Maryland had the second-highest percentage of HIV-positive prisoners in the nation in 2000 and the problem is growing, according to a recent US Department of Justice report. Of the state's more than 23,200 prisoners, 4.3 percent -- 998 inmates -- were known to be HIV-positive in 2000, second only to New York, and up by more than 21 percent from the 820 HIV-positive inmates the year before.

The third consecutive increase in as many years comes at a time when the total number of HIV-positive prisoners nationwide fell -- from 25,801 in 1999 to 25,088 in 2000. Maryland prison officials argue that the increase is not the result of a problem in the prison health care system but a reflection of high HIV infection rates in the state's general population.

The HIV/AIDS rates in the prisons are symptomatic of the high rates of injection drug use and needle sharing among addicts in Baltimore City and urban areas of central Maryland, said Leonard Sipes, spokesperson for the state Department of Public Safety and Correctional Services. Maryland AIDS Administration Director Dr. Liza Solomon said the state has consistently ranked second or third nationwide in the number of HIV infections and AIDS cases among the general population, and that is due largely to injection drug use.

Of the 23,664 Maryland residents with HIV/AIDS last year, 63 percent were in Baltimore City or Anne Arundel, Baltimore, Carroll, Hartford and Howard counties. Another 20 percent were in the Washington suburbs. About half of those diagnosed in 2001 were infected through injection drug use, according to AIDS Administration statistics. Injection drug use across the state has been "the leading risk behavior associated with infection" since 1991, Solomon said. "Our prisons are reflecting the epidemiological profile in Maryland," she said.

Women inmates fared even worse, according to the DOJ report. Maryland had the fourth-highest percentage of HIV infection among its female inmates, increasing by 38 percent from 86 inmates in 1999 to 119 in 2000. HIV incidence in female prisoners was more than twice that of male prisoners. However, AIDS-related deaths dropped significantly. In 1995, nearly half of the 54 inmate deaths were AIDS-related, whereas only 10 percent of the 49 prison deaths in 2000 were AIDS-related.

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