Forecasting Sexual Abuse in Prison: The Prison Subculture of Masculinity as a Backdrop for Deliberate Indifference

Nearly 1.4 million men are incarcerated in federal and state prisons in the United States. These men are disproportionately affected by HIV in comparison with the at-large male population. The elevated prevalence of HIV infection in U.S. prisons has raised concerns over the potential for intra-prison HIV transmission due to rape and other forms of sexual victimization. However, the number of men who acquire HIV after being raped in U.S. prisons is not known. We developed a mathematical model of HIV transmission to estimate the likelihood that an incarcerated man would become infected as a result of prison rape and to provide preliminary estimates of the number of prison rape victims who acquire HIV. Our results suggest that between 43 and 93 currently incarcerated men already have or will acquire HIV as a result of being raped in prison.