The human immunodeficiency virus (HIV) rates are higher among the African American community
compared to the White population. However, research shows that engagement in
risky behaviors does not fully account for these differences.
Researchers at the University of Louisville School of Public Health
and Information Sciences have developed a tool for framing the
relationship between policy, criminal justice practices and HIV-related
factors that impact racial disparities. Jelani Kerr and Trinidad
Jackson utilized a review of scientific literature and
an historical analysis of drug policy to create the Drug War HIV/AIDS
Inequities Model, which appeared this month in the International Journal of Drug Policy
‘Two main factors - disproportionate drug-arrests and sentencing of African American communities - lead to pathways of HIV vulnerability.’
"Inequitable criminal justice practices associated with drug policy
impact HIV vulnerability of African Americans," Kerr said. "These
practices and their byproducts can impact social marginalization, health
care utilization, access to resources, and intimate relationships. All
of these affect HIV vulnerability."
According to the model, two main factors - disproportionate
drug-arrests and sentencing of African American communities - lead to
pathways of HIV vulnerability. The study points out that although the
rates of lifetime drug use and drug distribution are similar between
African American and White communities, more African Americans are under
correctional control because of drugs. The study explains that the
incarceration rate for African Americans related to drug offenses (256.2
per 100,000) is 10 times greater than the rate for white individuals
(25.3 per 100,000).
The model suggests that not only are those who engage in high risk
behaviors such as unprotected sex and needle sharing through injection
drug use or tattooing within correctional facilities at an increased
risk of HIV acquisition, but the broader African American community also
is affected. First, mass incarceration disrupts monogamous
relationships and promotes an imbalance in the number of men and women
in African American communities. The scarcity in the male selection pool
can increase the risk of multiple sexual partnerships and increase
difficulty in negotiating risk-reduction practices such as condom use.
As the model further delineates, African Americans with a history of
incarceration are often marginalized and experience stigma associated
with having served time in jail or prison. As the study explains, a
history of incarceration is "a negative credential that sanctions social
and legal employment discrimination." These individuals often face
barriers to accessing educational opportunities, less consistent and
safe housing, and less access to health care.
Kerr says he hopes the Drug War HIV/AIDS Inequities Model will not
only guide intervention development to eliminate racial/ethnic HIV
disparities, but also improve the effectiveness of HIV risk reduction
strategies, as well as influence future policy decisions.