Acquired Immunodeficiency Syndrome in Male Prisoners

Abstract

Between Sept. 1981 and June 1982, the acquired immunodeficiency syndrome [AIDS] and Pneumocystis carinii pneumonia were diagnosed in 7 previously healthy young men incarcerated for 5-38 mo. in New York State [USA] correctional facilities. All 7 patients were anergic, 6 were lymphopenic and all developed oral candidiasis. Immunologic evaluation in vitro showed profound defects in cellular immune function in patients tested, with inversion of the normal ratio of helper to suppressor T cell populations in 4 of 5 patients studied. No underlying immunosuppressive disorder was found in any patient, including 3 patients who had postmortem examinations. Based on these cases, the incidence of this syndrome among inmates of New York State correctional facilities is estimated to be at least 20/100,000 per yr. None of the inmates were homosexual but all had used i.v. drugs extensively before incarceration. If i.v. drug use is a cause of the syndrome, then the epidemiologic finsings of this study suggest a prolonged incubation period (mean, 14.6 mo.) before development of serious opportunistic infection. Recognitition that certain prisoners are at high risk for the AIDS has important implications for the prison health-care system.