Imprisonment disproportionately affects people of color and transgender persons. At the same time, those who are or have been in prison or jail are significantly more likely to live with HIV than those who have never been involved with the criminal justice system. These facts not only impact individuals, but are one of the drivers behind the higher HIV rates among African Americans.
In 2014, 2,724 of every 100,000 African-American men were in prison or jail, according to The Sentencing Project. That rate was 1,091 per 100,000 for Latinos and 465 per 100,000 for white men. A similar picture emerged among women, with 109 of every 100,000 African-American women imprisoned, compared with 64 per 100,000 among Latinas and 53 of every 100,000 white women. The U.S. Centers for Disease Control and Prevention (CDC) estimates that the HIV incidence rate for African-American men is six times that of white men, according to a recent comment in The Lancet. Around one-quarter (22-28%) of African-American men living with HIV passed through a correctional institution in 2006, compared with around one-sixth (11-17%) of white men, according to an article in PLoS One.
Those figures, however, transcend prison walls; they are one of the reasons for the higher HIV prevalence rates in African-American communities, Laurie Shrage of Florida International University argues in The Lancet comment. The imprisonment of large numbers of African-American men, combined with de-facto segregated housing, encourages the "formation of insular sexual networks with overlapping, concurrent partners," making heterosexual African-American women more likely to have a male partner who is living with HIV, says Shrage. Thus it is notable that African-American women's HIV incidence is significantly worse than African-American men's: They are 20 times more likely to live with HIV than white women.
Statistics on imprisonment are even more dire for the transgender community. Lambda Legal reports that almost one in six transgender Americans has been imprisoned; that number increases to one in two for transgender African-Americans.
One of the reasons for the racial disparity in imprisonment rates is the unequal enforcement of drug laws. According to the National Association for the Advancement of Colored People, African Americans comprise 12% of those who use illegal drugs but 38% of those arrested for drug offenses and 59% of state prisoners convicted of possessing or selling illegal substances. Another reason is the 33 states with laws criminalizing sex without disclosing one's HIV status, sometimes even when the person is using a condom and has an undetectable viral load. At the CDC's 2016 Sexually Transmitted Disease Prevention Conference, Richard Elliot called the U.S. and Canada "world leaders in HIV criminalization."