Demographic and spatial disparity in HIV prevalence among incarcerated population in the US: A state-level analysis

Abstract

The purpose of this study was to explore empirically the presence of any spatial and demographic disparity in the Human Immunodeficiency Virus (HIV) infection rate among the prison inmates across 48 states in the US and compare the results for 2000 and 2010. HIV infection is a severe health issue for incarcerated populations in the US. In 2010, the rate of diagnosed HIV infection among inmates in state and federal prisons was five times more than the nonincarcerated population. The National Prisoner Statistics database was used to find the demographic disparities in HIV prevalence rate based on incarceration rate, gender, race/ethnicity, the proportion of non-US citizens, and proportion of population below 18 years. State-level spatial mapping, Pearson correlation coefficient, and Moran's I statistic (univariate and bivariate) were computed based on these demographic characteristics using QGIS and Geoda software. There was a statistically significant pattern of spatial disparity in overall, male and female HIV infection rates across the state prisoners, with South and South-Eastern states facing a higher risk of infection. There was also statistically significant bivariate spatial association of HIV infection rate with the covariates: whites (negative), blacks (positive), non-US citizen (positive), and prisoners under age 18 years (positive) for both 2000 and 2010. There was a statistically significant higher HIV infection rate among the female prisoners in comparison to the male prisoners. It is of prime importance to examine the state-level disparities in HIV infection rate based on place and demographics. This is because evaluating the spatial pattern will help in accessing the relevant local information and provide federal agencies with better knowledge to target interventions and prevention programs toward the subgroup of the population at higher risk and help in controlling and reducing HIV infection prevalence.

HIV in prison: results from a national prison census in Peru

“…4 These differences are also seen in other regions, such as eastern Europe and central Asia (4.1% vs. 0.5%, both regions), western Europe (4.6% vs. 0.2%) 5 and North America (1.5% vs. 0.5%). 1 Similar to the results reported by Bose, 1 high subnational level disparities in HIV prevalence among the incarcerated Peruvian population are evident (Figure 1), where Amazonas is the region with the highest prevalence (0.93%), followed by Loreto (0.88%) and Lima (0.74%). In addition, 5 regions are above the incarcerated prevalence (0.47%) and 14 above the general population of Peru (0.3%).…”

“…The reasons could be related to the social marginalization, violence, stigma and discrimination, risk of sexual victimization and little or no access to HIV prevention that women encounter in prison. 1 The major limitations of this study are the cross-sectional nature of the data and that the presence of HIV infection was assessed using self-reported data. However, in low middle-income countries, these kinds of surveys are frequently done.…”

“…We read with special interest the original article published by Bose describing the spatial variation and demographic factors associated with HIV infection rates among the incarcerated population in the United States of America. 1 The health of penitentiary populations is a subject of growing interest worldwide due to the high burden of HIV infection in this population; however, in Latin America, there is a lack of information about the epidemiology of HIV infection in prisoners.…”

“…4 These differences are also seen in other regions, such as eastern Europe and central Asia (4.1% vs. 0.5%, both regions), western Europe (4.6% vs. 0.2%) 5 and North America (1.5% vs. 0.5%). 1…”

Spatial inequalities and predictors of HIV/AIDS mortality risk in Hamadan, Iran: a retrospective cohort study

“…Furthermore, numerous studies have shown that health insurance, which is related to socioeconomic status, plays an important role in the survival of HIV patients. Patients who are insured survive longer than those who lack health insurance, because they are more likely to have access to medical services [ 9 - 11 ]. Understanding the geographic variation of HIV/AIDS mortality and HIV infection could help identify high-burden areas.…”