Transcript Mass Incarceration and HIV/AIDS

Mass Incarceration and HIV/AIDS
Robert E Fullilove, EdD
Mailman School of Public Health
Columbia University
MOTION
• The most important driver of any infectious
disease epidemic is the creation of new hosts
• Without new potential hosts moving in and
out of a reservoir of infection, there can be no
epidemic
Imagine….
• The impact of removing one half of all men 16
or older from a community….
• What would their loss mean in the lives of the
women and children they left behind?
Mass incarceration and AIDS
• The War on Drugs ranks as the number one
“social driver” of the epidemic
• The high rates of incarceration of drug users
and dealers placed the group at greatest risk
for HIV infection behind bars
Growth in the prison population
• 200,000 men were in state and federal prison
in 1972
• In 2010, that number was 2.3 million with
another 5.7 on parole, probation or under the
supervision of the courts
Demographics
• 38% of all men serving time in state or federal
prison are black
• Black men have a 1 in 3 chance of serving time
in prison at some point in their life
• I in 4 persons incarcerated in 2002 did time for
a drug-related offense
Rates of HIV/AIDS in prison
• Rates vary by state, but overall, rates of
infection are 2-3 times what they are in the
general US population
• Given high rates of recidivism [70%], cycling of
infected men in and out of prison and into the
community impacts the epidemic significantly
Impact on community
• “The New Jim Crow” [Michelle Alexander]
demonstrates that felons and ex-felons
comprise the new “underclass”
• Having so many men in poor communities
without the rights of citizenship destabilizes
the family and community functioning
Community Losses
Housing insecurity and homelessness
Lack of employment opportunities
Loss of political and economic clout via Census
counts
Incarceration impacts
• The capacity of communities to respond to the
epidemic is seriously compromised through:
• Changes in mating rituals and the marriage
market
• Changes in child rearing practices
Incarceration Impacts
• Loss of social controls, particularly in the all
important task of raising young people to
assume adult roles in the community
• Loss of so many adults creates ruptures in the
amount of social capital that is available to
everyone, but especially the young
Resources for HIV prevention
• Changes in parole/probation policies
• Engagement of the Black Church
• Changes in civil status or returning prisoners
• Improvement of educational opportunities
Resources
• The men themselves….
• Ex-prisoners are increasingly becoming an
effective group of community organizers
• They constitute the next step in HIV/AIDS
prevention…..
Thank you