HIV-positive prisoners in Louisiana jails are not provided medication and basic services, which endangers both their health and the communities they return to upon release. That was one of the findings of “Paying the Price: Failure to Deliver HIV Services in Louisiana Parish Jails,” a report published by Human Rights Watch (HRW) in 2016.
HRW interviewed over 100 people, including representatives of organizations involved in HIV and health services related to the criminal justice system. It concluded that “Louisiana is ‘ground zero’ for the dual epidemics of HIV and incarceration.”
Baton Rouge and New Orleans lead the country in new HIV infections each year, and the death rate “from AIDS in Louisiana is among the highest in the U.S.,” the report found. “As of January 2016, the Louisiana Department of Corrections [LDOC] housed 525 prisoners with HIV.”
Louisiana also has the highest state incarceration rate in the nation. “At any given point in time, roughly 1 in 75 Louisiana adults are in jail or prison,” according to the report. The intersection between HIV and incarceration occurs because “[o]ne out of seven people living with HIV will enter a jail or prison each year.”
The report added that “The same socioeconomic factors that place people at risk for HIV – poverty, homelessness, drug dependence, mental illness – also place them at higher risk of incarceration.”
So what happens when people with HIV land behind bars?
While the Centers for Disease Control recommends that all correctional facilities provide routine HIV testing to inform prisoners of their status and provide services if needed, only 5 of Louisiana’s 104 parish jails, including the New Orleans Parish Prison, regularly offer HIV tests to all prisoners. The failure is purely budgetary.
“Why don’t we do routine HIV testing? We cannot afford to treat someone who was identified as HIV-positive,” said S. Wright, nursing director at the Caddo Parish Correctional Center. “It sounds cold, I know, but that is the reality.”
The LDOC has decided that HIV is not a reimbursable expense, which means jails that house state prisoners have to cover HIV-related costs. In early 2016 there were about 18,000 state prisoners held in parish facilities; due to the lack of comprehensive testing, it is unknown how many are HIV-positive.
As a result of the LDOC’s non-reimbursement policy and budgetary issues, jails provide few HIV services. Even prisoners who self-report having HIV are left in the lurch, which means their “treatment is often delayed, interrupted, or denied altogether.”
An interruption in HIV medication can have serious consequences, including making the treatment regimen ineffective. Parish jails not only fail to provide those medications, they refuse to allow them to be retained upon booking if prisoners have them in their possession. Further, upon release, prisoners are not connected with community-based HIV service agencies.
In response to the HRW report, Louisiana Governor John Bel Edwards stated, “I’m concerned about the access to health care in our jails and our prisons, generally speaking,” and “It wouldn’t be any different with respect to HIV.”
The 70-page report is available on PLN’s website.
Sources: www.hrw.org, www.theadvocate.com
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