Proof: Prisons Are Making The Spread of HIV Much, Much Worse

As the Atlantic reported this week, America’s addiction to mass incarceration is fueling the HIV epidemic. In our own special report earlier this year on HIV in prisons, "Locked up & Lost," incarcerated individuals often don’t know that they have HIV, and those that do rarely remain in care through the course of their incarceration and parole.

Despite recommendations by from the World Health Organization and the Centers for Disease Control and Prevention, California and Vermont are the only states that offer inmates access to condoms, leaving most — even those who want to play safe — with little more than plastic bags and sometimes rubber gloves to do so.

Now a new study published in the medical journal The Lancet blames this for the spread of infectious diseases in prisons.

Researchers at Johns Hopkins went so far as to argue that allowing HIV and other STIs to run rampant in prisons is the equivalent of abusing human rights and violating international law by failing to ensure humane prison conditions.

The study was actually just one of a series published in The Lancet that confirms that former inmates have a higher burden of HIV and other infectious diseases than the general population, and this fact plays a role in increasing the spread of diseases among the general population. After all, most inmates are eventually released, taking their illnesses with them.

Researchers from the Johns Hopkins Bloomberg School of Public Health reviewed rates of infections in prisons for diseases like HIV, hepatitis C, hepatitis B, and tuberculosis. They determined that 3.8 percent of those incarcerated world wide are living with HIV (vs 1.3 percent of prisoners and .38 percent of  the general population in the U.S..), 15.1 percent had hepatitis C, 4.8 percent had chronic hepatitis B, and 2.8 percent had active tuberculosis.

Just as we noted in our special report, the researchers found that many of those with HIV do receive treatment while incarcerated, but few are able to maintain care upon release.

The CDC continues to maintain that most of those who are HIV-positive in America's prisons seroconverted before being incarcerated, rather than becoming positive during the course of their sentence. Proving this, however, has been more difficult, especially since very few institutions test inmates both when they come in and when they are released, and activists have long maintained the CDC is wrong. The latest research appears to disagree with the CDC's contention as well, as one of the Lancet papers argues that the disproportionately high rates of black men in prison may indeed be contributing to the higher rates of HIV in the black community as a whole.

Ultimately, the researchers involved with these studies recommend wide scale reforms aimed at altering everything from policing practices and healthcare in prisons to decriminalizing drug use and possession. Unless we do so, they argue, we will continue failing to meet global standards regarding maintaining the health of  prisoners — and fail to end the HIV epidemic.