A Systematic Review of HIV/AIDS Studies in U.S. Prisons

Introduction: The U.S. criminal justice system provides a critical public health opportunity to examine HIV diagnosis, prevention and treatment. Over 1.5 million people were incarcerated in state and federal prisons in 2013. HIV prevalence among correctional populations is approximately five times that of the general population, and of all people living with HIV/AIDS in the U.S.; approximately one in seven individuals have passed through the correctional system. While previous U.S. based systematic reviews have explored HIV preventions and health service delivery in jails and prisons, this review examines the broad question of HIV/AIDS prevention and interventions for reducing inmate HIV-related risk behaviors in U.S. federal and state prisons.

Methods: We conducted a systematic review of multiple medical databases and Google Scholar to identify behavioral, biomedical, social, and policy studies related to HIV/AIDS among U.S. prison populations from 1980 – 2014. Studies were excluded if they did not focus on HIV/AIDS, prison inmates, if they were conducted outside of the U.S., if they involved juvenile offenders, or if they included post-release outcomes.

Results:  101 articles met our study criteria. Evidence suggests that research related to the HIV/AIDS care continuum, risk-taking behaviors, gender, prevention, and policy are relevant to our understanding of the impact of HIV/AIDS interventions in the criminal justice system.

Discussion: This review provides a comprehensive, prison-specific overview of HIV/AIDS in U.S. correctional populations and highlights effective interventions, including inmate peer education.