Why HIV Inmates Shoud Not Be Intergrated with General Population Inmates - Research Paper Example

HIV & Segregation in Inmates The prisons across the globe pose a serious challenge regarding the endemics of HIV and AIDS. It has generally been observed that the risk factor in context to HIV is much higher in prisons than in any other general environment. Despite the rapid transmission of HIV in inmates, especially those in prisons, there isn’t much being done to counter the issue. Moreover, the perception that the endemic is only restricted to male populace is also flawed as a lot of such cases have been reported amongst the female inmates as well. A few prisons in developed countries, US for instance, have introduced a few prevention programmes which have proven to be quite successful as well (Bosworth 2005). However, these programmes are rarely acquired in prisons owing to various reasons. Also, prisoners already suffering from HIV don`t have any access to antiretroviral treatment, which further complicates the situation of inmates. In most of the cases, even the basic healthcare facilities are not available for the prisoners. A few prisons have also introduced mandatory testing by authorities, but that is deemed as a breach of rights by the activists. Thus, in this scenario, where other alternatives fail to offer a viable solution, the segregation of HIV inmates from generation population inmates, seem to be the only possible solution. In order to understand why HIV inmates must be segregated, it is crucial to understand why then risk is higher in prisons and the mode of transmission. Research indicates that injecting drugs is very closely linked with incarceration. Also, there have been many cases where the injecting drug users (IDUs) have committed drug related offenses which makes them pass through the correctional system (Adamson 1987). Thus, since IDUs are more likely to acquire HIV, the risk of infection is higher. Also prisons are deemed to be breeding grounds for HIV infection due to a variety of reasons. Firstly, these prisons are usually overcrowded which implies that the risk of HIV is higher, as chances for a higher number of people carrying the risk is apparent. Similarly, the atmosphere bears fear and resentment, not to mention violence. Thus, sexual encounters and drugs is often the escape route for the prisoners, which pave way for risks of HIV infection. Furthermore, the modes of HIV transmission mostly are injecting drug use, sexual transmission, tattooing and violence. The inmates use contaminated and unsterilized injecting equipments while using drugs which is the most common cause of HIV, as indicated above as well. Around 17 Multi-Country studies have indicated that 50 to 90 percent of those injecting drugs have been found to be incarcerated, and the percentage of those inmates injecting drugs is around 30 percent. Sexual intercourse is also one of the modes how the infection can be transmitted between inmates. Consensual intercourse, though forbidden under the prison rules, is still unusually common though it goes unreported mostly. In addition, non-consensual intercourse i.e. rape or sexual abuse is also common in prison owing to resentment and violent environment. For this reason, reforms are often proposed to reducing inmates population; however, lack of resources is a huge issue. Also, unavailability of condoms also leads toward the rapid transmission of the HIV endemic. In addition, prison population is also divided into categories and group, and the life in prison is much more complex than it may seem. Owing to peer pressure and the need to associate oneself to a particular group, tattoing is also practiced in prisons. Since prisons don`t often offer sterilized equipment or even proper tools to conduct the surgery, thus risks of HIV are again high. Moreover, violent and bloody fights are also common amongst the prison inmates. This involved exchange of body fluids and exposure to blood from external sources, again a viable outlet for HIV retrovirus. In all such scenarios subjected above, the most viable solution seems to be segregation of inmates, since there`s nothing biased about the proposition and caution is always better than cure. Those against the proposition complain inmates segregation based on the risk of HIV infection as awfully unfair. However, research indicates that in the given scenario, it`s the most viable solution. For the purpose, it is critical to discuss a few other alternatives which may help resolve the transmission of HIV infection amongst the inmates. These alternatives include measures to help these inmates reverse the problems listed above by spreading awareness. It is a quite striking observation that most of these inmates are completely unaware of the transmission of HIV infection. If programs are introduced to educate the inmates about the seriousness of the infection and the possible ways to avoid the disease, chances are that the issue can be controlled (American Psychiatric Association 2000). This is also one of the most uncontroversial ways to deal with the problem, as HIV prevention issues can just be a part of the routine educational programs. However, the fact that the inmates don`t take any educational programs seriously isn’t a hidden fact. Thus, chances are that the results won`t be as effective as expected. Moreover, ‘Harm Reduction Programs’ as they`re called, can also be proposed as a viable solution to the issue. These programs include initiatives like the incorporation of needle sterilization facilities in the prisons, or needle substitution possibilities. Initiatives like these have proven to be effective in a few European states, Germany for instance. Similarly, drug substitution therapy is also recommended by a few to counter the problem. For instance, replacing heroine by methadone may prove to be helpful. In other cases these Harm Reduction Programs involve just frequent allowance of such activities under surveillance which may prove to be helpful, given the situation. Also, many prisons don`t have the system of providing condoms to the inmates, thus, even if they have HIV awareness and education, they are bound to fall into the HIV trap. Thus, giving free condoms around prison can also be a useful proposition. However, not all states are liberal enough to introduce such a program since the masses may not approve and the entire initiative may be back-lashed into a controversy. Thus, the risks need to be assessed prior to taking any steps. Moreover, HIV testing and treatments in prison must also be on the agenda of the policy makers for inmates. In a few cases, where the issue seems to be very critical, HIV testing needs to be made mandatory. However, this case has earlier fallen prey to the human rights breaches since this may be considered as a personal issue. In other cases optional testing maybe introduced at least for those who are willing. However, healthcare system in most states in unfortunately quite biased, especially against the interest of the inmates. However, WHO was reported to take initiative and suggest that the inmates must be tested, if not for the cause of health, still for the cause of the prison staff which is government personnel and must be protected. Yet, the legislation in this direction needs to go a long way. Also, another issue arises even if the HIV patients are diagnosed, and that deals with the treatment of the problems. Many states have very recently become open to the idea of offering HIV anit-retroviral drugs commonly to the population alone; Malawi for instance, considering the inmates to be chosen for the cases is still another story (Alarid & Cromwell 2002). Moreover, in more developed countries like the UK, where the drug is commonly available at the disposal of these inmates, the prison system is complicated enough to let the treatment run smoothly. A case reported from a prison in UK narrated that an inmate had his regimen interrupted due to the prison transfers. Thus, similar issues due to either system interruptions or lack of resources make a fair and square treatment of inmates suffering from the HIV endemic near to impossible. Thus, the transmission of disease then becomes inevitable and segregation is the only option left. It has thus been rationally determined that segregation is the only cost-effective yet still quite a controversial policy. In a few prisons across the world, segregation policies have been implemented for HIV patients. In this case, as soon as the prisoners are taken to their respective prisons, they are tested against HIV virus and on being reported HIV positive they are sent to a separate prison specifically allotted to these patients. However, just being housed in a separate living space isn’t the only requirements. Some other initiatives, for instance the one introduced in South Carolina involved the requirement of wearing a badge or an arm-band for the others to identify their condition. Human Rights advocates have also tried to resist these efforts as they indicate this one as a breach on one`s personal life. Also, they acclaim this practice to be not only quite outdated, but also one with the risks of raising an even higher health issue. For instance, South Carolina also saw an outbreak of the endemic of Tuberculosis as one of the unforeseen consequences of the practice of segregation (Palmer 2010). However, at the same time, the fact that certain interactions amongst these inmates may prove be an issue for the entire prison population can`t be ignored, thus in any case segregation still proves to be the most effective practice to counter the endemic. On one hand, those advocating against the segregation of inmates reported HIV positive aggressively campaign against the discriminatory practices, on the other hand they cease to offer any viable solution to protect the rest of the prison populace. They argue that owing to the segregation policies, those fearing to be HIV positive may not even come forward for testing, which is even worse. Also, they complain of psychological stress on such patients who have to be discriminated. However, they ignore the blessings of the correctional settings in prisons which allows for these inmates to be properly treated for the virus as well. The fact that most of these inmates are offenders who come from the unfortunate class fail to access healthcare has been established (Renshaw & Suarez 2009). Thus, if these people are able to access health care by virtue of prison segregation policies, there shouldn’t be any deterrence to such initiatives in such a case. A prisoner in US reported that he had to deliberately commit offense to access the HIV treatment at prison which was halted when he completed his charges and was dismissed from prison (McLemore 2010). Moreover, the inmates in correctional settings also find the segregation quite accommodating, as in this case the housing can be altered according to the particular requirements of treatment. Though, despite segregation, the healthcare at this point may not seem to be cost effective which may seem to kill the purpose. However, if massive adoption of the practice takes place, the policy makers will be bound to take steps to ensure healthcare for such inmates as they can now lobby for the cause as a larger group. Conclusively, incorporating segregation practices for inmates seem to be the most viable solution to deal with the endemic of HIV virus. Though, advocates often deem it discriminatory, yet it offers the most logical and pragmatic solution to the issue of the rapid transmission of HIV infection in the other inmates. Since the fact remains that the prison will always be the breeding ground for the HIV virus, the hard way has to be adopted. Violence leading to bloody exchanges, sexual encounters amongst inmates, rape, and tattooing and drug intake are the most common causes behind the transmission of HIV (Reinert, Kraft-Stolar 2012). There are however other alternatives to dealing with the problem, for instance spreading awareness or giving free condoms, however, as discussed above, they aren’t very practical. Thus, research indicated that segregating the inmates is the best option available at this point, given that the discrimination is instead treated as an opportunity to resolve the crisis and instead help those with need in accessing healthcare, otherwise not available to them. References: Adamson, E., & New South Wales. (1987). AIDS contamination in N.S.W. gaols: A report from the M.T.C. : AIDS contamination in gaols : Malabar Training Centre, Long Bay Prison Complexes. Sydney: NSW Dept. of Corrective Services. Alarid, L. F., & Cromwell, P. F. (2002). Correctional perspectives: Views from academics, practitioners, and prisoners. Los Angeles, Calif: Roxbury Pub. Co. American Psychiatric Association. (2000). Psychiatric Services in Jails and Prison: A Task Force Report of the American Psychiatric Association. American Psychiatric Publishing Inc. Bosworth, M., & Sage Publications. (2005). Encyclopedia of prisons & correctional facilities. Thousand Oaks, Calif: Sage Publications. McLemore, M., Human Rights Watch (Organization), & American Civil Liberties Union. (2010). Sentenced to stigma: Segregation of HIV-positive prisoners in Alabama and South Carolina. New York, N.Y: Human Rights Watch. Palmer, J. W. (2010). Constitutional rights of prisoners. New Providence, NJ: LexisNexis. Renshaw, A., & Suárez, E. (2009). Violent crime and prisons: Population, health conditions and recidivism. Hauppauge, NY: Nova Science Publishers. Reinert, A. A., Kraft-Stolar, T., & Practising Law Institute. (2012). Prison law, 2012. New York, N.Y: Practising Law Institute. Read More