Up to date figures for the actual numbers of HIV+ prisoners in America are hard to come by, but a U.S. Department of Justice report issued in 2007 recorded the numbers as 1.7 percent. A 2009 study showed that between 17 and 25 percent of HIV+ individuals in America are now, or were once, a part of the criminal justice system.
HIV transmission in jails and prisons can occur for a variety of reasons, including injecting drugs, having sex, rape and other acts of violence, and tattooing and body piercing. The zero-tolerance policy of the prison system in regard to drugs and sex is both unrealistic and harmful.
Attempts to eradicate drug use in prison have generally been unsuccessful. Inmates still manage to receive drugs that are smuggled in via visits, or by crooked correctional staff members. Many prisoners who are incarcerated for drug offenses have injected drugs, according to Avert. Some of these injecting drug users (IDUs) are HIV+ and spread the disease by sharing needles and syringes which are also obtained illegally in prison. The World Health Organization (WHO) advocates needle exchanges in prisons as a method of harm reduction.
Needles and syringes are also used to produce tattoos in prison. Because of the lack of availability of new units, injection equipment is passed on and used, even when the risk factors for contacting an infectious disease are known. WHO also recommends that needle and syringe cleaning chemicals such as bleach should be made available for inmates to clean their equipment.
Female prisoners, as well as males, use body piercing as a way to assert their individuality in an environment that is designed to suppress any identity except that of Prisoner. Again, un-sterile equipment that is shared can transfer viruses.
Sexual desires do not stop upon entering prison gates. Sexual relations between prisoners are forbidden, but frequently happen. Both male and female inmates who do not consider themselves to be homosexual or lesbian engage in sexual relations for a variety of reasons including lust, release of sexual tension and love. Condoms are not allowed in most prisons so the spread of sexually transmitted diseases (STDs) is a reality of prison life. Although WHO believes condoms should be given to prisoners, this recommendation, as well as WHO’s suggestions of providing new injecting devices and cleaning supplies to prisoners has largely been rejected by prison administrations. Providing condoms to prisoners could not only prevent the transmission of disease to other prisoners, but to the spouses and significant others of prisoners. Few heterosexual prisoners will admit to participating in same-sex sexual relations while in prison. And when these prisoners are released few of their partners will assume that they did. The collateral damages to wives, husbands, and other sexual partners have been overlooked in the debate about whether prisoners should be given condoms, or, for that matter, new drug injecting equipment.
While some sexual acts in prison are consensual, others are not. Prison rape is another area in which the zero-tolerance policy of the US prison system causes irreparable harm. According to Human Rights Watch in 2007, the latest year that numbers were available, one in twenty U.S. prisoners reported being the victim of sexual abuse behind bars. The key word of that sentence is reported. Not all victims report their abuse due to shame, or fear. And while prison rapists are far from caring whether they may spread an STD, if condoms were available, the rapists might use them, if only to prevent the detection of their DNA, thereby reducing exposing their victim to HIV.
Prison violence is another way HIV can be contracted. HIV must have portals to exit and to enter to be transmitted. Skin, broken in a fight, can certainly be that portal. Stress factors are abundant in prison, and fights are inevitable.
The US prison system has created policies that are certain to continue the transmission of HIV and other STDs. While the thought of promoting sexual relations and drug use among prisoners is certainly disconcerting to most, the reality is that implementing a harm reduction policy will save lives, and money. Treating sexually transmitted diseases in prison is costly. Drug use in prison will continue. The question may be asked, “Is it better to provide sterile injection equipment, or have an unenforceable policy that will perpetuate the spread of HIV?”
Another solution to preventing the spread of HIV or Hepatitis C is to provide drug treatment to addicts entering prison. Methadone or other drugs used to treat heroin addiction is also recommended by WHO. This year’s theme for World AIDS Day is Universal Access and Human Rights. Certainly that means that prisoners should have universal access to treatment and prevention methods. That prisoners are entitled to human rights is often forgotten, but should be emphasized.
Sources: Avert, and Human Rights Watch
The full Avert report can be viewed in the Library section of www.reentrycentral.org
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