59–006 

110TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 1st Session 110–342 

STOP AIDS IN PRISON ACT OF 2007 

SEPTEMBER 24, 2007.—Committed to the Committee of the Whole House on the 

State of the Union and ordered to be printed 

Mr. CONYERS, from the Committee on the Judiciary, 

submitted the following 

R E P O R T 

[To accompany H.R. 1943] 

[Including cost estimate of the Congressional Budget Office] 

The Committee on the Judiciary, to whom was referred the bill 

(H.R. 1943) to provide for an effective HIV/AIDS program in Federal prisons, having considered the same, reports favorably thereon 

without amendment and recommends that the bill do pass. 

CONTENTS 

Page 

Purpose and Summary ............................................................................................ 1 

Background and Need for the Legislation ............................................................. 2 

Hearings ................................................................................................................... 2 

Committee Consideration ........................................................................................ 2 

Committee Votes ...................................................................................................... 3 

Committee Oversight Findings ............................................................................... 3 

New Budget Authority and Tax Expenditures ...................................................... 3 

Congressional Budget Office Cost Estimate .......................................................... 3 

Performance Goals and Objectives ......................................................................... 5 

Constitutional Authority Statement ...................................................................... 6 

Advisory on Earmarks ............................................................................................. 6 

Section-by-Section Analysis .................................................................................... 6 

Changes in Existing Law Made by the Bill, as Reported ..................................... 7 

PURPOSE AND SUMMARY

H.R. 1943 directs the Bureau of Prisons (BOP) to develop a comprehensive policy to provide HIV testing, treatment, and prevention for inmates during incarceration in Federal prisons and immediately before reentry into the community, while protecting confidentiality of prisoners and allowing them to refuse routine HIV 

testing. 


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BACKGROUND AND NEED FOR THE LEGISLATION

HIV/AIDS in prison poses a threat not only to prison inmates 

and prison employees, but ultimately to the community at large. 

Prisoners who are unaware of their condition or who do not know 

how to keep others safe from the infection can unwittingly infect 

fellow prisoners. Prison workers, including corrections officers, 

healthcare workers, and administrators, are also at risk from exposure incidents resulting from close interaction with the prison population. The threat to the community at large comes from infected 

prisoners being released without having had the proper screening, 

education, and treatment, thereby exposing friends and loved ones 

to the disease. 

The Stop AIDS in Prison Act would require initial testing and 

counseling of inmates upon entry into the prison system, and then 

make ongoing testing available up to once a year upon the request 

of the inmate, or sooner if an inmate is exposed to the HIV/AIDS 

virus or becomes pregnant. The bill requires that the BOP make 

HIV/AIDS counseling and treatment available to prisoners, and 

give testing and treatment referrals to prisoners prior to their reentering the outside community. 

The bill may have a particularly beneficial effect on minority 

communities. According to the Centers for Disease Control and Prevention, racial minorities comprise 69% of all new HIV/AIDS cases 

in the nation. Since African Americans are disproportionately represented in the inmate population—41 percent of all inmates in the 

prison system at the end of 2004, according to the Bureau of Justice Statistics—the risks associated with contracting HIV/AIDS in 

prison are one factor putting minority communities at higher risk 

of exposure. The Stop AIDS in Prison Act is therefore one way to 

begin reversing the high incidence of HIV/AIDS in minority communities. 

HEARINGS

The Committee’s Subcommittee on Crime, Terrorism, and Homeland Security held 1 day of hearings on May 22, 2007. Testimony 

was received and heard from Mr. Devon Brown, Director of the Department of Corrections for the District of Columbia; Mr. Vincent 

Jones, Executive Director of the Center for Health Justice in West 

Hollywood California; Mr. Philip Fornaci, Director of the D.C. Prisoner’s Project for the Washington Lawyer’s Committee for Civil 

Rights and Urban Affairs; RADM Newton E. Kendig, M.D. the Assistant Director of the Health Services Division for the Federal Bureau of Prisons; and Mr. Willie Mitchell, Chairman of the Board for 

San Antonio Fighting Back. 

COMMITTEE CONSIDERATION

On July 24, 2007, the Subcommittee on Crime, Terrorism and 

Homeland Security met in open session and ordered the bill 

H.R.1943 favorably reported by voice vote without amendment, a 

quorum being present. On July 25, 2007, the Committee met in 

open session and ordered the bill H.R. 1943 favorably reported 

without amendment by voice vote, a quorum being present. 


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COMMITTEE VOTES

In compliance with clause 3(b) of rule XIII of the Rules of the 

House of Representatives, the Committee advises that there were 

no recorded votes during the Committee’s consideration of H.R. 

1943 

COMMITTEE OVERSIGHT FINDINGS

In compliance with clause 3(c)(1) of rule XIII of the Rules of the 

House of Representatives, the Committee advises that the findings 

and recommendations of the Committee, based on oversight activities under clause 2(b)(1) of rule X of the Rules of the House of Representatives, are incorporated in the descriptive portions of this report. 

NEW BUDGET AUTHORITY AND TAX EXPENDITURES

Clause 3(c)(2) of rule XIII of the Rules of the House of Representatives is inapplicable because this legislation does not provide new 

budgetary authority or increased tax expenditures. 

CONGRESSIONAL BUDGET OFFICE COST ESTIMATE

In compliance with clause 3(c)(3) of rule XIII of the Rules of the 

House of Representatives, the Committee sets forth, with respect to 

the bill, H.R. 1943, the following estimate and comparison prepared 

by the Director of the Congressional Budget Office under section 

402 of the Congressional Budget Act of 1974: 

U.S. CONGRESS, CONGRESSIONAL BUDGET OFFICE, Washington, DC, September 7, 2007. 

Hon. JOHN CONYERS, Jr., Chairman, 

Committee on the Judiciary, 

House of Representatives, Washington, DC. 

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for H.R. 1943, the Stop AIDS in 

Prison Act of 2007. 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Leigh Angres, who can 

be reached at 226–2860. 

Sincerely, 

PETER R. ORSZAG, 

DIRECTOR. 

Enclosure 

cc: Honorable Lamar S. Smith. 

Ranking Member 

H.R. 1943—Stop AIDS in Prison Act of 2007. 

SUMMARY

H.R. 1943 would amend current law to require the Bureau of 

Prisons (BOP) to test all incoming and outgoing inmates for the 

human immunodeficiency virus (HIV). The legislation would offer 

an opt-out provision to most inmates. Presently, BOP performs HIV 

testing on those inmates who are sentenced to six months or more 


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in prison if they are determined to be at risk for HIV. CBO estimates that implementing H.R. 1943 would cost about $3 million in 

fiscal year 2008 and $12 million over the 2008–2012 period, assuming appropriation of the necessary funds. Enacting H.R. 1943 would 

not affect direct spending or revenues. 

H.R. 1943 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act (UMRA) 

and would impose no costs on State, local, or tribal governments. 

ESTIMATED COST TO THE FEDERAL GOVERNMENT

The estimated budgetary impact of H.R. 1943 is shown in the following table. The costs of this legislation fall within budget function 750 (administration of justice). 

By Fiscal Year, in Millions of Dollars 

2008 2009 2010 2011 2012 

CHANGES IN SPENDING SUBJECT TO APPROPRIATION 

HIV Testing and Services for BOP Inmates 

Estimated Authorization Level 3 2 2 2 2 

Estimated Outlays 3 2 2 2 2 

Reporting Requirements 

Estimated Authorization Level * 1 * * * 

Estimated Outlays * 1 * * * 

Total Changes 

Estimated Authorization Level 3 3 2 2 2 

Estimated Outlays 3 3 2 2 2 

Note: HIV = Human Immunodeficiency Virus; BOP = Bureau of Prisons; * = less than $500,000. 

BASIS OF ESTIMATE

For this estimate, CBO assumes that H.R. 1943 will be enacted 

near the start of fiscal year 2008 and that the amounts estimated 

to be necessary will be appropriated for each fiscal year. 

Current HIV Testing Procedures in Bureau of Prisons’ Facilities 

Under current law, BOP performs HIV testing on those inmates 

sentenced to six months or more in prison who are determined to 

be at risk for HIV—about 25,000 tests a year. Inmates can also request an HIV test once a year or when an inmate believes that he 

or she has been exposed to the virus. BOP also has the right to 

mandate testing for any inmate that it believes has intentionally 

or unintentionally transmitted the virus. For those who receive a 

test, BOP provides pre- and post-testing counseling, regardless of 

the diagnosis. Inmates who test positive for the virus—about 1 percent of the nearly 200,000 incarcerated by BOP a year—also receive treatment during their incarceration and a 30-day supply of 

medication upon their release. 

New Testing Procedures under H.R. 1943 

CBO estimates that implementing the expanded testing, medical 

treatment, and associated services under H.R. 1943 would cost $11 

million over the 2008–2012 period, subject to appropriation of the 

necessary amounts. H.R. 1943 would require BOP to test all incoming and outgoing inmates but would allow inmates to opt out of 

such testing. As under current law, if BOP believes that an inmate 


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intentionally or unintentionally transmitted the virus, the inmate 

would be subject to mandatory testing. For inmates admitted prior 

to the effective date of the new policy, a test would be required 

within six months. 

Based on information from BOP, CBO expects that comprehensive HIV testing would likely be incorporated into the current medical examination system at an average cost of $10 per inmate. We 

estimate that the cost of additional HIV testing on about 200,000 

additional inmates in fiscal year 2008 under H.R. 1943 would be 

about $2 million, subject to the availability of appropriated funds. 

That first-year total would include tests for all inmates admitted 

prior to implementation of the new policy near the middle of fiscal 

year 2008. We anticipate that for years after 2008, BOP would conduct about 110,000 additional tests a year (assuming that few inmates would opt out of testing), at a cost of about $1 million annually, also subject to the availability of appropriated funds. 

Testing of entering and exiting inmates may result in the diagnosis of some new HIV cases. CBO estimates that the cost of providing additional medical services for newly diagnosed inmates 

would be nearly $1 million a year. We estimate that the cost of 

HIV education and counseling programs would be less than 

$500,000. 

Reporting Requirements 

CBO estimates that BOP would spend about $1 million over the 

2008–2012 period to prepare two reports required by the bill, assuming the availability of appropriated funds. The first report 

would delineate BOP procedures for testing, treating, and preventing hepatitis and other infections diseases. The second report 

would provide the Congress with statistics on HIV test results. 

INTERGOVERNMENTAL AND PRIVATE-SECTOR IMPACT

H.R. 1943 contains no intergovernmental or private-sector mandates as defined in UMRA and would impose no costs on State, 

local, or tribal governments. 

ESTIMATE PREPARED BY: 

Federal Costs: Leigh Angres (226–2860) 

Impact on State, Local, and Tribal Governments: Melissa Merrell 

(225–3220) 

Impact on the Private Sector: Paige Piper-Bach (226–2940) 

ESTIMATE APPROVED BY: 

Peter H. Fontaine 

Assistant Director for Budget Analysis 

PERFORMANCE GOALS AND OBJECTIVES

The Committee states that pursuant to clause 3(c)(4) of rule XIII 

of the Rules of the House of Representatives, H.R. 1943 will help 

stem the spread of HIV/AIDS in the prison inmate population and 

in the community at large. 


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CONSTITUTIONAL AUTHORITY STATEMENT

Pursuant to clause 3(d)(1) of rule XIII of the Rules of the House 

of Representatives, the Committee finds the authority for this legislation in Article I, Section 8 of the Constitution. 

ADVISORY ON EARMARKS

In accordance with clause 9 of rule XXI of the Rules of the House 

of Representatives, H.R. 1943 does not contain any congressional 

earmarks, limited tax benefits, or limited tariff benefits as defined 

in clause 9(d), 9(e), or 9(f) of Rule XXI. 

SECTION-BY-SECTION ANALYSIS

SEC. 1. SHORT TITLE. 

This section sets forth the short title of the bill as the ‘‘Stop 

AIDS in Prison Act of 2007.’’

SEC. 2. COMPREHENSIVE HIV/AIDS POLICY. 

This section requires the Bureau of Prisons to develop a comprehensive HIV testing, treatment and prevention policy to stop 

the spread of HIV/AIDS among inmates, protect prison guards, provide medical treatment to affected prisoners and to provide comprehensive AIDS education, within 1 year of enactment. All inmates who test positive shall be provided confidential pre-release 

counseling and referrals to appropriate health care providers, and 

a 30-day supply of medications the prisoner is currently receiving 

SEC. 3. REQUIREMENTS FOR POLICY. 

This section requires the BOP to administer a routing HIV test 

upon intake of all prisoners regardless of how long they will be in 

prison. The BOP must administer the test within 6 months of the 

date of enactment to prisoners who are already incarcerated. Prisoners shall be provided with pre-test and post-test counseling. Prisoners have the right to ‘‘opt out’’ and choose not to be tested. 

Besides the testing upon admission, prisoners may obtain HIV 

tests upon request up to once a year. If a prisoner is involved in 

an ‘‘exposure incident,’’ the BOP may perform testing without the 

prisoners consent. Medical personnel shall notify prisoners of the 

test results and all results shall be confidential. 

SEC. 4. CHANGES IN EXISTING LAW. 

This section amends existing law to incorporate HIV test results 

from this Act including amending Title 18 sec 4014(d) so that all 

test results from this Act will be inadmissible in criminal or civil 

proceedings. 

SEC. 5. REPORTING REQUIREMENTS. 

This section requires the BOP to provide Congress a report on 

the policies and procedures to provide testing, treatment and prevention education programs for Hepatitis and other diseases transmitted through sexual activity and intravenous drug use with in a 

year of enactment. This section also requires the BOP to report to 

Congress on the incidence of diseases transmitted through sexual 


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activity and intravenous drug use within 2 years of enactment. The 

report will also contain information about the incidence of HIV/ 

AIDS in prison. 

SECTION 6. APPROPRIATIONS. 

This section authorizes the appropriation of such sums as necessary to carry out this Act. 

CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

In compliance with clause 3(e) of rule XIII of the Rules of the 

House of Representatives, changes in existing law made by the bill, 

as reported, are shown as follows (existing law proposed to be omitted is enclosed in black brackets, new matter is printed in italics, 

existing law in which no change is proposed is shown in roman): 

TITLE 18, UNITED STATES CODE 

* * * * * * * 

PART III—PRISONS AND PRISONERS 

* * * * * * * 

CHAPTER 301—GENERAL PROVISIONS 

* * * * * * * 

§ 4014. Testing for human immunodeficiency virus 

(a) The Attorney General shall cause each individual convicted 

of a Federal offense who is sentenced to incarceration øfor a period 

of 6 months or more¿ to be tested for the presence of the human 

immunodeficiency virusø, as appropriate,¿ after the commencement 

of that incarceration, øif such individual is determined to be at risk 

for infection with such virus in accordance with the guidelines 

issued by the Bureau of Prisons relating to infectious disease management¿ unless the individual declines. The Attorney General 

shall also cause such individual to be so tested before release unless 

the individual declines.. 

* * * * * * * 

(d) The results of a test under this section or under the Stop 

AIDS in Prison Act of 2007 are inadmissible against the person 

tested in any Federal or State civil or criminal case or proceeding. 

(e) Not later than 1 year after the date of the enactment of this 

section, the Attorney General shall issue rules to implement this 

section. Such rules shall require that the results of any test are 

communicated only to the person tested, and, if the results of the 

test indicate the presence of the virus, to correctional facility personnel consistent with guidelines issued by the Bureau of Prisons. 

Such rules shall also provide for procedures designed to protect the 

privacy of a person requesting that the test be performed and the 

privacy of the person tested. Such rules shall also provide that the 


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initial test under this section be performed as part of the routine 

health screening conducted at intake. 

Æ 


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