A study of men who became HIV-positive while incarcerated in Georgia prisons show that two activities - male-male sex and tattooing - increase the risk of HIV infection more than 10-fold, investigators report.

J. Taussig, of the Georgia Department of Corrections, and colleagues point out that 2 percent of prison inmates have HIV, making it nearly five times more common than among with the US general population.

To identify factors associated with the increased risk of becoming infected in the prison population, the researchers studied 88 male inmates who were HIV-negative when they went into Georgia prisons but became infected during incarceration.

Taussig and the research team compared this group with randomly selected uninfected prisoners, and with men with a similar sentence length and time already served. All the subjects completed audio computer-assisted self-interviews with no personally identifying information.

The findings are reported in the Morbidity and Mortality Weekly Report published by the Centers for Disease Control and Prevention.

Analysis of the information showed that male-male sex in prison, age older than 26 years, having served at least 5 years, and having a no more than normal body-weight were significantly associated with becoming HIV-positive. Receiving a tattoo in prison and black race were also tied to the risk of acquiring HIV.

Many of the men who had consensual sex reported using condoms or improvised barrier methods such as rubber gloves or plastic wrap.

When asked their opinions about how to reduce HIV infection rates in prison, the inmates suggested making condoms available, providing HIV education, and safe tattooing.

While condoms are considered contraband in most US prisons, the authors note that prisons in two states and jails in five cities currently make condoms available.

The Georgia Department of Corrections is considering modifications to existing HIV prevention education, and housing HIV-infected inmates separately. However, the investigators point out that these strategies have potential problems - including the likely disclosure of inmates’ HIV status and of HIV transmission by individuals who are unaware they are infected.

SOURCE: Morbidity and Mortality Weekly Report, April 21, 2006.