U.S. prisons report a high rate of AIDS
Inmates' widespread use of drugs before their incarceration blamed
Wednesday, September 1, 1999
By LAWRENCE K. ALTMAN
THE NEW YORK TIMES
The prevalence of AIDS among prisoners in the United States is five times that of the general population, and the rates for some other sexually transmitted diseases are even higher, scientists said yesterday.
Reporting on the first comprehensive study of these diseases in prisons and jails, the lead author, Dr. Theodore Hammett, said the high prevalence of AIDS among prisoners reflects their widespread use of drugs before they were imprisoned. He presented the findings yesterday at the National HIV Prevention Conference in Atlanta.
Prisons are a critical setting for detecting and treating sexually transmitted diseases, Hammett said, but the quality of health care varies widely. About 90 percent of the prisons and jails say they make the newer combinations of anti-HIV drugs available, but not necessarily to all inmates, Hammett said.
The high rates of sexually transmitted diseases such as syphilis, gonorrhea and chlamydia are particularly alarming, participants said, because they are adding fuel to the continuing epidemic of HIV, the AIDS virus. Syphilis, gonorrhea and chlamydia cause inflammation and sores that allow more HIV to concentrate in genital secretions and thus greatly increase the risk of acquiring and transmitting HIV.
Moreover, recent increases in sexually transmitted diseases signal an increase in HIV because such infections are an indicator of unsafe sexual practices. On Monday, health officials released new studies finding that AIDS deaths are no longer declining as sharply as in recent years and that the rate of infection does not appear to be declining at all.
The new findings on AIDS in prison highlight not only inadequacies in prison health care but also the importance of preventing transmission of the infections after the prisoners return to the community. Only 10 percent of state and federal prisons and 5 percent of city and county jails offer comprehensive HIV prevention programs for inmates.
In 1997 an estimated 8,900 inmates had AIDS, and 35,000 to 47,000 more were infected with HIV, said Hammett, who works for Abt Associates, a private research and consulting firm in Cambridge, Mass. Hammett conducted the study for the National Commission on Correctional Health Care, a private organization in Chicago that aims to improve health care in correctional facilities.
Health officials do not know for certain how much HIV is transmitted in prisons. Although the total prison population is less than 2 million on any given day, 7.75 million people are released from jails and prisons during a single year, Hammett said.
In 1996, 907 inmates in state prisons died from AIDS, representing 29 percent of all deaths in such institutions. Hammett did not report the number of AIDS deaths in federal prisons.
Other studies reported at the meeting in Atlanta suggested another reason for concern about HIV: that many gay men no longer view the virus as serious. Newer combinations of anti-HIV drugs that have given infected people a new lease on life are creating complacency and a false sense of security because many equate the new therapies with cures. Others erroneously believe that because the virus cannot be detected in their blood they cannot transmit HIV. As a result, many are abandoning safe sex practices, acquiring sexually transmitted diseases and increasing transmission of HIV, participants said.