The Effects of HIV and AIDS on Prison Populations - Essay Example

Running Head: HIV/AIDS The Effects of HIV/AIDS in Prison Populations College In the United States, there is a rise in the numbers of men and women becoming incarcerated. With incarceration sometimes comes an increase in sexually transmitted diseases, including the human immunodeficiency virus (HIV) and its later stage - the acquired immunodeficiency virus (AIDS). This essay will look at what society is doing to prevent and treat HIV/AIDS, and whether it is enough to keep the community at large safer, once convicts are released back into society. Population Statistics Unfortunately in today's society, crimes are committed. As punishment for those crimes, convicted criminals are sent to jail to be taught a lesson. No one can say just how effective that lesson is, though, because the number of incarcerated persons is steadily increasing. "The U.S. prison population has reached record numbers. At the end of 2005, more than 2.2 million American adults were incarcerated" (Okie, 2007). This number represents both men and women, but the rate of female inmates is more staggering still. "The number of women under correctional supervision has gradually increased in recent years. For example, in 2004, the number of women serving state or federal prison sentences increased 4% from 2003" (Staton-Tindall et al., 2007). With so many people living in such close quarters, increased rates of diseases like hepatitis are expected. What might be a little more shocking is the number of people, in prison, living with HIV or AIDS. In the United States in 2004, 1.8% of prison inmates were HIV-positive, more than four times the estimated rate in the general population" (Okie, 2007). This information proves that something needs to be done to prevent future HIV infections, and to educate those already living with the disease. Society's View It isn't hard to predict what society thinks about convicted criminals living with HIV or AIDS. "Many [people] adopt a 'just desserts' philosophy, viewing infections as the consequence of breaking prison rules" (Okie, 2007). The fact is that most people don't actually contract HIV in prisons. Okie's study calls transmission while in the prison system "low but not negligible" (Okie, 2007). Therefore, most people, whether they know it or not, have the disease prior to becoming incarcerated. There is evidence that links incarceration to the diseases. "About 25% of all HIV-infected persons in the United States spend time in a correctional facility" (Okie, 2007). Society, then, needs to consider how to help individuals with HIV or AIDS since we now know that these people are living with in while in general populations of every state, and some of the people who do contract it while in jail, may still be released one day, to live among us. Special Services Little is done to help inmates living with HIV in prisons. "Many U.S. prison officials contend that providing needles or condoms would send a mixed message" (Okie, 2007). Since, sex is illegal in almost every prison in the United States, officials see no need to provide protection for an activity that isn't supposed to be taking place. Reportedly, Okie interviewed a man who was identified only as Mr. M, a prisoner who is HIV positive. According to Mr. M, sex is happening in prison, whether it is supposed to be or not. Mr. M. stated, "Almost every second or minute, somebody's sneaking and doing something. Some participants are homosexual; others are curious, bored, lonely, and experimenting" (Okie, 2007). There is also segregated housing in some prisons. Another man interviewed separately was quoted as saying the only reason he had a (negative) AIDS test when he was first incarcerated in because he feared he would be sent to live with those who were already known to be HIV positive. He said, "If you got AIDS, they are coming to get you. 'Cause you got to be isolated for everybody's sake. If a guy has AIDS, he can't live with us I forgot what camp it was but they got an AIDS camp where everybody over there has AIDS" (Kacanek et al., 2007). Besides segregation, little is done for infected inmates. The United States isn't the only country said to be neglected its HIV positive prisoners. "Policy-makers in every jurisdiction in Canada continue to reject or ignore the evidence" (Elliott, 2007) that something needs to be done for HIV positive inmates. Canadians, too, believe that criminals living with HIV or AIDS are getting what they deserve. "Public comment commonly proceeds on the premise, sometimes stated but often assumed, that conviction removes all rights and that the prisoners are entitled to little consideration once incarcerated" (Elliott, 2007). Like Americans, there should be some focus on the fact that ignoring the problem is a public health concern in any country. Other than apathy, lack of means is said to be the other reason more efforts aren't made to help. "Drugs for treating HIV-infected prisoners are not covered by federal programs, and prison budgets often contain inadequate funding for health services" (Okie, 2007). With unreliable information, at best, about how often HIV is actually spread in prisons, most prison officials aren't going to push the issue of mandatory testing, or treatments, knowing that both are likely to bust the budget. Case Study Kacanek, Eldridge, Nealey-Moore, MacGowan, et al. performed a study. The purpose was to determine men's perceptions of HIV testing, so that more information could be gathered about why people do, or don't, get tested, in an effort to decrease the numbers of persons infected inside and outside of prison. To begin, the study showed that 1 in every 138 U.S. citizens goes to jail. That is the "highest rate of any nation" (Kacanek, et al., 2007). The study also determined that only "19 state systems tested all incarcerated persons for HIV upon entry or during incarceration" (Kacanek, et al., 2007). This makes it difficult to determine just how many inmates acquire HIV while in prisons because it has to be assumed that if they weren't tested upon entry, there is no way to determine when the infection was transmitted. The study started with an invitation to 170 men, but ended with 105 participants. Many of the men stated they were tested only in orisons, because it was free. Some of them didn't care that it was free, but thought it was mandatory. Some knew it wasn't mandatory, but feared "substandard treatment" (Kacanek, et al., 2007) by prison officials if they refused. The big bottom line was that regardless of whether they were tested or not, and regardless of the reason for the testing, most participants claimed that any education that went along with the testing was beneficial because it got them thinking about their life's choices, as well as what they would do differently, once released. Also according to the study, about 75 percent of men in prison receive an HIV test at one point or another, but less than half were ever tested outside of prison. This is proof that, for the safety of the public, testing should be implemented in every prison system. The study does not provide information about how many of the results were positive, but suffice it is to say that when 25 percent more people are tested, then 25 percent more people can find out if they have HIV or AIDS, before more people are infected. Prevention Since many prison convictions are drug related, and since the "prevalence of drug use among incarcerated women is an indicator of their risky lifestyles before incarceration, which may have also included risky sexual activity" (Staton-Tindall et al., 2007), officials need to focus on preventing HIV infections among women, just as much as men, if not more. "HIV infection is about 15 times higher among women offenders than among women in the general U.S. population" (Staton-Tindall et al., 2007). While teaching female inmates about abstinence from sex, and condom use, was a start, it wasn't enough. For women, preventing transmission has to start with teaching them to examine why they are willing to have unprotected sex (they feel loved, or think it shows trust). Drugs and alcohol were a huge factor in lower inhibitions, causing women to become more careless. In short, education should be provided for any activity that could "increase a woman's vulnerability for HIV and other STIs" (Staton-Tindall et al., 2007). The Canadians believe that "access to sterile injection equipment has been shown time and again to be one of the most important HIV prevention interventions" (Elliott, 2007). The state of Rhode Island is supposed to be among the best prison systems for "counseling and testing practices, medical care, and prerelease services," (Elliott, 2007) in the United States. Other states, too, have adopted methods of decreasing HIV transmission. State prisons in Vermont and Mississippi provide condoms to inmates; counties in New York, Philadelphia, San Francisco, Los Angeles, and Washington, D.C. also provide condoms (Okie, 2007). Since many crimes are drug related, and drugs are not eradicated just because of incarceration, a few prisons have a methadone treatment program. The methadone is given to prisoners until they are weaned off of harder drugs. Once weaned, the chances of engaging in risky behavior for drugs, is usually lowered. No U.S. prisons have a needle exchange program (Okie, 2007). Some countries allow prisoners to exchange used needles for clean ones, with no penalty, believing that if prisoners have access to clean drug paraphernalia, the risk of transmitting HIV will be lowered still. Conclusion Initially, I chose this particular prison population because I read somewhere that there was an increase in HIV and AIDS among women due to the fact that many men were engaging in homosexual activities with infected partners in prison. Then, these men get released and engage in sexual relationships with old or new partners, without warning them of their homosexual activities. My research didn't quite take me to that information, but I stuck with it because the facts were astounding, and still very interesting. I cannot say that I was persuaded one way or another. I do believe that even convicts have some rights, but I also think it is unfair for people to commit crimes, then run up bills for law abiding citizens to pay. The truth is, though, if I had to choose, I'd choose to mandate every prisoner to have an HIV test because sometimes people don't tell the truth about themselves, and sometimes people don't "look" like they've been convicted; therefore, I hope that if more people get tested, they also grow a conscience. I also hope that people who know the test results will warn future partners about their HIV status before it is too late, and while the partner still has a chance to make an informed decision. References Elliott, R. (2007, July 31). Deadly disregard: Government refusal to implement evidence- based measures to prevent HIV and hepatitis C virus infections in prisons. CMAJ: Canadian Medical Association Journal, 177(3), 262-264. Retrieved April 26, 2008, from Academic Search Complete database. Kacanek, D., Eldridge, G., Nealey-Moore, J., MacGowan, R., et al. (2007, July). Young incarcerated men's perceptions of and experiences with HIV testing. American Journal of Public Health, 97(7), 1209-1215. Retrieved April 26, 2008, from Academic Search Complete database. Okie, S. (2007, January 11). Sex, drugs, prisons, and HIV. New England Journal of Medicine, pp. 105, 108. Retrieved April 26, 2008, from Academic Search Complete database. Staton-Tindall, M., Leukefeld, C., Palmer, J., Oser, C., et al. (2007). Relationships and HIV risks among incarcerated women. The Prison Journal, 87(1), 143-165. Read More