Men are roughly four times more likely to be diagnosed HIV-positive than women in this country. Unique in the world, the United States HIV crisis still primarily affects gay and bisexual men, particularly young, black, gay men. In 2014, gay and bisexual men accounted for an estimated 70 percent of the 37,600 new HIV infections in the United States, according to the Centers for Disease Control and Prevention. Women, on the other hand, account for only about one in five new HIV diagnoses.
The one place where women’s HIV prevalence reaches and sometimes exceeds that of men is in our jails and prisons. Though the percentage of women in state and federal prisons with HIV has been on the decline for nearly two decades, the rates still far outpace the national averages: According to the most recent numbers from the Bureau of Justice Statistics, which collects data from inmates in state and federal correctional facilities, 1.3 percent of female inmates are HIV-positive. If that doesn’t sound high, consider that the HIV infection rate for the general female population is only 0.14 percent. That means that women in state and federal correctional facilities are over nine times more likely to be HIV-infected than women on the outside.
And those numbers don’t even account for what can be higher rates of HIV infection among women in jails. While prisons generally hold people convicted of felonies for sentences that are longer than one year, jails—the roughly 3,000 county or municipality-run detention facilities in communities across the country—temporarily hold people arrested but not yet convicted of a crime. Most incarcerated women today are in jails, and jails are transient places, with people constantly moving in and out. HIV-prevalence rates are often much higher in jails than they are in prisons—one study that reviewed jail health records from 2009–10 found that 9 percent of newly incarcerated women in New York City jails were HIV-positive.
“Jails and prisons are places where a disproportional number of HIV-infected women end up, primarily because both HIV and incarceration target those who are poor,” says Dr. Anne Spaulding, an infectious disease physician who has provided care for women and men with HIV and hepatitis C in prisons and jails for the past two decades.
What accounts for this glaring disparity? For one thing, the number of women in jail, prison, and on probation is ballooning. More women than ever before are being sent to jail and prisons, and the growth has largely impacted the most socially and economically disadvantaged: black women, Latina women, and women living in poverty.
Women in jails are now the fastest-growing incarcerated population in the country. Among women, rates of state and federal imprisonment were highest for adult black women ages 30–34 years (264 per 100,000), followed by Latina (174 per 100,000), and white women (163 per 100,000). Black women were between 1.6 and 4.1 times as likely to be imprisoned as white women of any age group. Thanks to stricter drug-enforcement laws and expanding law-enforcement efforts, the case of incarcerated women and HIV is truly one in which social, economic, racial, and gender inequity have created multiple, intersecting challenges for women who often lack robust social safety nets in the first place.