Incarceration’s HIV Challenges and Opportunities: The Communal Health Impact of Incarcerating Individuals.

Abstract

HIV and incarceration represent two epidemics facing the African American community, specifically, but the larger American population, as well. Most of the existing literature focuses on the disadvantages incarceration creates with regard to employment, voting rights or disenfranchisement, health insurance and governmental benefits, economics, social relationships and disengagement, conditions of incarceration within prison walls, and other aspects of effective citizenship. While there is growing speculation that incarceration also has health-related spillover effects both inside and outside prison walls, there are only a few studies that empirically test this relationship. This study seeks to fill that void by directly examining the effects of incarceration on the health of the larger community outside of prison walls, with specific attention given to HIV. Results suggest that increases in incarceration may decrease community HIV cases, signaling that incarceration itself can serve as a possible public health intervention in the HIV epidemic. One of the suggested intervention mechanisms is the introduction of HIV testing within state prisons. Although current HIV data is relatively limited and future inquiry is definitely needed to further unpack the possibility of the intervention of prisons, this study introduces a much-needed conversation with regard to looking to criminal justice policy as public health policy, not just for those incarcerated but for the entire population. Since what happens in prison can spill over to the outside community, prison policy needs to be considered in conjunction with larger health strategies in areas such as infectious disease. More importantly, additional attention and caution should be taken in interpreting the results of this study so as to not construe them to mean that more incarceration is the solution to slowing the spread of HIV. Incarceration itself poses many societal injuries, and much attention is being drawn toward reducing prison rolls. Instead, studies like this one should be used as a starting point to explore how current structures can be used to address health problems, while future policies are devised to build alternative interventions that avoid the harm of incarceration.