INCARCERATION AND THE ACQUIRED-IMMUNODEFICIENCY-SYNDROME - AUTOPSY RESULTS IN TEXAS PRISON-INMATES

The Texas Department of Criminal Justice (TDCJ) houses many subjects w ith acquired immunodeficiency syndrome (AIDS) who receive medical care in a comprehensive AIDS treatment center. In this case-control autops y survey, we compared pathological outcomes of TDCJ inmates treated at the center (n = 155) with nonincarcerated patients who died during th e same period (n = 155). Using multiple regression analysis and a prop ortional hazards model, survival time in the prisoners was equivalent to that in the controls. With few exceptions, the prevalences of oppor tunistic viral, fungal, protozoal, and bacterial infections contributi ng to mortality were equivalent between groups. Mycobacterium tubercul osis was isolated more frequently in the inmates, and M avium intracel lulare was isolated less frequently (P < .0001). The inmates had a hig her prevalence of bacterial infection of the central nervous system (C NS) (9.1% v 1.4%; P < .006); half of all CNS bacterial infections were caused by M tuberculosis. Inmates had significantly lower prevalences of vacuolar myelopathy < .006) and severe wasting disease (P < .0009) . We conclude that survival of prison inmates with AIDS treated in a c omprehensive AIDS treatment center was equivalent to that of nonincarc erated subjects with AIDS. Prevalences of certain complications of AID S differed in the inmates, showing that the prison environment influen ced some of the underlying causes of AIDS morbidity and mortality. Cop yright (C) 1996 by W.B. Saunders Company