News Release: School of Public Health

Nov. 30,  2009

Share of HIV/AIDS Epidemic Borne by U.S. Inmates and Releasees Declines; Numbers Don't

The portion of the HIV/AIDS epidemic borne by current and recent inmates of U.S. correctional facilities declined between 1997 and 2006; however, there are still as many inmates and releasees who are living with HIV, according to Emory University public health researchers.

The drop in the share of the epidemic may be attributable to several factors, including a decline in the rate of HIV infection among persons admitted to jails and prisons, prolonged survival and aging of the U.S. population with HIV/AIDS beyond crime-prone years, and success with discharge planning programs targeting HIV-infected prisoners.

“The number of persons admitted to U.S. prisons and jails has been rising exponentially,” says Anne Spaulding, MD, MPH, assistant professor of epidemiology at Emory’s Rollins School of Public Health. “The prevalence of HIV among those admitted has fallen to 1.7 percent. The number of persons with HIV in the community has climbed linearly. In the early years of the HIV era, much of the epidemic was concentrated in the correctional setting. This is less true now.”

Spaulding and team created a new model to calculate population flow into and out of correctional facilities to estimate that 9.1 million inmates were released in 2006. In 1997, approximately one in five of all HIV-infected Americans was among the 7.3 million who left a correctional facility that year. In 2006, only 14 percent, or one in seven infected Americans, was among the 9.1 million leaving, a 29.3 percent decline in the share.

Even so, for black and Hispanic males, two demographic groups with heightened incarceration rates, recently released inmates comprise roughly one in five of those groups’ total HIV-infected persons.

“Less of the epidemic is now represented by inmates and releasees,” says Spaulding. “Paradoxically, however, the number of persons with HIV who were in a correctional facility for at least part of the year has remained steady, at around 150,000 individuals. Bringing HIV testing and treatment programs to jails and prisons remains important for the health of the community.”  

The report titled, “HIV/AIDS among inmates of, and releasees, from U.S. correctional facilities, 2006: Declining share of epidemic but persistent public health opportunity,” was published Nov. 11 in the online journal PLoS ONE (

In addition to Spaulding, study authors were: Amanda K. Brzozowski, Matthew J. Page, and Ryan M. Seals of the Rollins School of Public Health, Emory University; Williams Rhodes of Abt Associates Inc., Cambridge, Mass.; and Theodore M. Hammett of Abt Associates Inc., Hanoi, Vietnam.


The Robert W. Woodruff Health Sciences Center of Emory University is an academic health science and service center focused on missions of teaching, research, health care and public service.

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Twitter: @emoryhealthsci

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