HIV+ IN PRISON: THE SHADOW OF DEATH ROW
BY Charla Greene
October/November 1996
There are now over 3,000 people on Death Row in the U.S., living under an official death sentence; however, there are also uncountable thousands also living with an "unofficial" death sentence. These are the people who end up dying in prison from medical neglect; these are the people living on Shadow Death Row. A large percentage of the deaths on this Row are from AIDS. An increasingly high proportion of people entering the prison system are HIV+, detected, undetected and sometimes intentionally hidden, and even a short sentence of a couple years can end up a death sentence for them. Studies have now proven that incarceration cuts in half the life expectancy of those with HIV seropositivity. AIDS is now the main cause of death in prisons.
AIDS is recognized world wide as a frightening threat, and anti-AIDS campaigns have gone mainstream, but what doesn't seem to be as recognized is the pattern the epidemic is taking. It is now in its second wave and is targeting drug users, their partners and families. That means that a high percentage of people who go through the prison system is in this high-risk category, yet the opportunity to take the message to where it's needed, which is not the mainstream, heterosexual, low-risk audience, is being ignored. There are no attempts to reach the incarcerated population with information about prevention, harm reduction or outside services in either short-term jails, where the turn-over is so high, or longer term prisons, where there is the time for in-depth education. Nor is there any discharge planning being done, which is especially important for HIV+ ex-offenders in need of health related services.
This misdirection of mainstream attention is exacerbated by the Department of Corrections (DOC) approach to the problem they have on their hands. It is as if the DOC is in complete denial of the seriousness and tragedy of HIV/AIDS, is in complete denial of what would constitute humane treatment of those affected so they would not have to go through such a dehumanizing death in the isolation of a prison cell, and in complete denial that these suffering beings are human and that to allow this to happen is the same as premeditated torture or extrajudicial execution. Rick Lines, with the Prisoner's HIV/AIDS Support Action Network in Toronto observes: "HIV/AIDS highlights everything that's wrong and harmful about prisons - indeed everything that's wrong and harmful in society - simply because those conditions effect HIV+ people more dramatically than they do HIV- people. Overcrowding, poor diet, poor medical treatment, stress, TB, difficulty in accessing family and community supports, excessive and vindictive sentencing, lack of support programs, racism, prejudice sexism, violence - all of these societal problems are magnified within the prison setting and then magnified many times over in their impact on people living with HIV/AIDS."
Perhaps the DOC's actions are actually calculated? The prison population is over 50% minority. AIDS is on the rise in Latino and African American communities. "As of October 31, 1995, more than 500,000 cases of AIDS had been reported to the Centers for Disease Control and Prevention, with African Americans and Hispanics comprising just under 50% of these cases. Perhaps the most tragic toll: 80% of all pediatric AIDS cases in the US are reported among Blacks and Latinos." (Dr. Robert Fullilove, Fortune News, June '96.) Considering the history of genocide in this country, imprisoning targeted groups in an epidemic situation and then withholding treatment and education to stop the spread of the disease sounds like giving smallpox contaminated blankets to the Native Americans.
There are so many steps that are not being taken to slow down this epidemic where it's happening. Education is so important for both infected and noninfected to prevent possible infection and minimize the stigma caused by misinformation, yet there are now fewer prison-initiated peer programs in prisons than two years ago, even though there is more interest among the prisoners. DOC may say it's because of lack of funds, lack of personnel, whatever excuse, but they have also been known to actively discourage educational material from being sent into prison, and they have a policy in California that if there is no HIV unit in the prison, there will be no HIV education program. Huh?
AT the recent International AIDS Conference there were new drugs discussed, and may be available to those on the outside, but they are not available to any of the women's prisons and only a couple of the men's prisons in California- thus missing where the need is greatest. The fact that NO women's prisons have access to these drugs is not a surprise; it follows the pattern of extreme medical neglect in these institutions. A class action suit was filed by several women in California prisons in April, 1995, citing criminal medical neglect; there has been no improvement in treatment yet. The women are still dying in their cells, spitting up blood and tissue, collapsing in the halls, taken to the infirmary no longer able to function, and never coming back. There are so many of these stories it's hard to put one name on them, and daily, women are lining up for needed medical attention and being given Tylenol and told to go back to their cells, "nothing is wrong". Because of the stigma of AIDS, many hide their HIV+ status, hoping to get out before it develops into AIDS. But prison conditions are too harsh for that, and they became inhabitants of Shadow Death Row. There are no statistics for this Row, no press coverage, only invisible, extrajudicial executions.
In California's Central Valley there are now two prisons holding more than 5,000 women. There is still no infectious disease specialist, no special dietary considerations for those women who are HIV+ and need this for survival, and the women have no access to any clinical trials. Eighty percent of women's convictions are for non-violent, economic crimes, which means many drug sales/use and sex workers. Incarceration rates for women have increased over 200% in the last few years, so that means a flood of high risk inmates coming into the Central Valley system, where the medical facilities are criminally inadequate. That means that Central Valley is becoming a Death Camp! Coincidentally, the "official" Death Row is also housed there (CCWF).
We seem to be caught in a fear frenzy, whipped up by politicians, prison officials and the media; I would like to interject the concept of compassion in the middle of their chaos. I think part of compassion is understanding an individual as he/she is rather than trying to force that person into another mold and then getting mad when they don't fit. I think part of compassion is recognizing that risk reduction tools are necessary when dealing with HIV/AIDS in prison, and so providing condoms, dental dams and clean needles to inmates. DOC's present way to reduce risk is to isolate anyone who reveals being HIV+, consequently many hide their condition because they don't want that stigma (which could be lessened with education).
Compassion is also letting a person die at home rather than in a cell. Compassion is understanding that even though a person has acted in a way to get imprisoned, if he/she can no longer function and is just waiting to die, further incarceration serves no purpose. Two bills for compassionate release have been turned down in the California legislature, the feeling seeming to be that these people, who are in the last stages of their lives, would "pose a threat" because they are "criminals". They may have committed a criminal act, but they are "human beings".
It is confusing to see a whole group of individuals acting in collusion with each other, display this extreme blindness or denial, so that they allow a deadly epidemic to flourish in their midst, discourage any techniques that could slow it down, and then when they end up with dying people, deny the severity of their illness and won't let them go home to die! To deny the threat of HIV/AIDS in prison is to invite disaster. This new wave of the epidemic will not be contained by prison walls.
I want to thank Judy Greenspan with HIV/AIDS in Prison Project for a lot of information! She also works on compassionate release, and can be reached at 510-834-5657 ext. 3150.