hiv in the texas department of criminal justice (tdcj) inmate population

Jonathon Poe, MSSWProgram Specialist VTB/HIV/STD Epidemiology and SurveillanceTexas Department of State Health Services

HIV in the Texas Department of Criminal Justice (TDCJ) Inmate PopulationHIV in the Texas Department of Criminal Justice (TDCJ) Inmate Population

Texas Department of State Health Services 2

Outline

About Texas Department of Criminal Justice (TDCJ)

2008 General TDCJ Demographics

HIV Testing, Reporting and Prevention in TDCJ

HIV Diagnoses in TDCJ

Summary


About TDCJ

Composed of eleven divisions Correctional Institutions Division

113 Units 59 Prisons 20 State Jails 5 Substance Abuse Felony Punishment

Facilities (SAFPF) 13 Transfer facilities 15 Other facility types

156,126 people were “on hand” on August 31, 2008 “On Hand” includes people incarcerated in a prison,

state prison or SAFPF facility


About TDCJUnit Map



2008 Age Groups

11%2%

19%29%

18%29%

18%

26%

34%15%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

TDCJ (n=156,128) Texas (n=19,021,721)

Per

cen

t o

f P

op

ula

tio

n 50+

40-49

30-39

20-29

14-19


General TDCJ Population in 2008

Race/Ethnicity

11%

37%36%

31%5%

<1%47%

31%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

TDCJ (n=156,126) Texas (n=19,021,721)

Per

cen

t o

f P

op

ula

tio

n

White

Other

Hispanic

Black


General TDCJ Population in 2008

Sex for TDCJ Population

Female8.0%

Male92.0%



Mandatory testing for all offenders At intake Before release

Voluntary testing twice per year

Possible exposures



TDCJ HIV/AIDS Coordinator

Positive Western Blot Lab Report

DSHS Central Office Loc./Reg. HD

Unit Galveston HD


Post-test counseling

Education

Drug Rehab

Condom distribution prohibited




Compare diagnosis rates for two populations Initial HIV Diagnosis (DX) in TDCJ

Includes concurrent diagnoses Initial HIV Diagnosis Not in TDCJ Excludes people under 14 years of age Denominator for TDCJ Diagnosis Rates from TDCJ

Statistical Reports Number of people on hand on August 31 Transient population


Number of HIV Diagnoses in TDCJ 2000-2008*

0

50

100

150

200

250

300

350

400

2000 2001 2002 2003 2004 2005 2006 2007 2008

Year of Diagnosis

Num

ber

Dia

gnos

ed




TDCJ HIV Diagnosis Rates 2005-2008

181 181 184169

18 17 18 18

0

20

40

60

80

100

120

140

160

180

200

2005 2006 2007 2008

Year

HIV

Dia

gnos

is R

ate

per

100,0

00

TDCJ

Texas



Ten Texas Counties with Most HIV Diagnoses in 2008

1266

811

285 264 258 21384 73 67 66

0

200

400

600

800

1000

1200

1400

Harris

Dalla

s

Bexa

rTD

CJ

Tarran

t

Trav

is

El Pas

o

Collin

Jeffer

son

Hida

lgo

County

Num

ber

of HIV

Dia

gnos

es


2008 HIV Diagnosis Rate-Age at Initial Diagnosis

7566

171

203

110

10

35 33 278

0

50

100

150

200

250

14-19 20-29 30-39 40-49 50+

Age Group

HIV

Dia

gn

os

is R

ate

pe

r 10

0,00

0

DX inTDCJ

Not DX inTDCJ


Median age for people diagnosed in TDCJ: 35Median age for people not diagnosed in TDCJ: 34


2008 HIV Diagnosis Rate-Race/Etnicity

256

125110

130

61

9 613

0

50

100

150

200

250

300

Black White Hispanic Other

Race/Ethnicity

HIV

Dia

gn

osi

s R

ate

per

100

,000

DX inTDCJ

Not DX inTDCJ




2008 Diagnosis Rate-Sex

165

258

394

0

50

100

150

200

250

300

350

400

450

Male FemaleSex

Dia

gn

os

is R

ate

pe

r 1

00

,00

0 DX inTDCJ

Not DX inTDCJ



2008 HIV Diagnoses-Female Age Groups

7%4%

28%44%

29%12%

22%32%

14%8%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

DX in TDCJ (n=50) Not DX in TDCJ (n=923)

Residence at Initial HIV Diagnosis

Pe

rce

nt

of

Ca

se

s 50+

40-49

30-39

20-29

14-19

*One case categorized as “Other” excluded from analysis



2008 Diagnoses-Male Age Groups

4%1%

26%27%

22%

31%

18%32%

9%10%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

DX in TDCJ (n=215) Not DX in TDCJ (n=3,092)


Pe

rce

nt

of

Ca

se

s

50+

40-49

30-39

20-29

14-19



2008 HIV Diagnoses-Female Race/Ethnicity

18%30% 2%

0% 21%18%

60%52%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%



Pe

rce

nt

of

Ca

se

s Black

Hispanic

Other

White



2008 HIV Diagnoses-Male Race/Ethnicity

29%21%

2%0%

32%

20%

37%

58%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%



Pe

rce

nt

of

Ca

se

s Black

Hispanic

Other

White



2008 Female Mode of Transmission

15%

72%

85%

28%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


Residence at Initial Diagnosis

Pe

rce

nt

of

Ca

se

s

Het

IDU


HIV/AIDS Prison Population

2008 Male Mode of Transmission*

76%

19%

7%

57%

4%15%

13%9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%



Pe

rce

nt

of

Ca

se

s

Het

MSM/IDU

IDU

MSM

*One case categorized as “Other” excluded from analysis



2008 Concurrent Diagnoses

20%

34%

0%

5%

10%

15%

20%

25%

30%

35%

40%

0-12 Months

Time Between HIV and AIDS Diagnoses

Per

cen

t o

f C

ases

DX in TDCJ

Not DX in TDCJ


Summary

Diagnosis rates much higher than general population

Diagnosis rates differ between cases diagnosed in TDCJ and cases not diagnosed in TDCJ Peaks in later age groups for TDCJ diagnoses Rate disparities between race/ethnic groups not as

great among cases diagnosed in TDCJ

IDU is the dominate mode of transmission for those diagnosed in TDCJ

A smaller proportion of cases diagnosed with HIV in TDCJ progressed to AIDS within one year compared to cases not diagnosed in TDCJ


Thank You!

Contact

Jonathon Poe

[email protected]

512-533-3032

Acknowledgements

Connie Adams, LVN III, TDCJ, HIV/AIDS Coordinator

Miranda Fanning, MPH, DSHS, Epidemiologist

Douglas Shehan, UT Southwestern, Senior Research Scientist

hiv in the texas department of criminal justice (tdcj) inmate population

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