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AIDS In Prison: The New Death Row

By Heather Rhoads

[Note: The following article originally appeared in the September 1991 issue of The Progressive magazine. It was edited for length by Ed Mead.]

Prison AIDS wards are being called the new death row. A 1987 study by the Correctional Association of New York found prisoners with AIDS to be dying at twice the rate of non-prisoners with AIDS. "Many prisoners with AIDS spend their last days in prison isolated and alone, far from their families and loved ones," says Cathy Potler, director of the Association's AIDS Prison Project.

The National Institute of Justice reports a 606 percent increase in confirmed AIDS cases in U.S. prisons and a sample of large jails from 1985 to 1989. AIDS is currently the leading cause of death in New York state prisons, where an estimated 9,000 of the state's 54,000 inmates are HIV positive. Health officials expect a surge in AIDS deaths among prisoners across the country.

The penal systems in New York, New Jersey, California and Florida have been hit the hardest by the AIDS crisis so far - states where poverty and IV-drug use have also reached epidemic proportions. The New Jersey Department of Corrections estimates that 30 to 50 percent of its inmates are HIV-infected; in Broward Country, Florida, more than 50 percent of inmates who volunteered to take the test were diagnosed as seropositive.

The National Institute of Justice reports that infection rates among female inmates are skyrocketing as well. A recent epidemiological study found higher seropositive rates for women than for men in nine out of ten correctional systems. In New York City, 26.5 percent of female inmates tested seropositive in a blind survey compared to 16.1 percent of male inmates. About 35 percent of the more than 400 women who chose to take the test at MCI Framingham in Massachusetts were found to be HIV-positive, compared to 13 percent of male prisoners.

According to Social Justice for Women, a nonprofit prisoners' advocacy group in Boston, the higher seropositive rates among women reflect the tendency of judges to sentence women for crimes related to poverty and substance abuse. More than 90 percent of incarcerated women have histories of chronic drug use and many have worked as prostitutes; most are serving short sentences for nonviolent crimes related to their addictions. By contrast, relatively few male prisoners are IV-drug users, and they are more often convicted of violent crimes.

By choosing mass imprisonment as the response to drug use, federal and state governments have created a de facto policy of incarcerating more and more HIV-positive infected individuals. "Under the present policy, the percentage of drug offenders in the federal prison system will rise by 1995 from 47 percent to 70 percent," the National Commission on AIDS warns in its 1991 report.

"With the amount of needle-sharing that goes on, we are sitting on top of a powder keg" says Doug Nelson, director of the Milwaukee AIDS Project. "We may well have an explosion of HIV infection. That will obviously have an effect on correctional systems."

Prison and jail overcrowding further exacerbates the crises. In the past decade, the United States had dramatically increased its prisoner population. The federal prison system alone holds double the number of inmates it had in 1980. Chronic overcrowding increases inmates' exposure to infectious diseases - a particularly grim situation for immuno-deficient prisoners. Proper nutrition is often unavailable and experimental treatments and alternative therapies are virtually unobtainable in the nation's penal facilities.

Last spring, the Legal Aid Society Prisoners' Rights Project filed a federal class-action lawsuit against New York State corrections officials, charging them with failing to deliver even nominal health care to inmates with AIDS and violating the Eighth Amendment ban on cruel and unusual punishment. Among the ten plaintiffs is an inmate with an advanced brain infection who cannot walk or feed himself and has no control of his bowels or bladder. For weeks he was left to dehydrate and lie in his own urine and feces; nurses dismissed his incontinence as "manipulative" and "childish."

"The situation today for many prisoners living with HIV disease is nothing if not 'cruel and unusual,'" the National Commission on AIDS declares. "Too many correctional facilities subject inmates to a series of unnecessary, arbitrary indignities which fundamentally affect their basic human rights."

According to Judy Greenspan of the ACLU's National Prison Project, one third of AIDS cases in New York are not diagnosed until the time of autopsy.

In many states, prisoners suspected of prior high-risk activity are victims of mandatory testing policies; in seventeen states and the federal prisons, all inmates are forced to undergo HIV tests. Several penal systems follow up testing with segregation or isolation of those determined to be HIV-positive, depriving them of work, recreation, rehabilitation, parole, and furloughs.

The National Commission on AIDS determined segregation to be "wholly without public-health merit." Segregation effectively targets HIV-positive prisoners for "assaults, discrimination, and disparate treatment," the commission's 1991 report warned.

The National Institute of justice recommends "universal precautions" such as wearing gloves or surgical masks for all inmates' bodily fluids. "The guards should treat all prisoners as if they were HIV-positive, because every prisoner potentially is, Savage agrees. "This singling out of HIV-positive prisoners is criminal."

Between 1985 and 1987, the AIDS situation at Bedford Hills Correctional Facility in New York was characterized by "secrecy and denial, shame and fear, ignorance and ostracism, and poor medical care," according to Bedford inmates Judy Clark and Kathy Boudine. The prison's unwillingness to cope with the AIDS crisis prompted inmates there to start their own self-help projects, education workshops, and counseling services. Now, the inmate-run ACE program (AIDS Counseling and Education) at Bedford has begun to improve conditions and create an atmosphere of trust and caring for HIV-positive inmates. It has become a model for peer programs across the nation.

Still, inmates face bureaucratic obstacles and opposition from prison officials in their efforts to motivate and empower other inmates. Prisoners who have been involved in organizing efforts have found themselves locked down or placed on "diesel therapy" - transporting shackled inmates from prison to prison is the way officials quiet troublemakers. James Magner, publisher of a newsletter called PWA-RAG (Prisoners With AIDS - Rights Advocacy Group), has been relocated more than twenty times in the past two-and-a-half years.

"It's really important for those of us on the outside to support the peer programs," Potler asserts. "A number of them end up going underground because they don't get support from the institutions."

The Progressive is available free to prisoners from The Progressive, 409 E. Main St., Madison, WI 75703.

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