The Effects of Male Incarceration Dynamics on AIDS Infection Rates among African-American Women and Men

In this paper, we investigate the potential connection between incarceration dynamics and AIDS infection rates, with a particular emphasis on the black-white AIDS rate disparity. Using caselevel data from the U.S. Centers for Disease Control and Prevention, we construct a panel data set of AIDS infection rates covering the period 1982 to 2001 that vary by year of onset, mode of transmission, state of residence, age, gender, and race/ethnicity. Using data from the U.S. Census, we construct a conforming panel of male and female incarceration rates. We use this panel data to model the dynamic relationship between the male and female AIDS infection rates and the proportion of men in the age/state/race-matched cohort that are incarcerated. We find very strong effects of male incarceration rates on both male and female AIDS infection rates. The dynamic structure of this relationship—i.e., the lagged effects of the proportion of incarcerated males—parallels the distribution of the incubation time between HIV infection and the onset of full-blown AIDS documented in the medical and epidemiological literature. These results are robust to explicit controls for (race-specific) year fixed effects and a fully interacted set of age/race/state fixed effects. Our results reveal that the higher incarceration rates among black males over this period explain a substantial share of the racial disparity in AIDS infection between black women and women of other racial and ethnic groups. In a separate analysis, we estimate a two-stage-least-squares (TSLS) model of AIDS infection rates employing a set of variables describing intra-state changes in sentencing regimes as instruments for variation in incarceration rates. We find TSLS effects of incarceration rates on AIDS infection rates that are significant and comparable in magnitude to the corresponding OLS estimates.