January 9, 2014
This article was reported by Huntsville Item.
The Huntsville Item reported that a spatial analysis of HIV rates found that locations with Texas Department of Criminal Justice (TDCJ) prison facilities had higher HIV rates than areas without prisons. The study could not determine whether this was due to the communities' lower socioeconomic status or to the release of HIV-infected individuals into the community. Authors hypothesized that HIV incidence was higher in prison areas because TDCJ built correctional facilities in communities with higher HIV prevalence. The authors urged that surveillance and interventions target areas surrounding prisons to reduce the new infection rate.
According to a 2012 Texas Department of State Health Services report, the cumulative number of HIV diagnoses for Walker County -- home to seven prisons -- was 150 per 100,000 persons, in comparison with 16.4 for Texas and 16 for the United States. TDCJ Director of Public Information Jason Clark stated that it was unlikely the release of prisoners caused higher HIV rates in Walker County. State law dictated that parolees return to their legal county of residence upon release.
Authors suggested three reasons for higher HIV rates in prison locations. The state originally sited prisons in poor, rural areas. In the 1980s, impoverished places competed to become prison sites for economic reasons. Finally, the state built many prisons in densely populated areas. Rural and high-density areas were home to high-risk groups, according to CDC.
TDCJ evaluations of newly diagnosed inmates included lab testing, medical and sexual history, physical exams, antiretroviral treatment, and counseling and support referrals. HIV-infected inmates saw a provider at least every six months. Prior to discharge, TDCJ tested all inmates and established a plan for transitioning to care.
The full study, "Vulnerable Places: Prison Locations, Socioeconomic Status, and HIV Infection in Texas," was published online in the journal the Professional Geographer (2013; doi:10.1080/00330124.2013.852040).