HIV/AIDS Infection among
ANNE S. DE GROOT
The “common wisdom” about HIV/AIDS in prisons is that prisons serve as “breeding grounds” or “incubators” for the HIV/AIDS epidemic (“Prisons are breeding ground” 2001; UNAIDS1997; Weed 2001). It is often assumed that the main reason prisoners are four times more likely than the general population to have AIDS is because of unprotected sex, drug use, and other HIV risk behaviors behind bars (Maruschak 2002). If in-prison risk behavior was the main factor driving high HIV rates among prisoners, one might expect to find higher rates of HIV among male prisoners than among female prisoners because of the relatively high HIV transmission risk associated with unprotected sex between men. In fact, incarcerated women are almost twice as likely as incarcerated men to be HIV positive: at the end of the year 2000, 3.6 percent of women prisoners were known to be HIV positive, as compared with 2.0 percent of male prisoners (Maruschak 2002).
Experts maintain that the high rate of HIV/AIDS among male and female prisoners is due to the fact that there is a higher concentration of individuals at high risk for HIV infection within prisons and jails than in the community (Braithwaite, Hammett, and Mayberry 1996). While in-prison HIV risk behaviors occur, it is likely that most HIV-positive prisoners were infected in the community, not while they were incarcerated. Incarcerated women have higher rates of HIV infection than men because women have particularly high rates of HIV risk factors in the community both before and after incarceration, including drug use, sex work, childhood sexual abuse, and physical abuse (DeGroot 2000; Fogel and Belyea 1999).
In this chapter, we describe the prevalence of HIV/AIDS among women prisoners, discuss the risk factors that give rise to the high rates of HIV/AIDS in this population, and provide basic information about culturally appropriate management of HIV/AIDS in correctional facilities that house women. As advocates and