Introduction: Reading HIV/AIDS and Criminal Justice Involvement in African Americans as a Consequence of Drug Abuse

There are few significant differences in the overall use of drugs in the United States by racial/ethnic population group.¹ In certain instances, racial/ethnic minority groups engage in less drug use than the White population, especially during the adolescent years. Despite the similarity in use, there are differences in the impact of drug involvement on the health and well-being of racial/ethnic minority populations, with racial/ethnic minority populations frequently experiencing more severe consequences of drug use and addiction than their White counterparts. African Americans have disproportionately experienced the consequences of drug abuse and addiction, especially with respect to the rates of HIV/AIDS infection and criminal justice involvement. African Americans constitute about 13% of the U.S. population; yet, from 1981 through 2003, they accounted for 39% of the total AIDS cases reported to the Centers for Disease Control and Prevention (CDC). Injection drug use was the most frequent transmission category (37%) among African Americans.² African Americans are vastly over-represented in the criminal system (47% of the prison population), especially for drug-law violations.³

Moreover, this disparity in consequences has been steadily increasing over the last twenty years. For example, although African Americans accounted for about 25% of the AIDS cases in 1985, they accounted for about 50% of the HIV/AIDS cases in 2002.⁴ Similarly, Iguchi (in this issue) reports that the prison population of drug offenders has increased from 10,000–20,000 persons per year in 1983–1984 to about 160,000 per year in 1998–2001. Most of this growth has been among African American males, in proportions that far outstrip their proportion of the general population.

The National Institute on Drug Abuse (NIDA), which has as its mission the production of scientific knowledge to prevent and treat drug abuse recognized the need to address the significant role that drug use and addiction plays in the high and increasing rates of HIV/AIDS and criminal justice involvement in the African American population. NIDA's Director, Nora Volkow, MD, convened representatives from NIDA's Divisions to address these concerns. As a result, the African American Initiative Committee organized a meeting, Reducing HIV and Criminal Justice Involvement in African Americans as a Consequence of Drug Use. The NIDA sponsored meeting held on October 12-13, 2004 brought together researchers and professionals with expertise and clinical and program experience surrounding these critical issues. The goals of the meeting were to (1) summarize what we know about the relationships among drug use, HIV/AIDS, and criminal justice involvement as experienced in the African American population; (2) identify gaps in research and knowledge base that frustrate our efforts to develop and implement effective drug abuse/HIV prevention and treatment interventions for African Americans; and (3) discuss how to address these gaps or research needs as they pertain to health-related aspects of drug abuse research.

Presentations were made by 21 experts in the areas of etiology, interventions, treatments, services, promising models and research dissemination in relation to HIV/AIDS and criminal justice involvement among African Americans as a consequence of drug use. Presentations included details on epidemiological trends and community factors influencing the increasing rates of HIV/AIDS and criminal justice involvement. Experts discussed the high risk behaviors that contribute to African Americans' exposure to HIV/AIDS and the criminal justice system, including men who have sex with men and IDUs. Experts also introduced findings on analyses of drug policies and access to HIV/AIDS services in the criminal justice system. All of the presentations sparked discussions on addressing these issues, examining the research and determining appropriate next steps.

Following the meeting in October...