Letter From the Editor

Dear Correctional Colleagues:

As HEPP Report approaches its sixth year of publication, it seems the appropriate time to reflect on what we're facing in correctional health care, as well as what we've accomplished. What we're currently facing is sobering. There are 42 million people living with HIV/AIDS, worldwide, approximately two million more than last year. Five million new infections worldwide -- 40,000 in the U.S. -- occurred in 2002, according to the recently released biannual report from UNAIDS and the World Health Organization. By the end of 2001, there were 850,000 to 950,000 people living with HIV/AIDS in the U.S.

What we face in prisons and jails reflects these numbers -- and more. The Bureau of Justice Statistics reports a total of 25,088 state and federal inmates known to be HIV positive -- and the number of actual cases is probably higher. In percentages: 2.2% of state prison inmates and 0.8% of federal prison inmates were known to be infected. What do these numbers mean? Overall, the rate of confirmed AIDS among the nation's prison populations is four times the rate in the general population (0.52% in incarcerated communities vs. 0.13% in the general population). We've also made heartening strides in correctional health care. While there are still more accomplishments to be made -- more widespread testing, more infectious disease specialists in correctional health care, more comprehensive treatment for all prison populations -- we believe that correctional health care has come a long way in the last five years.

Even as we look at the enormity of this entire picture, we still believe the best way to accomplish our mission of improving the level of health care in prisons and jails is to give correctional health care workers the tools to do it. With that in mind, this month's issue discusses immunizing HIV-infected patients including vaccines are safe and recommended for HIV-positive patients (including HIV-positive pregnant women). Considering the large number of HIV-infected inmates, vaccination may be the safest and most cost-effective way to prevent a number of vaccine-preventable diseases like HAV, HBV and influenza.

In this issue, we also provide coverage of reports from IDSA, ICAAC and NCCHC that could have a bearing on the work we do with infected populations in prison. After reviewing this issue, readers should be able to identify vaccines that are safe and effective for HIV populations.

As we wrap up our fifth year of publishing HEPP Report, we want to thank you for your continued support and as always encourage your feedback, comments, and contributions. Best wishes for the holiday season and the New Year from all of us at HEPP.

Sincerely,
Elizabeth Herbert

Back to the HEPP Report December 2002 contents page.