U.S. Department of Justice

•

Office of Justice Programs
Bureau of Justice Statistics

September 2012, NCJ 238877

Laura M. Maruschak, BJS Statistician

A

t yearend 2010, state and federal prisons
held a reported 20,093 inmates who had
HIV or AIDS, down from 20,880 at yearend
2009. As a result of this decline, the estimated rate
of HIV/AIDS among prisoners in custody dropped
from 151 HIV/AIDS cases per 10,000 inmates in
2009 to 146 per 10,000 in 2010. The number of state
and federal inmates who died from AIDS-related
causes also declined between 2009 and 2010, from
94 to 72 deaths. During the same period, the rate of
AIDS-related deaths among inmates with HIV/AIDS
declined from 47 deaths per 10,000 inmates to 38 per
10,000.
The 1-year declines between 2009 and 2010 were
consistent with trends over the past decade. Between
2001 and 2010, the estimated rate of HIV/AIDS
among state and federal prison inmates declined
an average of 3% each year (figure 1). During the
same period, the AIDS-related death rate declined
an average of 13% per year among inmates with
HIV/AIDS and 16% among all prison inmates. (See
Metholodogy for estimation method for missing data
on HIV/AIDS cases.)

Figure 1
Rate of HIV/AIDS cases and AIDS-related deaths
among state and federal prison inmates, 2001–2010
Rate per 10,000

Bul l etin

HIV in Prisons, 2001-2010
Rate per 100,000

250

25
AIDS-related deaths per 100,000 inmates

200

20

150

15
HIV/AIDS cases per 10,000 inmates

100

10

50

5
AIDS-related deaths per 10,000 HIV/AIDS cases

0

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

0

Source: Bureau of Justice Statistics, National Prisoner Statistics Program
(NPS-1) and Deaths in Custody Reporting Program (DCRP).

HIGHLIGHTS
„„ The rate of HIV/AIDS among state and federal prison

inmates declined from 194 cases per 10,000 inmates
in 2001 to 146 per 10,000 at yearend 2010.
„„ AIDS-related deaths among all state and federal

prison inmates declined an average 16% per
year between 2001 and 2010, from 24 deaths per
100,000 inmates in 2001 to 5 per 100,000 in 2010.

„„ Between 2001 and 2010, the average annual decline

of 16% in the national AIDS mortality rate was
similar to the decline in small (down 12%), medium
(down 17%), and large (down 19%) state prison
populations.
„„ Rates of HIV/AIDS cases and AIDS-related deaths

declined across all sizes of prison populations.

„„ Among state and federal inmates with HIV/AIDS, the

„„ In 2009, the AIDS mortality rate among state prison

rate of AIDS-related deaths dropped significantly,
from 134 deaths per 10,000 inmates with HIV/AIDS
in 2001 to 38 per 10,000 in 2010.

inmates (6 per 100,000) fell below the rate for the
U.S. general population (7 per 100,000).

„„ When grouped by 2010 yearend custody

populations, the declining rate of HIV/AIDS in small,
medium, and large state prisons had the same 3%
average annual decline in the national rate between
2001 and 2010.

„„ AIDS-related deaths in state prisons declined from

89 in 2009 to 69 in 2010 among males, from 70 to
43 among black non-Hispanics, and from 87 to 60
among all state inmates age 35 or older.

BJS
HJS

Findings in this report are based on data collected from
50 states and Federal Bureau of Prisons through the Bureau
of Justice Statistics’ (BJS) National Prisoner Statistics (NPS-1)
(which annually collects data on prisoner counts, characteristics,
admissions, and releases) and Deaths in Custody Reporting
Program (DCRP) (which collects individual-level data on cause
of inmate death and characteristics of those who died).
This bulletin provides data on national trends in the estimated
rates of HIV/AIDS cases and AIDS-related deaths among state
and federal prison inmates for 2001 through 2010. It includes
age-specific comparisons between state prison inmates and the
U.S. general population from 2001 through 2009. It also provides
jurisdiction-level data for 2009 and 2010 on the number of state
and federal inmates who were infected with HIV/AIDS,
HIV/AIDS cases by sex, confirmed AIDS cases, and AIDSrelated deaths that occurred in state prison by demographics of
inmates who died.
Rates of HIV/AIDS and AIDS-related deaths in prisons have
declined steadily since 2001
Between 2001 and 2010, the estimated number of inmates with
HIV/AIDS declined by 16%, and the number of AIDS-related
deaths in prison declined by 77% (not shown in table) resulting
in declines in the rates of HIV/AIDS and AIDS-related deaths
among all inmates and those with HIV/AIDS. At yearend
2001, the estimated rate of HIV/AIDS among state and federal
prison inmates was 194 HIV/AIDS cases per 10,000 inmates.
By yearend 2010, the estimated rate was 146 cases per 10,000.
Among the total inmate population, the rate of AIDS-related
deaths declined from 24 per 100,000 inmates in 2001 to 5 per
100,000 in 2010. Among the inmate population with HIV/AIDS,
the rate declined from 134 AIDS-related deaths per 10,000
inmates in 2001 to 38 per 10,000 in 2010. (See Methodology for
discussion of calculation of rates.)
Rates of HIV/AIDS cases and AIDS-related deaths declined
across all sizes of prison populations

for a list of states included in each group.) From 2001 to 2010,
the rate of HIV/AIDS declined from 275 to 211 HIV/AIDS cases
per 10,000 inmates in the largest group, from 144 to 110 cases
per 10,000 inmates in the medium group, and from 174 to 130
cases per 10,000 inmates in the smallest group (figure 2). Over
the 9-year period, all groups, regardless of population size, saw
an average annual decline of about 3% in the rate of HIV/AIDS
cases.
Figure 2
Rate of HIV/AIDS cases per 10,000 inmates, by size of state
prison custody population, 2001–2010
Rate per 10,000 inmates
300

250

200

Large (50,000 or more)

150
Small (24,999 or fewer)

100

Medium (25,000–49,999)
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Note: Classification based on 2010 yearend custody population.
Source: Bureau of Justice Statistics, National Prisoner Statistics Program (NPS-1).

Regardless of the size of the state prison population, as measured
by the number of inmates in custody at yearend 2010, trends in
the rates of HIV/AIDS cases and AIDS-related deaths in state
prisons followed the overall decline of the national rate. States
were grouped into three categories based on the size of their
2010 yearend custody populations. The smallest group included
states with 24,999 or fewer inmates, the medium group included
states with 25,000 to 49,999 inmates, and the largest group
included states with 50,000 or more inmates. (See Methodology

H I V I N P R I S O N S , 2009 - 2010 | S E P T E M B E R 2012	

2

Between 2001 to 2010, the rate of AIDS-related deaths declined
from 28 to 4 per 100,000 inmates in the large group of states, from
24 to 4 per 100,000 inmates in the medium group, and from 22 to 8
per 100,000 inmates in the small group. The smallest average annual
decline in the rate of AIDS-related deaths was observed in small
states (down 12%), followed by medium (down 17%) and large
states (down 19%) (figure 3).
Figure 3
Rate of AIDS-related deaths per 100,000 inmates, grouped by
size of state prison custody population, 2001–2010
Rate per 100,000 inmates
30

25

Large (50,000 or more)

20

15

The rate of AIDS-related deaths for state prison inmates
dropped below the rate for the U.S. general population
To make AIDS-related death rate comparisons to the general
population, individual-level data from DCRP were used to
calculate age-specific rates of AIDS-related deaths among those
in state prison and AIDS-related deaths as a percentage of
all deaths in state prison. (See Methodology for calculation of
age-specific death rates and for sources of national mortality
data.) The rate of AIDS-related deaths in state prisons among
inmates ages 15 to 54 declined sharply between 2001 and 2009,
compared to the more modest decline observed among the
same age group in the U.S. general population. As a result, the
AIDS-related death rate in state prisons fell below the rate in
the U.S. general population in 2009. Between 2001 and 2009,
the AIDS-related death rate among state prisoners ages 15
to 54 declined from 22 deaths per 100,000 inmates to 6 per
100,000, while the rate among that age group in the general
population declined from 9 per 100,000 to 7 per 100,000
(figure 4).
Figure 4
Rate of AIDS-related deaths in state prisons and in the U.S.
general population among persons ages 15 to 54, 2001–2009

Small (24,999 or fewer)

Rate per 100,000
25

10

State prisonsa

5
Medium (25,000–49,999)
0

2001

2002

2003

2004

2005

2006

2007

20
2008

2009

2010

Note: Classification based on 2010 yearend custody population.
Source: Bureau of Justice Statistics, National Prisoner Statistics Program (NPS-1) and
Deaths in Custody Reporting Program (DCRP).

15

10
U.S. general populationb
5

0

2001

2002

2003

2004

2005

2006

2007

2008

2009

aThe number of AIDS-related deaths used to calculate the rate was based on

individual reports submitted to the Deaths in Custody Reporting Program (DCRP).

bExcludes deaths reported in state prisons. See Methodology for data sources.

Source: Bureau of Justice Statistics, Deaths in Custody Reporting Program and
National Prisoner Statistics-1 data collections; Center for Disease Control and
Prevention, HIV/AIDS Surveillance Report and Monthly Vital Statistics Reports.

H I V I N P R I S O N S , 2009 - 2010 | S E P T E M B E R 2012	

3

As a percentage of all inmate deaths, AIDS-related deaths
among state prisoners ages 15 to 54 declined from 13.4%
to 3.6% between 2001 and 2009. The AIDS death rate, as a
percentage of all deaths among the general population ages 15
to 54, remained relatively stable at about 4% (figure 5).
Figure 5
Percent of AIDS-related deaths among all deaths in state
prisons and in the U.S. general population among persons ages
15 to 54, 2001–2009
Percent
15

Selected findings from 2009 and 2010
data
„„ A reported 20,093 inmates with HIV/AIDS were in

custody in state or federal prison at yearend 2010, down
from 20,880 at yearend 2009 (table 1).
„„ The reported number of state inmates with HIV/AIDS

decreased from 19,290 in 2009 to 18,515 in 2010. The
number of federal inmates with HIV/AIDS also declined,
from 1,590 in 2009 to 1,578 in 2010.
„„ California, Florida, New York, and Texas each reported

holding more than 1,000 inmates with HIV/AIDS at
yearend 2010. These states held 51% (9,492) of all state
prisoners with HIV/AIDS.
„„ Among state and federal inmates with HIV/AIDS at

yearend 2010, 18,337 were male and 1,756 were female,
compared to 19,027 male and 1,853 female inmates at
yearend 2009 (table 2).

10

„„ Among jurisdictions reporting the number of inmates

State prisonsa
5
U.S. general population agesb

0

2001

2002

2003

2004

2005

2006

2007

2008

2009

Note: Deaths by execution were not included in the calculation of the percent of
AIDS-related deaths among all deaths in state prisons. For data on executions, see
Capital Punishment, 2010-Statistical Tables, NCJ 236510, BJS website, December 2011.
aThe number of AIDS-related deaths used to calculate the rate was based on
individual reports submitted to the Deaths in Custody Reporting Program (DCRP).
bExcludes deaths reported in state prisons. See Methodology for data sources.
Source: Bureau of Justice Statistics, Deaths in Custody Reporting Program; Center
for Disease Control and Prevention, HIV/AIDS Surveillance Report and Monthly Vital
Statistics Reports.

H I V I N P R I S O N S , 2009 - 2010 | S E P T E M B E R 2012	

with confirmed AIDS in both 2009 and 2010 (37 states
and the Bureau of Federal Prisons), 4,344 inmates had
confirmed AIDS in 2009 and 3,913 in 2010—a decrease
of 431 cases (table 3).*
„„ After an increase of five AIDS-related deaths in state

prisons between 2008 and 2009 (89 to 94), the number
fell to 72 deaths in 2010. Seven federal inmates died
from AIDS-related causes, which was unchanged from
2009 (table 4).
„„ AIDS-related deaths in state prisons declined from 89 in

2009 to 69 in 2010 among males, from 70 to 43 among
black non-Hispanics, and from 87 to 60 among all state
inmates ages 35 or older (table 5).
*BJS no longer estimates for jurisdictions not reporting confirmed AIDS
due to insufficient data in recent years. See previous HIV reports for
estimated confirmed AIDS cases and methodologies.

4

Table 1
Inmates in custody of state and federal prison authorities and reported to be HIV positive or have confirmed AIDS,
by jurisdiction, yearend 2008–2010
Jurisdiction
U.S. totalc
Federal
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregond
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Northeast
Midwest
South
West

2008
21,611
1,538
20,073
275
13
179
118
1,402
173
380
132
3,250
961
23
28
457
/
41
46
131
458
9
588
264
341
44
246
304
6
16
116
16
520
33
3,500
824
6
414
139
55
727
54
409
13
188
2,450
36
14
433
79
25
132
5
5,484
1,814
10,627
2,148

Total HIV/AIDS casesa
2009
20,880
1,590
19,290
275
28
154
112
1,235
185
320
71
3,082
951
24
23
460
/
28
53
90
573
8
565
247
404
48
222
313
7
21
132
12
417
34
3,200
791
7
379
146
66
782
48
418
11
195
2,414
38
17
433
78
19
145
9
5,051
1,869
10,357
2,013

2010
20,093
1,578
18,515
252
/
164
128
1,098
181
301
73
2,920
912
18
20
487
/
36
33
87
665
15
722
206
233
47
254
273
7
20
133
12
420
27
3,080
720
9
381
155
63
703
47
412
11
219
2,394
35
3
306
75
25
128
5
4,787
1,658
10,244
1,826

HIV/AIDS cases as a percent of total custody populationb
2008
2009
2010
1.6%
1.5%
1.5%
0.9%
0.9%
0.9%
1.6%
1.6%
1.5%
1.1
1.0
1.0
0.4
0.7
/
0.6
0.5
0.5
0.9
0.8
0.9
0.8
0.7
0.7
1.0
1.0
1.0
2.0
1.8
1.7
1.9
1.1
1.1
3.6
3.4
3.2
1.8
1.8
1.9
0.7
0.8
0.5
0.6
0.4
0.4
1.0
1.0
1.0
/
/
/
0.5
0.3
0.4
0.5
0.6
0.4
1.0
0.7
0.7
2.2
2.9
3.5
0.4
0.4
0.8
2.6
2.6
3.2
2.4
2.2
1.8
0.7
0.9
0.5
0.5
0.5
0.5
2.0
1.9
2.3
1.0
1.0
0.9
0.4
0.4
0.4
0.4
0.5
0.4
0.9
1.1
1.1
0.6
0.4
0.5
2.3
2.0
1.9
0.5
0.5
0.4
5.8
5.5
5.5
2.1
2.0
1.8
0.4
0.5
0.6
0.8
0.8
0.8
0.8
0.8
0.9
0.4
0.5
0.5
1.5
1.6
1.5
1.4
1.4
1.5
1.7
1.8
1.8
0.4
0.3
0.3
1.3
1.3
1.5
1.8
1.7
1.7
0.7
0.7
0.6
1.0
1.1
0.2
1.4
1.5
1.0
0.5
0.5
0.4
0.5
0.4
0.5
0.6
0.7
0.6
0.4
0.6
0.3
3.2%
3.0%
2.9%
0.8%
0.7%
0.8%
2.0%
2.0%
2.0%
0.7%
0.7%
0.6%

Note: Excludes inmates held in private facilities.
/Not reported.
aCounts published in previous reports may have been revised.
bExcludes data from Alaska due to incomplete reporting.
cExcludes inmates in jurisdictions that did not report data.
dThe number of HIV/AIDS cases in Oregon was based on a 3/9/09 count for 2008, a 7/20/2010 count for 2009, and a 6/28/11 count for 2010.
Source: Bureau of Justice Statistics, National Prisoner Statistics Program (NPS-1).

H I V I N P R I S O N S , 2009 - 2010 | S E P T E M B E R 2012	

5

Table 2
Inmates in custody of state and federal prison authorities and reported to be HIV positive or have confirmed AIDS,
by jurisdiction, yearend 2009 and 2010
Male

Female

Number
Jurisdiction
U.S. total*
Federal
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Northeast
Midwest
South
West

2009
19,027
1,495
17,532
260
20
135
101
1,146
160
268
63
2,749
864
18
19
411
/
27
48
81
488
8
533
230
385
45
196
309
7
19
111
12
385
33
2,930
716
7
350
136
61
720
40
391
11
181
2,182
32
17
398
72
18
131
8
4,610
1,743
9,357
1,822

2010
18,337
1,498
16,839
236
/
154
121
1,023
159
261
65
2,636
832
14
16
439
/
31
29
78
599
15
658
192
231
43
221
259
7
19
118
12
389
27
2,820
650
9
355
146
59
629
40
388
9
199
2,153
30
3
275
70
23
93
4
4,361
1,517
9,280
1,681

Percent
2009
1.5%
0.9%
1.6%
1.1%
0.6
0.5
0.8
0.7
1.0
1.6
1.0
3.2
1.7
0.7
0.4
1.0
/
0.3
0.6
0.7
2.6
0.4
2.5
2.2
0.9
0.5
1.9
1.1
0.5
0.5
1.0
0.4
1.9
0.6
5.2
1.9
0.6
0.8
0.9
0.5
1.5
1.2
1.8
0.4
1.3
1.7
0.7
1.2
1.5
0.5
0.4
0.6
0.6
2.9%
0.8%
1.9%
0.7%

Number
2010
1.4%
0.9%
1.5%
1.0%
/
0.5
0.9
0.7
1.0
1.6
1.1
3.1
1.8
0.5
0.4
1.0
/
0.4
0.3
0.7
3.3
0.8
3.0
1.8
0.5
0.5
2.2
0.9
0.5
0.5
1.0
0.5
1.9
0.4
5.2
1.7
0.7
0.8
0.9
0.5
1.4
1.3
1.8
0.3
1.4
1.6
0.6
0.2
1.0
0.4
0.5
0.4
0.2
2.8%
0.7%
1.9%
0.6%

2009
1,853
95
1,758
15
8
19
11
89
25
52
8
333
87
6
4
49
/
1
5
9
85
0
32
17
19
3
26
4
0
2
21
0
32
1
270
75
0
29
10
5
62
8
27
0
14
232
6
0
35
6
1
14
1
441
126
1,000
191

Percent
2010
1,756
80
1,676
16
/
10
7
75
22
40
8
284
80
4
4
48
/
5
4
9
66
0
64
14
2
4
33
14
0
1
15
0
31
0
260
70
0
26
9
4
74
7
24
2
20
241
5
0
31
5
2
35
1
426
141
964
145

2009
1.9%
0.8%
2.1%
0.9%
1.5
0.5
1.1
0.8
1.3
4.8
1.7
6.3
2.3
1.2
0.6
1.9
/
0.1
0.9
1.0
7.7
0.0
3.1
2.4
1.1
0.5
1.8
0.2
0.0
0.5
2.2
0.0
3.6
0.2
10.8
2.6
0.0
0.7
0.4
0.5
2.4
4.3
1.8
0.0
1.2
2.3
1.1
0.0
1.5
0.5
0.2
1.1
0.5
5.2%
0.8%
2.7%
0.8%

2010
1.9%
0.7%
2.0%
1.0%
/
0.3
0.6
0.8
1.1
3.9
1.8
5.3
2.1
0.7
0.5
1.6
/
0.6
0.6
0.7
6.1
0.0
6.6
1.8
0.1
0.7
2.6
0.6
0.0
0.2
1.6
0.0
3.7
0.0
11.7
2.5
0.0
0.7
0.4
0.4
2.9
3.9
1.6
0.5
1.7
2.3
0.9
0.0
1.3
0.4
0.4
2.8
0.5
5.3%
0.9%
2.5%
0.7%

Note: Excludes inmates held in private facilities.
/Not reported.
*Excludes inmates in jurisdictions that did not report HIV/AIDS infection by sex.
Source: Bureau of Justice Statistics, National Prisoner Statistics Program (NPS-1).

H I V I N P R I S O N S , 2009 - 2010 | S E P T E M B E R 2012	

6

Table 3

Inmates in custody of state and federal prison authorities and
reported to have confirmed AIDS, by jurisdiction, yearend 2009
and 2010
Jurisdiction
U.S. totalb
Federal
State
Alabama
Alaska
Arkansas
Colorado
Connecticut
Delaware
Illinois
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Washington
West Virginia
Wisconsin
Wyoming
Northeast
Midwest
South
West

2009
4,349
621
3,728
92
5
46
21
134
13
74
15
7
6
156
0
162
111
301
18
50
83
0
6
29
0
76
15
610
333
1
123
/
217
0
42
823
29
7
68
4
43
8
938
671
1,944
175

Numbera

2010
3,928
615
3,313
71
/
44
20
138
10
85
13
3
18
131
15
161
132
34
20
55
102
1
4
41
12
73
13
540
287
1
134
15
203
0
40
779
27
0
64
3
24
0
925
420
1,802
166

Percent
2009
0.5%
0.4%
0.5%
0.3%
0.1
0.3
0.1
0.7
0.2
0.2
0.2
0.1
-0.8
0
0.7
1.0
0.7
0.2
0.4
0.3
0
0.1
0.2
0
0.4
0.2
1.0
0.8
0.1
0.3
/
0.9
0
0.3
0.6
0.6
0.5
0.4
0.1
0.2
0.5
0.8%
0.3%
0.6%
0.3%

2010
0.5%
0.4%
0.4%
0.3%
/
0.3
0.1
0.8
0.2
0.2
0.1
-0.1
0.7
0.8
0.7
1.2
0.1
0.2
0.5
0.3
0.1
0.1
0.3
0.5
0.3
0.2
1.0
0.7
0.1
0.3
0.5
0.9
0
0.3
0.6
0.5
0
0.4
0.1
0.1
0
0.8%
0.2%
0.5%
0.3%

Note: BJS no longer estimates for jurisdictions not reporting confirmed AIDS due to
insufficient data in recent years. See previous HIV reports for estimated confirmed
AIDS cases and methodologies. Excludes inmates held in private facilities.
/Not reported.
--Less than 0.05%.
aIn 2009 and 2010, Arizona, California, Florida, Georgia, Hawaii, Idaho, Indiana,
Oklahoma, Oregon, Pennsylvania, and Virginia did not report data.
bExcludes inmates in jurisdictions that did not report type of HIV/AIDS infection.
Source: Bureau of Justice Statistics, National Prisoner Statistics Program (NPS-1).

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7

Table 4
AIDS-related deaths among state prison inmates in custody,
2008–2010
Jurisdiction
U.S. total
Federal
State

2008
102
13
89

Number
2009
101
7
94

2010
79
7
72

Rate per 100,000 inmates
2008
2009
2010
7
7
5
6
3
3
7
7
5

Note: Includes deaths in private facilities.
Source: Bureau of Justice Statistics Deaths in Custody Reporting Program.

Table 5
AIDS-related deaths among state prison inmates in custody, by demographic characteristics, 2008–2010
Characteristics
State total
Sex
Male
Female
Race/Hispanicc
Whited
Blackd
Hispanic
Age
19 or younger
20–24
25–34
35–44
45–54
55 or older

2008
89

Number of AIDS-related deathsa
2009
94

2010
72

Rate of AIDS-related deaths per 100,000 inmatesb
2008
2009
2010
7
7
5

78
11

89
5

69
3

6
12

7
5

6
3

21
57
10

15
70
8

23
43
5

4
27
2

3
33
1

5
21
1

0
0
9
21
43
16

0
3
4
29
38
20

0
1
11
22
25
13

0
0
2
5
23
24

0
1
1
7
20
30

0
0
3
5
13
20

Note: Includes deaths in a private facilities.
aBased on individual reports submitted to the program.
bTo calculate the age rates, the number of state prisoners by age was first estimated by applying the age distribution reported in the 2004 Survey of Inmates in State
Correctional Facilities to the 2008–2010 midyear custody counts in NPS-1.
cDetail does not sum to total because deaths among those of other races are excluded.
dExcludes persons of Hispanic/Latino origin.
Source: Bureau of Justice Statistics Deaths in Custody Reporting Program (DCRP), National Prisoner Statistics Program (NPS-1).

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8

Methodology
National Prisoner Statistics
The federal government began collecting National Prisoner
Statistics (NPS-1), which primarily measures prison population
movement, in 1926. The series comprises reports from the
Departments of Corrections in the 50 states and the Federal
Bureau of Prisons. NPS-1 includes yearend counts of prisoners
by jurisdiction, sex, race, Hispanic/Latino origin, and
admissions and releases during the year. In 1991, the Bureau
of Justice Statistics (BJS) began using the NPS-1 to collect data
on HIV and confirmed AIDS cases in prisons. BJS respondents
indicated the circumstances under which inmates were tested
for HIV and reported the number of inmates with HIV/
AIDS in their custody. Until 2007, the respondents provided
the number of deaths occurring among inmates under their
jurisdiction, including those from AIDS-related causes. In this
report, yearend and midyear custody counts as well as midyear
jurisdiction counts were used when calculating the rates of HIV/
AIDS cases and AIDS related death in prison. Jurisdiction refers
to the legal authority of state or federal correctional officials over
a prisoner regardless of where the prisoner is held. Jurisdiction
counts include inmates in private facilities. To have custody of a
prisoner, a state or federal prison system must hold that inmate
in one of its facilities. Custody counts do not include inmates
held in private facilities.
Measuring deaths in prison
From 1991 to 2006, BJS used NPS-1 to collect data on the
number of deaths among inmates under the jurisdiction of each
prison system by cause, including AIDS-related deaths. In 2001,
BJS implemented the Deaths in Custody Reporting Program
(DCRP), which collects information describing events and
characteristics of each death excluding executions, occurring
among inmates in custody of state prisons. Deaths reported
through DCRP include those that occurred in private facilities.
Prior to 2001, BJS relied solely on data in the NPS-1 to report
on AIDS-related deaths. From 2001 to 2006, BJS estimated
the number of AIDS-related deaths using both data sources.
The greater of the two numbers of deaths reported was used
to calculate the totals for those years. After 2006, BJS stopped
collecting detailed data on deaths in NPS-1 and relied solely
on the DCRP data. Whether using reported or estimated data
from multiple data sources, a downward trend in the number of
AIDS-related deaths has been observed (figure 6).
Rate of HIV/AIDS and AIDS-related deaths in prison
To calculate the estimated rate of HIV/AIDS among inmates
in custody of state and federal prison, the estimated yearend
count of HIV/AIDS cases was divided by the yearend custody
population for each year.

Figure 6
Number of AIDS-related deaths in state prison, 2001–2010
Number
350
300
250
200
NPS-1 and DCRP
150
100
50
0

NPS-1
DCRP

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Source: Bureau of Justice Statistics, National Prisoner Statistics Program (NPS-1) and
Deaths in Custody Reporting Program (DCRP).

To calculate the rate of AIDS-related deaths in prison per inmate
population for 2001 to 2006, the number of AIDS-related deaths
estimated in each year from the NPS-1 and DCRP were divided
by the midyear jurisdiction population for 2001 to 2006. The
midyear jurisdiction population was the denominator because
deaths in the NPS-1 were reported among those inmates under
the jurisdiction of each prison system. For 2007 to 2010, the
number of AIDS-related deaths reported in DCRP was divided
by the midyear custody count (including inmates held in private
facilities) in state prisons plus the midyear jurisdiction count in
federal prisons. The midyear state custody population was the
denominator because deaths reported in DCRP were among
those inmates in custody of state prisons. The denominator
included the midyear federal jurisdiction population because
deaths reported in the federal prisons were among those under
federal jurisdiction.
To calculate the rate of AIDS-related deaths among those at risk
for dying from HIV/AIDS (those estimated to have HIV/AIDS),
the number of AIDS-related deaths reported in each year was
divided by an estimate of the average daily population of inmates
in prison with HIV/AIDS. The average daily population of those
with HIV/AIDS for a given year was the average of the most
recent year’s estimated yearend count of those with HIV/AIDS
and the estimated yearend count from the previous year.
For comparisons to the general population ages 15 to 54, data on
deaths reported in the DCRP between 2001 and 2010 were used
solely for the calculations of AIDS-related death rates among
those 54 or younger in the state prison population.

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9

Grouping of states by yearend custody
To assess the trends in the rates of HIV/AIDS and AIDS-related
deaths among inmates, state prison populations were grouped
into categories of small, medium, and large. Groups were based
on the size of the 2010 yearend custody populations. Included
in the small group were states with fewer than 25,000 inmates,
specifically North Dakota, Vermont, Montana, Wyoming,
Maine, New Hampshire, Rhode Island, Hawaii, South Dakota,
New Mexico, Alaska, Nebraska, Idaho, West Virginia, Utah,
Delaware, Kansas, Minnesota, Iowa, Massachusetts, Mississippi,
Kentucky, Nevada, Oregon, Arkansas, Tennessee, Washington,
Connecticut, Oklahoma, Colorado, Louisiana, New Jersey,
Wisconsin, Maryland, South Carolina, and Indiana. Included
in the medium group were states with 25,000 to 49,999 inmates,
specifically Alabama, Virginia, Missouri, Arizona, North
Carolina, Michigan, Pennsylvania, Illinois, Ohio, and Georgia.
Included in the large group were states with 50,000 or more
inmates, specifically New York, Florida, Texas, and California.
AIDS-related deaths in the U.S. general population
The number of AIDS-related deaths for persons ages 15 to 54
was based on the Center for Disease Control’s (CDC),
HIV/AIDS Surveillance Report, yearend editions (Vols. 17-22).
Deaths in the U.S. population for persons ages 15 to 54 were
taken from the CDC, National Center for Health Statistics’
(NCHS) Monthly Vital Statistics Report, Vol. 45, No. 11(S). Also,
deaths were taken from the NCHS’s National Vital Statistics
Report, Vol. 52, No. 3; Vol. 53, No. 5; Vol. 53, No.15; Vol. 54, No.
19; Vol. 57, No. 14; Vol. 58, No.19; Vol. 59, No.10; and Vol. 60,
No.4.
For 2005, U.S. general population deaths can be found in the
NCHS’s Deaths: Preliminary Data for 2005. For 2001 to 2009,
AIDS-related deaths were calculated as a percentage of all deaths
among persons ages 15 to 54 in the U.S. general population.
The national estimate of AIDS-related deaths of persons ages
15 to 54 minus AIDS-related deaths of persons ages 15 to 54 in
state prisons was divided by the national mortality estimates of
persons ages 15 to 54 minus total deaths of persons ages 15 to 54
in state prisons.
For 2001 to 2009, the rates of AIDS-related deaths in the U.S.
general population were calculated by taking the difference of
the national estimate of AIDS-related deaths for persons ages 15
to 54 and the number of AIDS-related deaths for state inmates
ages 15 to 54, and dividing it by the U.S. general population
estimate of those 15 to 54 minus the state prison population ages
15 to 54.
Estimating for missing data on HIV/AIDS cases
The NPS-1 database for 2001 to 2010 was missing data on the
number of inmates with HIV/AIDS in state and federal prison in
six states that did not report the number of cases for 1 or more
years. The missing data ranged from a state missing 1 year of

H I V I N P R I S O N S , 2009 - 2010 | S E P T E M B E R 2012	

data to another state where data for all 10 years (2001 through
2010) were not reported. Estimates do not include counts from
the state missing data in all years and rates were calculated using
a denominator that excluded this state prison population thereby
assuming that the rate in this state was equal to the national rate.
The remaining four states included two missing data for 2 years
and two missing data for 5 years.
The five states that reported missing data (excluding the one
state that did not report data in any year) reported HIV/AIDS
cases in 2001 and, in that year, comprised 3.4% of the total
number of reported HIV/AIDS cases in state correctional
facilities (759 out of 22,553 total cases). In 2008, the five states
comprised a similar share of the total number of reported HIV/
AIDS cases in state correctional facilities (3.3% or 665 out of
20,073).
STATA, a statistical software package, was used to linearly
interpolate the number of HIV/AIDS cases that were not
reported. This method estimates the missing value by using
observed data values that are closest in time to the missing data
value. The missing value is assumed to fall on a straight line
plotted between two known data points. The ipolate function
in STATA interpolates the missing value in instances where
observed values appear before and after the missing value to be
estimated. The epolate function extrapolates the missing value
where observed values appear only before or after the missing
value that is to be estimated.
For example, the interpolated value of HIV/AIDS cases (y) in
a given state (x) is computed by using the closest known values
for reported HIV/AIDS cases. If in 2001 (x1) there were 15
(y1) cases and in 2003 (x2) there were 10 (y2) known cases, the
interpolated value for 2002 is computed using the following
formula: y=y1+(x-x1)(y2-y1)/(x2-x1). In this example, the
interpolated number of HIV/AIDS cases for that state in 2002
would be an estimated 12.5. In some cases, data were missing
for multiple consecutive years. Data were interpolated using a
multi-stage process. For example, in a state missing 2006 and
2007 data, the interpolated value for 2006 was derived by using
observed values from 2005 and 2008. The interpolated value for
2007, in turn, was derived by using the interpolated value from
2006 and the observed value from 2008.
In one state it was necessary to extrapolate the missing value
as it occurred in the last year of the series (2010). This was
computed by using a linear equation to predict values beyond
the observed values using the epolate function in STATA 10.
A linear equation is derived from the observed values for 2008
and 2009 (y=15x-2) and then used to predict the value for 2010
where x=3 to determine the third year value (2010) in the linear
trend from 2008. The growth rate from 2009 to 2010 is assumed
to be the same as from 2008 to 2009 (x=15) and the formula is
solved as 43=(45)-2. The extrapolated value for 2010 is 43 HIV/
AIDS cases.

10

State-specific imputed values are not included in the report
tables, but were used to calculate national rates of HIV/
AIDS cases in prison and rates by size of state prison custody
population. For each state with imputed values, both upper
and lower estimates were produced around the imputed values.
These upper and lower limits were calculated for each state’s
imputed value or values by adding the largest 1-year increase
in HIV/AIDS cases and subtracting the largest 1-year decrease
from the imputed value or values. New national rates based on
upper and lower limits did not vary more than plus or minus 1
HIV/AIDS case per 10,000 inmates for any given year (figure
7). The variation in reporting by states from year to year did not
affect the overall downward trend in the rate of HIV/AIDS in
prisons.

Figure 7
Estimated rate of HIV/AIDS among state and federal inmates,
with upper and lower limits, 2001–2010
Rate per 10,000
200

Upper
Estimated
Lower

180

160

140

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Source: Bureau of Justice Statistics, National Prisoners Statistics Program (NPS-1).

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11

The Bureau of Justice Statistics is the statistical agency of the U.S.
Department of Justice. James P. Lynch is director.
This report was written by Laura M. Maruschak. Todd Minton verified
the report. Fan Zhang and Kyle Harbecek, BJS interns, provided
statistical assistance. The U.S. Census Bureau, U.S. Department of
Commerce, carried out the data collection and processing.
Catherine Bird and Jill Thomas edited the report, and Barbara Quinn
produced the report under the supervision of Doris J. James.
September 2012, NCJ 238877

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