Abstract
Using a “mass incarceration” framework and county-level national data, this paper examines the relationship between incarceration, ex-offender reentry locations, and HIV rates in counties with different racial compositions. A series of “race-of-county” stratified regression models estimate HIV prevalence rates with incarceration and ex-offender reentry locations when taking into consideration residential segregation (that is, Black isolation and White isolation), region, high school graduation rates, sex ratios, unemployment rates, median income, healthcare professional shortages, percentage of residents without insurance, population density, and income inequality. As predicted, HIV rates are higher in counties with high incarceration rates or with ex-offender reentry facilities. A race-of-county stratified analysis, however, reveals nuanced patterns: In White counties and the highest-percentage Black counties, HIV rates increase as incarceration rates increase. In integrated counties, they do not. In the highest-percentage Black counties, the presence of reentry locations is associated with higher rates of HIV, but this is not true in White and integrated counties. In integrated counties, higher levels of Black isolation are associated with high HIV rates. In counties of all racial compositions, higher levels of White isolation are associated with lower rates of HIV. Implications of these results are discussed. Key words: HIV, mass incarceration, residential segregation, racial disparities in HIV.
Highlights
Since the 1980s, driven by policies such as the “war on drugs,” the prison system has become a potent and often unseen organization that promotes and hardens social inequality (Wakefield and Uggen, 2010: 400)
Are racial disparities in county prevalence rates of human immunodeficiency virus (HIV) related to incarceration levels and ex-offender reentry locations, both of which are disproportionately present in communities with high concentrations of Black residents? To answer this question, this paper examines the relationship between incarceration, ex-offender reentry locations, and county-level HIV prevalence rates in counties with different racial compositions
The analysis examines how these factors are related to HIV rates when stratified by racial composition of the county
Summary
Since the 1980s, driven by policies such as the “war on drugs,” the prison system has become a potent and often unseen organization that promotes and hardens social inequality (Wakefield and Uggen, 2010: 400). Are racial disparities in county prevalence rates of HIV related to incarceration levels and ex-offender reentry locations, both of which are disproportionately present in communities with high concentrations of Black residents? Overall, where people live and the population densities of their communities influence their health (Williams and Collins, 2001), so the present research takes these socioenvironmental factors into account It accounts for the role of incarceration, ex-offender reentry, and residential segregation. Using national data at the county level allows for testing hypotheses consistent with the mass incarceration framework This analysis included all U.S counties for which HIV infection rates and racial composition have been released by the Centers for Disease Control and Prevention’s Division of HIV/AIDS Prevention (N = 2,310). Lockup rate refers to the number of county residents presently incarcerated in any correctional facility divided by the number of total residents in the county
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