosis was made in hospitals, clinics, and other settings (e.g., prisons) in the United States.
Patients: Adults (13 years or older) with AIDS reported from January 1994 through December 1996.
Results: Of the 220000 AIDS cases in adults, 4% were reported in incarcerated persons. Compared with all persons with AIDS, a higher proportion were male (89% versus 82%), black (58% versus 39%), younger at time of diagnosis (35 versus 37 years), had injected drugs (61% versus 27%), and were reported on the basis of the 1993 immunologic criteria (71% versus 50%). Fewer cases in incarcerated persons were diagnosed at death (3% versus 10%). The South (38%) and the Northeast (37%) United States accounted for the largest proportion of incarcerated persons. The 1996 AIDS rate for incarcerated persons (199 per 100000) was six times the national rate of 31 per 100000. Among persons incarcerated at time of diagnosis, rates for women were higher than for men (287 versus 185 per 100000) and higher for blacks and Hispanics than for whites (253, 313, and 100 per 100000, respectively). By state of report, Connecticut had the highest rate among incarcerated persons (1348 per 100000).
Conclusion: These data illustrate differences in demographic, behavioral, and geographic characteristics of incarcerated persons compared with all persons with AIDS. However, they reflect only the minimum numbers of incarcerated persons with AIDS in the United States. Our results highlight the need for state health departments to work with correctional systems to ensure accurate and timely reporting of AIDS cases and to develop HIV prevention, education, and treatment both in prison and on release into the community.