Report: U.S. Prison Population Tops 2 Million

The number of inmates in U.S. prisons and jails rose to 2,019,234 last year, the first time the number has exceeded 2 million, according to a report released by the Justice Department. California, Texas, Florida and New York remain the four largest state prison systems, though the number of inmates in federal prisons for the first time surpassed that of any state, with nearly 162,000 federal inmates. The report also noted a 5.4% increase in the number of people confined to local and county jails, the largest growth in the jail population in five years. Other findings: about 12% of all black men in the U.S. between 20-39 years old were in prison or jail, compared to 4% of Hispanic males and 1.6% of white males. New York Times and Associated Press, 4/7/03

HIV

Study: Ending Segregation of HIV-Positive Inmates Could Save Money

Alabama's prison system could save between $306,000 and $392,000 per year if it didn't segregate HIV-positive inmates from the rest of the prison population, according to a report by the Alabama Prison Project and the ACLU National Prison Project. If the segregation ceased, 56 inmates would be eligible to join community-run corrections programs. Community corrections programs cost the state $11 per day per inmate - $15 less per day than it costs for an inmate to remain in prison. Alabama is the only state prison system that still segregates HIV-positive prisoners. Associated Press, 4/30/03

New Formulation of Viracept Approved by the FDA

The FDA approved a new formulation of Viracept (nelfinavir) that reduces the number of pills patients must take each day. Previously available in 50 mg oral powder and 250 mg tablets, Viracept is now available in a 625 mg pill, reducing the number of tablets taken each day from 10 per day to four per day. The 625mg tablets will be available in the 3rd quarter of 2003 and will be parity priced with the 250mg tablets. Viracept 250mg will be continued to be manufactured. FDA Release, 4/30/03

CDC Urges Expanded HIV Screening, Recommends Testing All Pregnant Women

The Centers for Disease Control and Prevention (CDC), in partnership with other federal agencies, is launching a new initiative to advance HIV prevention activities. While previous CDC efforts have focused mainly on preventing people from acquiring HIV/AIDS, new strategies will focus on prevention efforts for individuals already infected with HIV. This includes increased efforts to diagnose people who are not aware they are infected, and to educate each HIV-infected person on ways to prevent spreading the disease. As part of the new initiative, the CDC is recommending that HIV testing become a routine part of medical care, and in particular, offered to all pregnant women. It also aims to streamline the testing procedures so that prevention counseling is not a prerequisite for testing. The agency will be conducting demonstration projects in high-prevalence settings (including correctional facilities) using the OraQuick HIV rapid test, which provides results in 20 minutes. The full report is available at www.cdc.gov/mmwr/preview/mmwrhtml/mm5215a1.htm CDC, 4/18/03. OR located this on AEGiS, at: pubs/mmwr/2003/MM5215-329.html

FDA Approves Valacyclovir for HIV-infected Patients

GlaxoSmithKline announced that it has received supplemental approval from the U.S. Food and Drug Administration (FDA) to market its antiviral valacyclovir HCl (Valtrex) as the first FDA-approved antiviral therapy for the suppression of recurrent genital herpes in HIV-infected individuals. Valtrex was already approved for the treatment of herpes zoster and cold sores. Reuters, 4/3/03

Roche Gets FDA OK for Improved HIV Test

Roche announced that it has received FDA approval for an automated version of a test used to detect and measure viral levels in the blood of HIV-positive patients. The Cobas Amplicor HIV-1 Monitor Test (version 1.5) can measure viral load levels as low as 50 copies of HIV RNA per millimeter of blood plasma. The test can also detect a broader range of HIV-1 subtypes than previous tests, according to Roche. Reuters, 4/11/03

Study: Physician Experience a Major Contributor to AIDS Survival

Results from a study in Vancouver show that physician experience has an independent effect on the survival of patients with AIDS. Investigators from the British Columbia Centre for Excellence in HIV/AIDS evaluated the impact of "non-immune-based factors" in survival in 1400 HIV-infected patients starting HAART for the first time, following the cohort for 42 months. When HAART was initiated at CD4 levels about 200, patients treated by either experienced or inexperienced physicians had similar survival rates. However, in patients with CD4 counts <50, the hazard of death was greater for patients treated by inexperienced physicians. The study is presented in the March 28 issue of AIDS. Reuters, 4/14/03

TB

Am J Prev Med: Treatment for Latent TB in Correctional Facilities

A field study conducted by the CDC in nearly 50 correctional facilities evaluated high-risk populations at risk for co-infection with tuberculosis (TB) and HIV to find out if treating latent TB infection (LTBI) in inmates was feasible. In 49 correctional facilities in 12 states, 198,102 inmates had a tuberculin skin test (TST) read; 17% were positive. Of those who were PPD-positive and who were also tested for HIV, 14.5% were HIV-positive. Inmates with a positive TST were 4.2 times more likely than those with a negative TST to be infected with HIV. HIV-positive patients who began the 12-month TB treatment regimen were less likely than HIV-negative patients (40% vs 68%, respectively) to complete treatment. The results from the 8-year HIV-Related TB Prevention (HRTP) were published in the April 2003 American Journal of Preventative Medicine. Am J Prev Med. 2003 Apr;24(3):249-53

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©1997,1998,1999,2000,2001,2002, 2003. The recently formed HIV Education Prison Project (HEPP) is a medical education program that targets a growing population, inmates in correctional facilities, that has been underserved in HIV care. It is part of the Brown University AIDS Program. Permission to use and reproduce portions of this newsletter is hereby granted provided that author and publication are fully credited and both copyright and permission notice appear with reprinted material. Inquiries may be directed to heppnews@brown.edu. Website: HIV Education Prison Project.

AEGiS is made possible through unrestricted grants from Boehringer Ingelheim, Elton John AIDS Foundation, iMetrikus, Inc., the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2003. This material is designed to support, not replace, the relationship that exists between you and your doctor.

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