The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #71489

Kim M. Blankenship, PhD¹, Kristin Mattocks, MPH¹, and Marilyn Stolar, MA². (1) Center for Interdisciplinary Research on AIDS, Yale University, 40 Temple Street, Suite 1B, New Haven, CT 06510, 203-764-4343, kim.blankenship@yale.edu, (2) Department of Epidemiology and Public Health, Yale University School of Medicine, 40 Temple Street, New Haven, CT 06520-8034

Objective: To analyze the impact of incarceration on disparities in HIV/AIDS between blacks and whites within the US. Methods: Using CDC data, we calculated rates of new AIDS cases by race for each of 99 Metropolitan Statistical Areas (MSAs) for 1990 - 1999; and 2001 rates of HIV infection by race for 30 states that collect HIV data. Using Census Bureau and Bureau of Justice Statistics data, we calculated measures of incarceration and extent missing from neighborhoods due to incarceration. We used the SAS GENMOD procedure to perform Poisson regression to estimate the associations between these variables and the incidence of HIV/AIDS (both as disease rates and as rate ratios of black and white populations). Results: AIDS incidence across MSAs declined for white men, but increased for all other race/gender groups, such that black/white disparities increased between 1990 and 1999, especially among women. Black/white disparities in HIV across states were substantial. Controlling for poverty, increases in the black-white incarceration ratio and the percentage of blacks missing due to incarceration relative to whites missing were both associated with an increase in AIDS case disparities (p<.0001) and in disparities in HIV infection (p < .0001). Discussion: High rates of incarceration among blacks, and their resulting absence from communities, are associated with their disproportionate risk for HIV; incarceration and absence from communities is a likely result of drug policy. Interestingly, these variables were not good predictors of overall AIDS case or HIV infection rates, suggesting the importance of focusing specifically on race disparities.

Learning Objectives:

• "At the conclusion of the session, the participant (learner) in this session will be able to:
• Identify key aspects of drug policy associated with high rates of incarceration among African Americans
• Discuss the relationships among incarceration, drug policy, and HIV/AIDS
• Identify policy changes that may reduce HIV risk in African Americans

Keywords: HIV/AIDS, African American

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.