Testing Spatial Patterns of HIV Disease in Mississippi The purpose of this paper is to determine if there is a spatial relationship between

HIV infection and incarceration in Mississippi counties. A panel dataset was constructed with demographic, socioeconomic, HIV rates, and incarceration data. Descriptive statistics, exploratory spatial analysis, and spatial regression were then performed. Findings showed a positive relationship between incarceration, HIV, and the proportion of females. This research builds on research that shows that mass incarceration harms societies and communities most affected by the phenomena. Introduction HIV and AIDS are steadily shifting from primarily affecting homosexual males to disproportionately affecting African American Females. Research suggests that the lion’s share of this shift may be attributed to mass incarceration (Johnson and Raphael, 2009). Although several research endeavors have been devoted to studying the relationship between HIV infections and mass incarceration there is a dearth of empirical explanations for the spatial diffusion of HIV infection and disease. This paper investigates the spatial relationship between HIV infection and incarceration. It places specific emphasis on the African American population in Mississippi. Using county-level data from 2005 and 2006 I model the spatial relationship between HIV infections and incarceration. Background Information The Federal Sentencing Act of 1984 and the Federal Violent Crime and Control Act of 1994 removed judicial discretion from judges, demanding mandatory sentencing and threestrikes laws in most states. This caused what is now known as the prison boom. Despite a steady decrease in crime there was an increase in arrests, more sentences imposed, and longer

Michael Massoglia (2008) shows that incarceration yields negative effects on midlife health functioning.5 percent likelihood of incarceration compared to a 4. Growth in the prison population over the last two decades has been widely studied. Inmates are typically released into the communities they lived in prior to incarceration. Men were more likely than women to go to prison. Bonczar and Allen J. 2004). Using the National Longitudinal Survey of Youth he was able to provide evidence of a relationship between incarceration and health status. survey. They found that 30 percent of African American males without college education and 60 percent of African American males with a high school diploma or less went to prison by 1999. The report showed that more than 5 percent of Americans would be incarcerated during their lifetime.sentences imposed. The report also showed that the chance of going to prison for the first time declines with age. Beck published Lifetime Likelihood of Going to State or Federal Prison. Pettit and Western (2004) used administrative. and race (Pettit and Western. Because low-income African Americans are disproportionately incarcerated. education. 1997). In March 1997 Thomas P. mass incarceration contributes to racial health disparities. Similarly.4 likelihood of incarceration for white males (Bonczar & Beck. This has caused a disruption in relationship patterns. especially among groups of people most affected by incarceration trends. For African Americans there was a 16. Massoglia (2008) has also shown that incarceration functions as exposure to communicable disease. and census data to better understand racial and educational disparities in incarceration. At birth African American males had a 28. 2 . Minorities were more likely than whites to go to prison. all disproportionately affecting African American males.2 percent likelihood of going to a state or federal prison. Their research shows that incarceration rates are stratified by age.

(1997) found that during 1997 20 to 26 percent of all people living with HIV in the United States. In other words one in three African American males will be incarcerated in their lifetime (Bonczar. and tattooing. as well as 29 to 43 percent of Hepatitis C infected individuals. Krebs. prison as exposure.8 million. Michael Massoglia (2008) attributed this to prisons disproportionately housing those with disadvantaged heath profiles across socioeconomic indicators (p. In 2006 15 percent of all HIV infected individuals and 40 percent of individuals with Hepatitis C had passed through correctional institutions (Massoglia. The first. In a study of incarcerated women in 2006 HIV was shown to have a higher prevalence in the South and that in women HIV infection was comorbid with other sexually transmitted infections (Hammett and DrachmanJones. 56). For African American males the chance of going to prison in their lifetime had increased to 32. intravenous drug use. 2002).2 percent. In addition to the study of mass incarceration the relationship between mass incarceration and the spread of infectious disease has been explored extensively as well. and 40 percent of people living with tuberculosis had all passed through correctional facilities. According to Bonczar over the last 30 years the prevalence of imprisonment for all Americans has increased by nearly 3. 2006). He reported that nearly 6 million Americans had been incarcerated in their lifetime. 2008). 2003). sex. and the stress of incarceration all facilitate the spread and transmission of HIV (Massoglia. There are two competing theories to explain this. suggests that the prison environment itself. There are two mechanisms of HIV infection attributed to incarceration.Bonczar (2003) revised and updated his 1997 report and found that racial disparities in incarceration as well as overall rates of incarceration had increased. 2008. Hammett et al. Three high-risk behaviors occur in prison that facilitate the transmission of HIV. high-risk behavior in prison. 3 .

Prison admissions. 2009). the disruption of sexual markets. suggest that HIV is spread due to five factors: the high prevalence of HIV in prisons. 2009. demographic. despite being incarcerated. and populations were extracted from the Mississippi Department of Corrections’ annual reports for 4 . The second. condoms. the reconfiguration of sexual networks as a result of incarceration. and the effects of incarceration on sexual market conditions (Johnson and Raphael. Substances that would prevent the transmission of HIV such as clean needles. and bleach are all contraband.. Other researchers have found that inmates have both a higher risk of death as well as a greater prevalence for chronic disease than their uninstitutionalized counterparts (Binswanger et al. and poverty estimates for Mississippi counties from 2005 through 20010. For researchers focused on health the racialization of mass incarceration has two important features (Bobo and Thompson. Depravation perspective suggests that high-risk behavior is a response to inmates being deprived of needs and wants available outside of prison. Binswanger et al.deprivation and importation. 2010). modifying them.and Uggen. Massoglia. 2011). The size of the prison system and the magnitude of its effects on and entire ethnic population as well as the stigma associated with a criminal record has devastating effects on incarcerated individuals and the communities their released to (Schnittker. HIV rates were extracted from HIV morbidity reports from the Mississippi Department of Health and placed into a dataset. prison populations. and releases. homosexual activity in prisons. Importation refers to inmates continuing certain behaviors. releases. an increase in the number of lifetime sex partners due to incarceration. admissions. 2007). Data and Explanation of Variables For this project I constructed a panel data set with HIV rates and occurrences.

the proportion in a county living with HIV in 2005. the proportion of the population reflecting reported HIV cases in 2006. The multiple datasets and spreadsheets were imported into a database combined using database queries for matching. The dependent variable in this project is PROPHIV06. The independent variables in this project are PROPHIV05. the proportion of the population from that county that is in the prison population as of June 30. PROPPOVALLAGES. FEMTOMALER. The proportion of the population newly infected with HIV is more explanatory than HIV rates per 100. 5 . The final product was then joined with the Mississippi county shapefile. PROPINC05. Methods Multiple analyses were conducted to test the spatial relationship between Rates of HIV infection and Incarceration. descriptive statistics were used to explore and identify patters across counties. Poverty estimates were downloaded in a spread sheet from the United States Census Bureau’s Small Area Income and Poverty Estimates Data Collection. also downloaded from the US Census. 2005. Population and demographic data were downloaded in a spreadsheet from the US Census Summary File Collection. First. the ratio of African American females to African American males in 2005.2005 through 2010 and placed into a dataset as well. the proportion of a county population estimated to be ling in poverty in 2006.000 and the number of new cases of HIV because it exposed the magnitude of HIV disease in a particular county. The results are displayed below.

526 .018149646 . Std.605 . This index is the most frequently used indicator of distance and commonalities.Descriptive Statistics N Statistic 82 82 82 82 82 Minimum Maximum Skewness Kurtosis Std.000000 .239972486 .002105923 .000000 1.266 .266 6.526 Mean Std.001597482 .836 .266 .759 5.070 -.266 .000165620 2.804 1.080982454 .222644300 . Deviation Proportion of the Population Incarcerated in 2005 Proportion of the Population Living with HIV in 2005 Proportion Living in Poverty.000000 . Moran’s I is expressed below.07100194 . 2005 Proportion of the 2006 Population Reported HIV Positive in 2006 Valid N (listwise) 82 Next. The outcome.000166654 . incarceration. ( ( ̅ )( ̅) ̅) 6 . and poverty data across Mississippi Counties.000959232 .000000 .22165605 1.689 1.526 .434 . GIS was used to map HIV. 2006 African American Female to Male Ratio.526 .421768707 .394 13. GeoDa spatial statistics software was employed to examine the significance of spatial clusters with high and low HIV rates to derive a Local Indicator of Spatial Autocorrelation (LISA) statistic.008971463 . Statistic Statistic Statistic Statistic Statistic Error Statistic Error .003615093 .000000 .008346060 .526 .303 .058 -3.266 .

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Next I ran four regression models. a spatial lag model. and X is the independent variable one unit in time prior to the occurrence. Where W is included as the spatial weight matrix and ε represents the vector error term Finally the spatial error model is expressed as . t. The spatial lag model is expressed as: +ε. Next I run a spatial lag model. and a spatial error model. 2008). t-1. of Y. a reduced OLS model. and β represents the coefficient. In this case Y is the proportion of the population newly infected with HIV in 2006 and X is the proportion of the population living with HIV in 2005. where the terms are similar to the previous models with the exception of µ is an error term and Wµ is a spatially lagged error term comparable to Wy (the spatially lagged variable (Chi and Zhu. a full OLS model. The OLS model is expressed as: Yt=Xt-1β Where Y is the dependent variable at one point in time. 8 .

51 -1212.0497.06101049*** (0.004254463) -6. In addition to the encryption and handling of point data 9 .443821e-005 (0.397 -1222.0549479*** (0.456 -1226.741596e-005) 0.01017274) Spatial Error model 2.004395701) -5. The incorporation of time in models would incorporate shags that occur in space simultaneously to social phenomena.0002017004) 0.0549479 (0.004060573) -6.0002202308) 0.009371756) OLS Model 0.501912e-005 (6.91 -1222.01047391) 0.657387e-005 (6.05826786*** (0.79 -1208.122675e-006 (0.883866e-005) 0. This statistic also reveals evidence of a spatial pattern of HIV Infections in Mississippi counties.556 -1225.007313012 (0.35 617. therefore. specifically Sunflower County and surrounding counties. Spatial epidemiology in the past has been dominated by aggregated data analyses.00984958) Measures of Fit Likelihood AIC BIC Spatial Dependence Moran's I 615.256 -1224.043687 617.005309774 (0.01047391) Spatial Lag Model 1.08 Results We first examine the Moran’s I statistic for HIV Rates.1 -0.40348e-005 (0.0561991*** (0.0002185386) 0.Spatial Regression Models of Mississippi Reported HIV Cases Independent Variables Female to Male Ratio Proportion Incarcerated Proportion Living in Poverty Propotion Living with HIV in 2005 Reduced OLS Model 0. must be rejected. The null hypothesis of spatial randomness. In addition to the statistic the LISA map reveal that there is a clustering of high rates in the Mississippi Dela.006919439 (0. Although this project yielded marginally significant results it does expose opportunities for future research.48 -0.11 -1213. specifically Harrison County. Other clusters of high HIV infection were in Hinds and surrounding counties and the Mississippi Gulf Coast. The coefficient is 0.128831 617.

This findings support the mechanism of infection theory that suggests that masss incarceration leads to more lifetime sexual partners. In addition to the encryption and handling of point data make point pattern analysis more possible and could further refine examinations of HIV and incarceration. Spatial epidemiology in the past has been dominated by aggregated data analyses. The proportion of the population living in poverty was negatively associated with HIV positivity in 2006. other variables in the equation were positively related to the proportion of the population reported HIV positive in 2006. This finding will require further examination.make point pattern analysis more possible and could further refine examinations of HIV and incarceration. The incorporation of time in models would incorporate shags that occur in space simultaneously to social phenomena. This supports Johnson and Raphael’s (2009) findings that HIV is a function of incarceration due to a disruption in sexual markets. Similarly the proportion of the population living in poverty was positively associated with HIV positivity. Discussion Although this project yielded marginally significant results it does expose opportunities for future research. 10 . Table 2 presents OLS Regression results for the reduced model that includes only the proportion of county populations living with HIV in 2005. However. The female to male ratio was positively associated with HIV positivity in 2006. This variable is the only variable that yielded significant effects.

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and Harrison Counties had the highest proportion of individuals living with HIV as well as a high number of offenders admitted to correctional institutions in 2005.0001 0.17.600001 .500000 Cases / Population 35.600000 .700001 .01 k k 12 0 50 100 200 Miles .001 0. k k k k k k k k k k k k k k k k k k k k k k k k k k k k k k k k k k k k Legend 1 Dot = 1 k Percent Living in Poverty 9. and Incarceration in Mississippi k k k k k k k k k k k k k k k k k k k k k k 8 k k kk k k k k k k k k k k k k k k k k k k In 2006 Hinds.35. Poverty.48.700000 17.300000 0.500001 .600000 Proportion of Population Living with HIV k ADMITTED05 PovPerAllA 25. Sunflower.25.HIV.

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